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Anesthesia and/or Sedation for Pulsed Dye Laser Therapy
Authors:Linda G. Rabinowitz  M.D.  Nancy B  Esterly  M.D.  Ilona J. Frieden  M.D.  Gregory S. Garbin  M.D.  Roy C. Grekin  M.D.  T. J. Stafford  M.D.  Ph.D.  O. T. Tan  M.D.  Linda G. Rabinowitz  M.D.  Gerald N. Goldberg  M.D.  Karen F  Rothman  M.D.  Lynne J. Roberts  M.D.  Roy G. Geronemus  M.D.  Susan B. Mallory  M.D.  Jerome M. Garden  M.D.  Joseph G. Morelli  M.D.  Moise L  Levy  M.D.  Bernard A. Cohen  M.D.
Affiliation:Medical College of Wisconsin Milwaukee, Wisconsin;University of California School of Medicine San Francisco, California;Boston City Hospital Boston, Massachusetts;Medical College of Wisconsin Milwaukee, Wisconsin;Tucson, Arizona;Westboro, Massachusetts;University of Texas Health Science Center Dallas, Texas;New York University Medical Center New York, New York;St. Louis Children's Hospital St. Louis, Missouri;Children's Memorial Hospital Chicago, Illinois;University of Colorado School of Medicine Denver, Colorado;Baylor College of Medicine Houston, Texas;Johns Hopkins University Baltimore, Maryland
Abstract:One of the most exciting developments in pediatric dermatology has been the use of the flashlamp-pumped, 585-nm, pulsed dye laser for treatment of vascular birthmarks. In many cases the results are miraculous. The increase in self-esteem and happiness of many children and adolescents has been overwhelming; for some, depression has been lifted, stuttering has ceased, social involvement has increased, and antidepressants have been discontinued. There are many success stories to tell.
Despite the remarkable effects of the pulsed dye laser and the medical and psychosocial indications for its use, the issue of pain control remains significant. We have no perfect outpatient pediatric anesthetic. Most methods carry either some risk or, if not hazardous, often are not very effective for controlling pain. Needless to say, a diversity of opinions exist on how to manage discomfort from this treatment modality. Therefore, we thought it would be useful to share the experiences and opinions of several dermatologists who have extensive experience with the pulsed dye laser.
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