Karen L Connolly1, Kishwer S Nehal1, Stephen W Dusza1, Anthony M Rossi1, Erica H Lee2. 1. Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, New York. 2. Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, New York. Electronic address: leee@mskcc.org.
Abstract
BACKGROUND: Intraoperative pain during Mohs micrographic surgery (MMS) has not been characterized. However, many patients report postoperative pain on the day of MMS. OBJECTIVE: We sought to determine if patients experience pain during their MMS visit. METHODS: In phase I of this study, patients were asked to report intraoperative pain level using the verbal numerical rating scale (0-10) at discharge. In phase II, pain levels were assessed before each Mohs layer and at discharge, to determine whether pain was experienced throughout the day. RESULTS: Pain was reported at some point during the MMS day for 32.8% of patients (n = 98). The mean pain number reported was 3.7 (range 1-8) out of 10. Pain was more commonly reported by patients who spent a longer time in the office, had 3 or more Mohs layers, and had a flap or graft repair. Patients most frequently reported pain with surgical sites of the periorbital area and nose. LIMITATIONS: Time between Mohs layers was not measured. There was nonstandardized use of intraoperative local anesthesia volume and oral pain medications. CONCLUSION: Some patients experience pain during MMS. However, the majority of patients report a low level of pain. Additional preventative measures could be considered in patients at higher risk.
BACKGROUND:Intraoperative pain during Mohs micrographic surgery (MMS) has not been characterized. However, many patients report postoperative pain on the day of MMS. OBJECTIVE: We sought to determine if patients experience pain during their MMS visit. METHODS: In phase I of this study, patients were asked to report intraoperative pain level using the verbal numerical rating scale (0-10) at discharge. In phase II, pain levels were assessed before each Mohs layer and at discharge, to determine whether pain was experienced throughout the day. RESULTS:Pain was reported at some point during the MMS day for 32.8% of patients (n = 98). The mean pain number reported was 3.7 (range 1-8) out of 10. Pain was more commonly reported by patients who spent a longer time in the office, had 3 or more Mohs layers, and had a flap or graft repair. Patients most frequently reported pain with surgical sites of the periorbital area and nose. LIMITATIONS: Time between Mohs layers was not measured. There was nonstandardized use of intraoperative local anesthesia volume and oral pain medications. CONCLUSION: Some patients experience pain during MMS. However, the majority of patients report a low level of pain. Additional preventative measures could be considered in patients at higher risk.
Authors: Marianne Jensen Hjermstad; Peter M Fayers; Dagny F Haugen; Augusto Caraceni; Geoffrey W Hanks; Jon H Loge; Robin Fainsinger; Nina Aass; Stein Kaasa Journal: J Pain Symptom Manage Date: 2011-06 Impact factor: 3.612
Authors: Andrea F Chen; David C Landy; Erik Kumetz; Gerard Smith; Eduardo Weiss; Eli R Saleeby Journal: Dermatol Surg Date: 2015-01 Impact factor: 3.398