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An analysis of pain and analgesia after Mohs micrographic surgery - 24/04/13

Doi : 10.1016/j.jaad.2009.10.049 
Bahar F. Firoz, MD, MPH a, b, Leonard H. Goldberg, MD a, b, , Ofer Arnon, MD d, Adam J. Mamelak, MD, FRCPC c
a DermSurgery Associates, Houston, Texas 
b Department of Dermatology, Weill Cornell Medical College, Methodist Hospital, Houston, Texas 
c Dermatology Consultants, Mississauga, Ontario, Canada 
d Department of Plastic and Reconstructive Surgery, Soroka University Medical Center, Beer-Sheva, Israel 

Reprint requests: Leonard H. Goldberg, MD, DermSurgery Associates, 7515 S Main St, Suite 240, Houston TX 77030.

Abstract

Background

Pain characteristics and analgesia in patients undergoing Mohs micrographic surgery have not been systematically studied. It is important to know about pain after Mohs micrographic surgery to better serve patient needs.

Objective

We sought to measure pain in patients after Mohs micrographic surgery, and to investigate the relationship among postoperative pain, surgical characteristics, patient characteristics, and analgesics used.

Methods

The Wong-Baker 0-to-10 pain scale was prospectively administered postoperatively to all patients presenting for Mohs micrographic surgery in a private practice setting between October 1, 2007, and December 31, 2008. Patients recorded their pain level from the day of surgery through postoperative day 4. The age, sex, location of surgery, number of lesions operated on, postoperative size, type of repair, severity of pain, and oral analgesics consumed and dosages used were recorded.

Results

A total of 433 patients were included in the final analysis. The highest pain scores were found on the day of surgery and steadily declined until postoperative day 4 (P < .000). In all, 52% of patients took pain medication on the day of surgery, which declined successively with each postoperative day. The highest mean pain scores were statistically significantly associated with repair type (flaps), age (<66 years), number of lesions, and consumption of narcotics for pain relief. No statistically significant differences existed for sex or postoperative defect size.

Limitations

The instrument used to measure pain relied on patient self-report in a private practice surgery center. Only the validated Wong-Baker pain scale was used to assess pain in this study.

Conclusion

Approximately half of the patients after Mohs micrographic surgery take medication for pain control. Type of closure, location of surgery, age, and type of pain medication taken were significantly associated with postoperative pain.

Le texte complet de cet article est disponible en PDF.

Key words : analgesia, Mohs micrographic surgery, pain, postoperative pain, Wong-Baker pain scale


Plan


 Funding sources: None.
 Conflicts of interest: None declared.


© 2009  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 63 - N° 1

P. 79-86 - juillet 2010 Retour au numéro
Article précédent Article précédent
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