Abstract: Purpose: To compare patients’ pain and stress reactions while fixing the stereotactic headstock for gamma knife treatment by applying compound lidocaine cream for epidermal anesthesia and lidocaine cream for local anesthesia, and applying lidocaine cream alone for local anesthesia. Method: 436 patients admitted to the Gamma Knife Center of the First Affiliated Hospital of Jinan University from February-September 2022 were randomly divided into a study group (n=216) and control group (n=219). In the study group, the lidocaine cream (5%) was applied at two nail positions behind the frontal pillow one hour before the stereotactic head holder was fixed, and the holder was installed following local anesthesia with lidocaine cream following local drug infiltration. In the control group, lidocaine injection was used for local anesthesia. The Visual Analogue Scale (VAS) score was used for self-assessment to objectively measure the degree of facial pain, and the revised Facial Pain Scale (FPS-R) was used for behavioral assessment. The pain was scored and graded before, during and after the fixation, recording changes of the mean arterial pressure and heart rate before and after the installation as the patients showed stress reaction. Results: There was no significant difference (P>0.05) in VAS score, FPS-R classification, mean arterial pressure and heart rate between the two groups before the stereotactic headstock fixation. During the fixation, the VAS scores of the study group and the control group decreased significantly, and the difference was statistically significant (P<0.0001). In the study group, the FPS-R showed more mild pain than in the control group, and the difference was statistically significant (P<0.001). Five minutes after the fixation, the VAS score of the study group was lower than that of the control group, with statistical significance (P<0.001). After the fixation, the mean arterial pressure was lower in the study group than in the control group, and the difference was statistically significant (P<0.001). Immediately after the fixation, the heart rate of the study group was lower than that of the control group, and the difference was statistically significant (P<0.05). Conclusion Applying 5% compound lidocaine cream to the stereotactic head holder nail positions prior to gamma knife treatment produces a good preemptive analgesia effect, with positive significance for reducing the occurrence of syncope and seizures caused by pain during head holder installation, making patients feel more comfortable during treatment.
Abstract: Purpose: To compare patients’ pain and stress reactions while fixing the stereotactic headstock for gamma knife treatment by applying compound lidocaine cream for epidermal anesthesia and lidocaine cream for local anesthesia, and applying lidocaine cream alone for local anesthesia. Method: 436 patients admitted to the Gamma Knife Center of the Firs...Show More
