Nearly one-third of patients reported pain at some point during their Mohs micrographic surgery day, with a majority of patients reporting a low level of pain, according to research published in the Journal of the American Academy of Dermatology.
Karen L. Connolly, MD, from the dermatology service at Memorial Sloan Kettering Cancer Center in New York, and colleagues asked patients at discharge to report intraoperative pain during Mohs micrographic surgery on a scale between 0 and 10. In a second phase of the study, the researchers asked patients to report pain levels at each Mohs layer and at discharge to determine pain levels throughout the day.
There were 299 skin cancer in 270 patients. Ninety-eight patients (32.8%) reported experiencing pain during the procedures at a mean pain number of 3.7 out of 10. Patients who had a flap or graft repair, who spent more time in-office and who had three or more Mohs layers reported pain more often. The most common painful surgical sites were the nose and the periorbital area.
The researchers concluded that standard pain questioning may allow for more interventions to control pain during a patient’s surgery day.
“Based on this study, instituting a policy of routine pain assessment in the [Mohs micrographic surgery] day better identifies patients who are in pain,” Connolly and colleagues wrote. “Identifying this group of patients allows the surgical team to address pain earlier and offer additional treatment such as ice packs, oral analgesics, and use of longer-acting local anesthetic agents for patients throughout the surgical day.” – by Jeff Craven
Disclosure: The researchers report no relevant financial disclosures.