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Management of pain associated with debridement of leg ulcers: a randomized, multicentre, pilot study comparing nitrous oxide-oxygen mixture inhalation and lidocaine-prilocaine cream.

Author(s): Claeys A, Gaudy-Marqueste C, Pauly V, Pelletier F, Truchetet F, Boye T, Aubin F, Schmutz JL, Grob JJ, Richard MA

Affiliation(s): Department of Dermatology, Fournier Hospital, University Henri Poincare, Nancy, France. antoine.claeys@hotmail.fr

Publication date & source: 2011-02, J Eur Acad Dermatol Venereol., 25(2):138-44. Epub 2010 Jun 21.

Publication type: Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

BACKGROUND: Mechanical debridement of fibrin and/or necrosis promotes healing of arterial and venous leg ulcers but is limited by pain associated with the procedure. OBJECTIVE: The main objective of this study was to compare the respective analgesic effect of nitrous oxide oxygen mixture (NOOM) inhalation and lidocaine-prilocaine cream (LPC) application during the mechanical repeated debridement of chronic arterial and venous leg ulcers. METHODS: In this randomized, multicentre, open-label study, pain was evaluated before and after each care and debridement session using a Visual Analog Scale (VAS) and a Verbal Rating Scale (VRS), in the context of usual debridement and wound care process. The Quality of debridement and tolerability of the treatments were also assessed. RESULTS: Forty-one patients were randomized: 20 received NOOM and 21 LPC. Pain assessed by VAS and VRS was more intense in the NOOM group than in the LPC group (5.29 vs. 3.68 and 2.87 vs. 1.71, P<0.001, for the two scales respectively). No differences were found concerning quality of debridement, safety or tolerability between the two groups. CONCLUSION: This pilot study demonstrates the superiority of the LPC over NOOM for pain control during the mechanical debridement of chronic leg ulcers. (c) 2010 The Authors. Journal of the European Academy of Dermatology and Venereology (c) 2010 European Academy of Dermatology and Venereology.

Page last updated: 2011-12-09

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