Local Injection of Lidocaine around Keloids and Hypertrophic Scars Dramatically Relieves Pain Following Intralesional Injection of Triamcinolone Acetonide / Papers of The 6th Japan Scar Workshop


Papers of The 6th Japan Scar Workshop
8. Local Injection of Lidocaine around Keloids and Hypertrophic Scars Dramatically Relieves Pain Following Intralesional Injection of Triamcinolone Acetonide Keisuke Okabe, Noriko Hattori, Shigeki Sakai, Kazuo Kishi Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
Intralesional injection of triamcinolone acetonide (TA) is one of the most widely used therapeutic modalities for keloids and hypertrophic scars, since it was reported by Hollander in 1961. The pain associated with the therapy, however, is so intense that it sometimes prevents the patients from undergoing serial injections. Since 2009, we have tried to relieve the pain by injecting lidocaine into subdermal adipose tissues around keloids and hypertrophic scars before intralesional injection of TA. To assess its efficacy, we asked 13 patients (6 males, 7 females) that had experienced keloids or hypertrophic scars and had undergone intralesional injection therapy with and without local lidocaine injection to evaluate the extent of the overall therapeutic pain.. The patients assessed pain using a 100-mm visual analog scale (VAS) with 0 mm for "no pain" and 100 mm for "worst possible pain". The mean VAS score during the intralesional injection therapy was 82.3(±10.5) without local anesthetic injection, and 18.5(±10.1) with local anesthetic injection (p<0.001). No major complication was observed except for a few cases of subdermal bleeding around the lesion, all of which healed within a week. Thus, pretreatment with local lidocaine injection dramatically relieves pain associated with intralesional TA injection.
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