부산대학교 도서관

BACKGROUND: Many patients find topical 5-aminolaevulinic acid (ALA) photodynamic therapy (PDT) painful. Local anaesthetics are not routinely used and their effect on PDT pain has not been examined. OBJECTIVES: To evaluate the efficacy of tetracaine gel (Ametop®) for pain relief during and after PDT. METHODS: A prospective, double-blind, placebo-controlled study of 42 patients with lesions (≤ 2 cm diameter) of superficial nonmelanoma skin cancer or dysplasia. Patients were randomized to either tetracaine (4% w/w) (n = 22) or vehicle (n = 20) gel under occlusion for 1 h pre-irradiation. Pain was assessed during and after irradiation using a visual analogue scale (VAS) and faces pain scale. RESULTS: Patients who received tetracaine gel experienced only slightly less pain during PDT (median VAS 4) compared with those who received placebo (median VAS 4·5) (95% confidence interval for difference 0–3, P = 0·08). No significant difference in pain was experienced between the treatment groups immediately after irradiation or later. CONCLUSIONS: When compared with placebo, tetracaine gel did not significantly reduce pain during or after PDT for small lesions of superficial basal cell carcinoma, Bowenʼs disease or actinic keratosis.