TABLE 2.

Pain management in photodynamic therapy with 5-aminolevulinic acid 10% gel

PAIN MANAGEMENT

Pain during illumination may limit the use and effectiveness of PDT as patients may not be able to tolerate multiple treatments or a full treatment session.

Pain intensity during the procedure may be monitored and measured using the 0-10 visual analogue scale score.

The use of a fan, possible short breaks or cold air cooling in illumination can also be used to manage treatment- related pain during PDT.

The patient’s skin can be cooled with a stationary and/or handheld fan, cold air cooling and patients are given a stress ball to squeeze Fans should be positioned in the treatment room to provide air movement.

Prior to PDT some patients may elect to use a topical anesthetic

For selected patients, pain can be managed with injection of 2-3 cc intralesional plain lidocaine: In general, administration of lidocaine with epinephrine should not be used to prolong the action of local anesthetics since associated vasoconstriction may decrease oxygen supply to the skin and compromise the effectiveness of PDT.

Lidocaine cream can be applied immediately post illumination to minimize pain.

Abbreviation: PDT, photodynamic therapy.