WAIKOLOA, HAWAII "DVD anesthesia" is an effective distraction technique when performing biopsies, excisions, and other office dermatologic procedures in children, Dr. Elizabeth Alvarez Connelly said.
The concept is straightforward: provide the child with a portable DVD player or handheld electronic game as a distraction from the time the procedure site is covered with topical lidocaine cream under occlusion through the procedure itself, said Dr. Connelly of the University of Miami.
Successful execution requires staff patience along with adherence to a few rules, she noted. Provided the parent is not overly anxious, he or she can remain at the child's side, but must stay seated. If the child is too young for an electronic device, consider having the parent sing a favorite song or talk to the child, she said at the annual Hawaii dermatology seminar sponsored by Skin Disease Education Foundation. "I do insist that the parents sit. I've had one that fainted, and it made things much more difficult," she recalled.
After at least a half an hour of lidocaine cream under occlusion, Dr. Connelly shows the child her fingers and explains that she is going to firmly pinch the skin around the injection site to stimulate the feeling of the local anesthesia. She reassures the child that the injection will not be felt because of the "magic cream." Dr. Connelly carefully avoids showing the child the needle, the scalpel or other instruments, and any bloody gauze.
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