Factors related to pain during routine photodynamic therapy: a descriptive study of 301 patients

J Eur Acad Dermatol Venereol. 2011 Nov;25(11):1275-81. doi: 10.1111/j.1468-3083.2010.03964.x. Epub 2011 Jan 17.

Abstract

Background: Pain may be a limiting factor in the use of photodynamic therapy (PDT). The consequences of the pain i.e. the resources spent on pain-intervention during routine PDT therapy are poorly described.

Objectives: To describe the consequences of pain during PDT by describing the use of pain-reducing interventions in routine use. We studied the frequency as well as level of pain-reducing intervention.

Methods: Descriptive data from PDT treated patients. The level of pain-reducing intervention was graded 0, no intervention; +, cold water spray and ++, pause or nerve block.

Results: Data from 983 PDT treatments on 579 lesions distributed on 301 patients: 56% did not require pain-reducing intervention, 35% required spraying of cold water, while 9% required pause or nerve block. Ordinate logistic regression revealed an association between lesion size and pain-reducing intervention: the larger the lesion, the more frequent the intervention. Lesion size did not, however, appear associated with the level of intervention. Intervention was most frequently required when treating the scalp/forehead and the extremities. The scalp/forehead also required the highest level of intervention. No significant association between pain-reducing intervention and diagnosis, pre-treatment, gender or age was found.

Conclusions: Pain-reducing intervention was required in 44% of the PDT treatments. Intervention was particularly required when treating lesions in areas suited for PDT therapy for cosmetic reasons such as the scalp/forehead or extremities. Treatment of large areas more frequently calls for pain intervention than treatment of small areas.

MeSH terms

  • Humans
  • Pain / etiology*
  • Photochemotherapy / adverse effects*
  • Retrospective Studies