DOI QR코드

DOI QR Code

The Use of Locally Applied Vibration to Minimize Pain during Fractional CO2 Laser Therapy in Living Liver-Donor Scar Management

  • Song, Sinyoung (Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Choi, Dong Hoon (Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Oh, Tae Suk (Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine)
  • 투고 : 2016.05.01
  • 심사 : 2016.10.19
  • 발행 : 2016.11.18

초록

Background Fractional $CO_2$ laser is an effective treatment for scars, but most patients complain about sharp burning pain, even after the application of lidocaine ointment. This study analyzed the impact of a vibrating device to nonpharmacologically reduce the acute pain of laser treatment, in accordance with the gate control theory of pain management. Methods This is a prospective study performed from May 2013 through March 2014. Fifty-three patients (mean age, 26.7 years; range, 16-44 years) who had donated livers for liver transplantation were treated with a fractional $CO_2$ laser (10,600 nm; model $eCO_2$, Lutronic Corp) for their abdomen scars. Laser treatment was applied 4 months after surgery. A commercially available, locally applied vibrating device (model UM-30M, Unix Electronics Co. Ltd.) was used, in an on-and-off pattern, together with the $CO_2$ laser. A visual analogue scale (VAS; 0, no pain; 10, most severe pain) of pain sensation was assessed and statistically analyzed using a paired t-test. Results The average VAS score for pain with the vibrating device was 4.60 and the average VAS score without the vibrating device was 6.11. The average difference between scores was 1.51 (P=0.001). Conclusions A locally applied vibrating device was demonstrated to be effective in reducing pain when treating with a fractional $CO_2$ laser. Vibration treatment could be helpful when treating scars with fractional $CO_2$ laser in pain-sensitive patients, particularly children.

키워드

참고문헌

  1. American Academy of Pediatrics Committee on Psychosocial Aspects of Child and Family Health; American Pain Society Task Force on Pain in Infants, Children, and Adolescents. The assessment and management of acute pain in infants, children, and adolescents. Pediatrics 2001;108:793-7. https://doi.org/10.1542/peds.108.3.793
  2. Eichenfield LF, Funk A, Fallon-Friedlander S, et al. A clinical study to evaluate the efficacy of ELA-Max (4% liposomal lidocaine) as compared with eutectic mixture of local anesthetics cream for pain reduction of venipuncture in children. Pediatrics 2002;109:1093-9. https://doi.org/10.1542/peds.109.6.1093
  3. Farion KJ, Splinter KL, Newhook K, et al. The effect of vapocoolant spray on pain due to intravenous cannulation in children: a randomized controlled trial. CMAJ 2008;179:31-6. https://doi.org/10.1503/cmaj.070874
  4. MacLaren JE, Cohen LL. A comparison of distraction strategies for venipuncture distress in children. J Pediatr Psychol 2005;30:387-96. https://doi.org/10.1093/jpepsy/jsi062
  5. Baxter AL, Ewing PH, Young GB, et al. EMLA application exceeding two hours improves pediatric emergency department venipuncture success. Adv Emerg Nurs J 2013;35:67-75. https://doi.org/10.1097/TME.0b013e31827f50cb
  6. Costello M, Ramundo M, Christopher NC, et al. Ethyl vinyl chloride vapocoolant spray fails to decrease pain associated with intravenous cannulation in children. Clin Pediatr (Phila) 2006;45:628-32. https://doi.org/10.1177/0009922806291013
  7. Cohen LL, MacLaren JE, DeMore M, et al. A randomized controlled trial of vapocoolant for pediatric immunization distress relief. Clin J Pain 2009;25:490-4. https://doi.org/10.1097/AJP.0b013e3181a00414
  8. Celik G, Ozbek O, Yilmaz M, et al. Vapocoolant spray vs lidocaine/prilocaine cream for reducing the pain of venipuncture in hemodialysis patients: a randomized, placebo-controlled, crossover study. Int J Med Sci 2011;8:623-7. https://doi.org/10.7150/ijms.8.623
  9. Melzack R. Gate control theory: on the evolution of pain concepts. Pain Forum 1996;5:128-38. https://doi.org/10.1016/S1082-3174(96)80050-X
  10. Meyerhoff AS, Weniger BG, Jacobs RJ. Economic value to parents of reducing the pain and emotional distress of childhood vaccine injections. Pediatr Infect Dis J 2001;20(11 Suppl):S57-62. https://doi.org/10.1097/00006454-200111001-00009
  11. Melzack R, Wall PD. Pain mechanisms: a new theory. Science 1965;150:971-9. https://doi.org/10.1126/science.150.3699.971
  12. Kakigi R, Shibasaki H. Mechanisms of pain relief by vibration and movement. J Neurol Neurosurg Psychiatry 1992;55:282-6. https://doi.org/10.1136/jnnp.55.4.282
  13. Baxter AL, Leong T, Mathew B. External thermomechanical stimulation versus vapocoolant for adult venipuncture pain: pilot data on a novel device. Clin J Pain 2009;25:705-10. https://doi.org/10.1097/AJP.0b013e3181af1236
  14. Hong J, Barnes M, Kessler N. Case study: use of vibration therapy in the treatment of diabetic peripheral small fiber neuropathy. J Bodyw Mov Ther 2013;17:235-8. https://doi.org/10.1016/j.jbmt.2012.08.007

피인용 문헌

  1. Investigation of the Efficacy and Safety of Topical Vibration Anesthesia to Reduce Pain From Cosmetic Botulinum Toxin A Injections in Chinese Patients: A Multicenter, Randomized, Self-Controlled Study vol.43, pp.3, 2016, https://doi.org/10.1097/dss.0000000000001349
  2. Parameters of vibration stimulation for the relief of pain of different origins and locations vol.22, pp.2, 2016, https://doi.org/10.5604/01.3001.0012.6875