Assessment of intraoperative pain during Mohs micrographic surgery (MMS): An opportunity for improved patient care Journal Article
| Authors: | Connolly, K. L.; Nehal, K. S.; Dusza, S. W.; Rossi, A. M.; Lee, E. H. |
| Article Title: | Assessment of intraoperative pain during Mohs micrographic surgery (MMS): An opportunity for improved patient care |
| 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. © 2016 American Academy of Dermatology, Inc. |
| Keywords: | adult; treatment outcome; aged; middle aged; pathophysiology; pain; cohort studies; skin neoplasms; logistic models; cohort analysis; odds ratio; pathology; risk assessment; patient care; pilot study; pilot projects; total quality management; intraoperative period; operation duration; pain measurement; statistical model; postoperative pain; pain, postoperative; mohs surgery; chemosurgery; monitoring, intraoperative; mohs micrographic surgery; quality improvement; adverse effects; procedures; operative time; intraoperative monitoring; humans; human; male; female; intraoperative pain; verbal numerical rating scale-11 |
| Journal Title: | Journal of the American Academy of Dermatology |
| Volume: | 75 |
| Issue: | 3 |
| ISSN: | 0190-9622 |
| Publisher: | Mosby Elsevier |
| Date Published: | 2016-09-01 |
| Start Page: | 590 |
| End Page: | 594 |
| Language: | English |
| DOI: | 10.1016/j.jaad.2016.02.1230 |
| PUBMED: | 27125530 |
| PROVIDER: | scopus |
| PMCID: | PMC5525145 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 September 2017 -- Source: Scopus |
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