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Hayoun M, Misery L. Pain Management in Dermatology. Dermatology 2023; 239:675-684. [PMID: 37433287 DOI: 10.1159/000531758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 06/23/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND The dermatologist has to deal with many situations where the patient feels pain and must therefore know how to manage it. SUMMARY The aim of this review was to explore the treatments available to manage pain in dermatology in different circumstances, with an emphasis on pharmacological and non-pharmacological interventions specifically studied in dermatology.
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Affiliation(s)
- Mathilde Hayoun
- Department of Dermatology, University Hospital of Brest, Brest, France
| | - Laurent Misery
- Department of Dermatology, University Hospital of Brest, Brest, France
- LIEN, University Brest, Brest, France
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Charalambides M, Yannoulias B, Gnanappiragasam D, Veitch D, Wernham A. Local anaesthetics in dermatological surgery: a review of adjuncts and pain reduction techniques. Clin Exp Dermatol 2022; 47:1781-1793. [PMID: 35633072 DOI: 10.1111/ced.15277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2022] [Indexed: 11/28/2022]
Abstract
A variety of adjuncts for local anaesthesia (LA) exists for dermatological surgery, along with many options to reduce the pain of LA. This review aims to summarize the evidence relating to such adjuncts and methods to reduce the pain of LA. Adjuncts to LA can be an important consideration to optimize anaesthetic effect. Current evidence suggests that buffering and warming of LA fluid, along with cooling, pinching and administering vibrations to the skin are effective at reducing pain during administration. In this review, no significant difference in pain reduction was found between cooling and administering vibrations to the skin. Studies demonstrate that, overall, LA injection into distal sites is safe. However, the evidence specific to dermatological surgery is limited with regard to ways to reduce pain during LA injection and in determining the safety of LA for distal sites with confidence. Further high-quality research in the form of multicentre randomized controlled trials is required.
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Affiliation(s)
| | - Basil Yannoulias
- New Cross Hospital, The Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | | | - David Veitch
- Leicester Royal Infirmary, Leicester University Hospitals NHS Trust, Leicester, UK
| | - Aaron Wernham
- Leicester Royal Infirmary, Leicester University Hospitals NHS Trust, Leicester, UK.,Walsall Manor Hospital, Walsall Healthcare NHS Trust, Walsall, UK
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Deng HY, Feng JR, Zhou WH, Kong WF, Ma GC, Hu TF, Luo SG, Xi Y, Zhang Y, Yang QT. Olfactory Sensitivity Is Related to Erectile Function in Adult Males. Front Cell Dev Biol 2020; 8:93. [PMID: 32175318 PMCID: PMC7056663 DOI: 10.3389/fcell.2020.00093] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 02/04/2020] [Indexed: 11/30/2022] Open
Abstract
Background The olfactory system influences human social behavior, in particular the selection of a spouse. However, there is currently a lack of clinical research on the relationship between the olfactory system and erectile dysfunction (ED) in adult males. Aim We explored the association between olfactory sensitivity and erectile function and its possible mechanisms. Results A total of 574 patients, adult males aged between 19 and 42 years, diagnosed with ED in the Department of Infertility and Sexual Medicine of the Third Affiliated Hospital of Sun Yat-sen University from 2015 to 2018 were analyzed retrospectively. Among them, 115 patients (20.03%) had rhinologic diseases (RDs). In addition, in 201 adult male patients who underwent nasal surgery in the ENT department from 2012 to 2016, including 29 (14.43%) with ED, nasal congestion, nasal discharge, and hyposmia were the most common complaints based on the numerical rating scale (NRS). Furthermore, a prospective study was performed in a total of 102 sequential outpatients (male adults) with RD only (n = 46), ED only (n = 42) and both RD and ED (n = 14) in 2019, together with 40 healthy (male adults) volunteers as controls. The results showed that ED patients with RD had severe nasal discomfort and decreased erectile function (P < 0.0001). The olfactory sensitivity of patients with ED was lower than that of the controls, and patients with both ED and RD had the worst olfactory sensitivity (P < 0.0001). Spearman correlation analyses showed that sense of smell was positively correlated with the International Index of Erectile Function-5 score (R = 0.507, P ≤ 0.0001) and the Erection Hardness Scale score (R = 0.341, P < 0.0001). Logistic regression analyses showed that having an olfactory disorder (OD), RD, age, and visual analog scale (VAS, over 5) score were risk factors for ED outcome, indicating that OD patients had a 16.479-fold increased risk for an ED outcome (P < 0.05). Conclusion A significant correlation was detected between olfactory sensitivity and erectile function in adult males. In particularly, impairment of olfactory sensitivity is more common in patients with both ED and RD than in patients suffering from a single disease.
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Affiliation(s)
- Hui-Yi Deng
- Department of Otorhinolaryngology-Head and Neck Surgery, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jia-Rong Feng
- Department of Infertility and Sexual Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wen-Hao Zhou
- Department of Otorhinolaryngology-Head and Neck Surgery, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wei-Feng Kong
- Department of Otorhinolaryngology-Head and Neck Surgery, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Gong-Chao Ma
- Department of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Teng-Fei Hu
- Department of Infertility and Sexual Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Shao-Ge Luo
- Department of Infertility and Sexual Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yu Xi
- Department of Infertility and Sexual Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yan Zhang
- Department of Infertility and Sexual Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qin-Tai Yang
- Department of Otorhinolaryngology-Head and Neck Surgery, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Department of Allergy, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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