Comparative study between cold air analgesia and supraorbital and supratrochlear nerve block for the management of pain during photodynamic therapy for actinic keratoses of the frontotemporal zone.

BACKGROUND: Photodynamic therapy (PDT) is an effective treatment for actinic keratoses, Bowen's disease and basal cell carcinoma. The main drawback of PDT is pain during application.
OBJECTIVES: To compare the efficacy of supratrochlear and supraorbital nerve block with cold air analgesia to control the pain experienced during PDT.
METHODS: A controlled open clinical trial was conducted in 34 patients having multiple actinic keratoses in the frontal region treated with PDT. On one side of the frontal region the supratrochlear and supraorbital nerves were blocked, while on the other side cold air was used as the method of analgesia. Pain was recorded on a visual analogue scale after treatment.
RESULTS: Thirty-one of 34 patients reported less pain in the zone treated with nerve block. This difference was statistically significant.
CONCLUSIONS: Nerve block is superior to cold air and is an easy, safe, effective means of controlling the pain associated with PDT.