Asunto(s)
Adenocarcinoma Sebáceo/diagnóstico , Infecciones por VIH/complicaciones , Neoplasias Cutáneas/diagnóstico , Adenocarcinoma Sebáceo/complicaciones , Adenocarcinoma Sebáceo/patología , Adenocarcinoma Sebáceo/cirugía , Dorso , Diagnóstico Diferencial , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Cutáneas/complicaciones , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/cirugíaRESUMEN
BACKGROUND: There are many different topical anesthetics available. Ice is an easy to use and inexpensive topical anesthetic. There are studies comparing different topical anesthetics but none have used ice. OBJECTIVE: To evaluate the efficacy between EMLA (2.5% lidocaine and 2.5% prilocaine cream) and ice prior to injection with a 30-gauge needle containing a painful stimuli. METHOD: A fingertip amount of EMLA cream was placed on the upper left arm and occluded with a bandage for an average of 52 minutes. Ice in a rubber glove was placed on the right upper arm for 1-2 minutes. The EMLA site, ice site, and a control site without anesthetic were tested for cutaneous analgesia with an injection of 1% lidocaine with 1:100,000 epinephrine through a 30-gauge needle using a 3 cc syringe. Discomfort was recorded using a visual acuity scale (VAS). Analysis of data was performed using a t test paired sample of two means. RESULTS: Statistically there was a significant difference in pain control between EMLA and ice (P <.05), EMLA and control (P <.01), and ice and control (P <.01). Clinically patients felt that EMLA performed slightly better as an analgesic than ice, and both EMLA and ice were more efficacious than the control. CONCLUSION: Both EMLA and ice decreased the discomfort associated with needle injection. Although EMLA performed better in pain control, ice has advantages in ease of use, fast action, and is less expensive than EMLA. Both EMLA and ice were good topical anesthetics, each with advantages and disadvantages in clinical use.
Asunto(s)
Anestésicos Locales , Hielo , Inyecciones/efectos adversos , Lidocaína , Prilocaína , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Combinación Lidocaína y Prilocaína , Masculino , Persona de Mediana Edad , Dimensión del DolorRESUMEN
BACKGROUND: Cryosurgery is one of the most common treatment methods in the dermatologists armamentarium. We describe a method combining forceps and a cotton applicator to freeze benign lesions for practitioners who prefer to use cotton-tipped applicators instead of a cryosurgery spray device. METHODS: We describe the technique using common in-office instruments. CONCLUSION: Lesions around delicate areas can be treated with forceps and a cotton-tipped applicator dipped in liquid nitrogen resulting in less pain and decreased collateral damage vs. traditional methods. For the most delicate areas, the forceps dipped directly in liquid nitrogen method is preferred.