Abstract
Background
The pain of cryosurgery for hand warts can lead to poor patient satisfaction and inadequate response to treatment.
Aim
To determine if local anaesthetic infiltration using a 30-gauge needle prior to cryosurgery is acceptable to patients.
Method
20 consecutive patients were recruited over a 14-month period who attended a cryosurgery clinic and who had at least two warts between 5 and 10 mm in diameter on different parts of the hands. In each patient, two warts of approximately equal size were treated using standard cryosurgery techniques, one under local anaesthetic (LA) and the other without.
Results
The average pain score of cryosurgery without LA was more than twice the pain score of administering the LA with a 30-gauge needle (p < 0.0005). One out of 20 warts failed to clear in the LA-treated group and 2 out of 20 warts failed to clear in the non-LA-treated group.
Conclusions
This research suggests that for the majority of patients with warts between five and ten millimetres in diameter, cryosurgery is significantly less painful when carried out under LA.
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References
Glover MG (1990) Plantar warts. Foot-Ankle. 11(3):172–178
Gibbs S, Harvey I (2006) Topical treatments for cutaneous warts. Cochrane Database Syst Rev (3):CD001781
Gibbs S, Harvey I, Sterling J, Stark R (2002) Local treatments for cutaneous warts: systematic review. BMJ 325(7362):461
Buckley D (2015) Cryosurgery for warts. In: Pasquali P (ed) Cryosurgery. A practical manual. Springer, pp 107–119
Buckley D (2000) Cryosurgery treatment of plantar warts. Ir Med J 93(5):140–143
Baust JG et al (2009) The patho-physiology of thermoablation: optimizing cryoablation. Curr Opin Urol 19:127–132
Zouboulis CC (1998) Cryosurgery in dermatology. Eur J Dermatol 8(7):466–474
Melzack R, Wall PD (1965) Pain mechanisms: a new theory. Science 150(3699):971–979. doi:10.1126/science.150.3699.971 PMID 5320816
Gupta AK, Koren G, Shear NH (1998) A double-blind, randomized, placebo-controlled trial of eutectic lidocaine/prilocaine cream 5% (EMLA) for analgesia prior to cryotherapy of warts in children and adults. Pediatr Dermatol 15(2):129–133
Acknowledgments
The author would like to acknowledge the help and support of his GP colleagues in the area who refer patients for assessment and treatment. He would also like to thank all the patients who put their trust in him. Thanks to Tadhg O’Shea, Institute of Technology, Tralee, for his valuable assistance with the statistical analysis.
Conflict of interest
None.
Ethical approval
This was obtained from the Clinical Research Ethical Committee, University College, Cork, Ireland [ref: ECM 4(dd) 01/10/13].
Informed consent
Informed consent was obtained from all individual participants included in the study.
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Buckley, D. Evaluation of local anaesthetic infiltration for cryosurgery of hand warts: a prospective comparative study. Ir J Med Sci 185, 561–564 (2016). https://doi.org/10.1007/s11845-015-1301-x
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DOI: https://doi.org/10.1007/s11845-015-1301-x