-Original-

Effect of Lidocaine Tape on Pain during Intralesional Injection of Triamcinolone Acetonide for the Treatment of Keloid

Mamiko Tosa^1,2, Masahiro Murakami^1,2 and Hiko Hyakusoku¹

¹Department of Plastic, Reconstructive and Regenerative Surgery, Graduate School of Medicine, Nippon Medical School
²Department of Plastic and Reconstructive Surgery, Nippon Medical School Musashi Kosugi Hospital

Background: Because intralesional injection of triamcinolone acetonide (TA), a widely used for the treatment of keloid, is painful, many patients discontinue treatment. We evaluated the effects of pretreatment with topical 60% lidocaine tape on the pain and tolerability of intralesional TA treatment in patients with keloid.
Methods: The subjects were 42 patients with keloid who had been treated with intralesional injection of TA but had discontinued treatment owing to intolerable pain. All patients were pretreated with 60% lidocaine tape placed on the keloids for more than 120 minutes before intralesional injection of TA. Patients assessed pain with a 100-mm visual analog scale (VAS) with 0 mm for "no pain" and 100 mm for "worst possible pain." Pain was assessed with the VAS immediately after TA injection. Finally, the patients assessed the tolerability of this treatment.
Results: The mean VAS score during intralesional TA injection therapy without pretreatment with lidocaine tape was 82.6 ± 14.4 mm. In contrast, the mean VAS score during intralesional TA injection therapy in the same patients after pretreatment with lidocaine tape was 18.9 ± 11.3 mm, which was significantly lower (P<.0.05), and 30 (71.4%) of the patients tolerated this therapy well.
Conclusion: Pretreatment with 60% lidocaine tape significantly reduces the pain associated with intralesional injection of TA. This approach increases patient comfort and should enable patients to continue the treatment.

J Nippon Med Sch 2009; 76: 9-12

Keywords
intralesional injection of triamcinolone acetonide, pain, keloid, lidocaine tape

Correspondence to
Mamiko Tosa, MD, PhD, Department of Plastic and Reconstructive Surgery, Nippon Medical School Musashi Kosugi Hospital, 1-396 Kosugi-cho, Nakahara-ku, Kawasaki, Kanagawa 211-8533, Japan
tosa-m@nms.ac.jp

Received, October 23, 2008
Accepted, December 9, 2008