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Tripod vibration anesthesia

  • Author(s): Stoecker, William V
  • Malters, Joseph M
  • Xu, Jin
  • Pikka, Jo
  • et al.
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Tripod vibration anesthesia
William V Stoecker MD1, Joseph M Malters MD1, Jin Xu2, Jo Pikka1
Dermatology Online Journal 14 (1): 20

1. The Dermatology Center, East 10th Street, Rolla MO
2. Stoecker & Associates


Abstract

Cutaneous vibrators have been introduced to relieve pain associated with a variety of dermatology procedures including injections and laser treatments. The simple tripod massager described in this report is effective and acceptable to patients for cutaneous injection anesthesia.


Most pain associated with cutaneous procedures results from injection of the local anesthetic. Smith et al. have described vibration anesthesia in this journal as an adjunct to any injection procedure, eliminating the need for local anesthesia for some procedures [1]. The authors recommend several units including the Acu Vibe Softouch™, the Hitachi Magic Wand™, and Conair™ double headed massager. We have used the technique they describe, and found it quite helpful for minimizing the pain of injections.


Figure 1
Homedics Mini Massage-On-The-Go™ massager used for tripod vibration anesthesia

We have found that these rather large massagers can be intimidating to some patients. Two of the three vibrators (the Acu Vibe Softouch™ and Hitachi Magic Wand™), have electric cords and therefore take a little extra time to use. Some of the vibration units recommended by Smith et al. are apparently sold for sexual stimulation and may be recognized as such by some patients.

We have found the inexpensive Homedics Mini Massage-On-The-Go™ massager to be useful for reducing the pain of injections. The unit is cordless and can be managed by a single operator. We cover each "foot" of the unit with a small sheet of Allrap All Purpose Adhesive Covering as a barrier for antisepsis. The injection is done within the triangular region formed by the 3 feet of the unit (Fig. 1). One of the feet should be positioned so that it is proximal to the injection site.

The unit has a toy-like appearance and may contribute to reduction of anxiety in pediatric patients. The arch allows placement of ice, if desired, followed by injection without needing to move the unit. The tripod technique is limited to broad surface areas such as the trunk and proximal extremities. For other sites such as fingers, two of the feet may be placed along the finger, one foot proximal to the injection site.

References

1. Smith KC, Comite SL, Balasubramanian S, Carver A, Liu JF. Vibration anesthesia: a noninvasive method of reducing discomfort prior to dermatologic procedures. Dermatol Online J. 2004 Oct 15;10(2):1 PubMed

© 2008 Dermatology Online Journal