The Use of Locally Applied Vibration to Minimize Pain during Fractional CO2 Laser Therapy in Living Liver-Donor Scar Management

Background Fractional $CO_2$ laser is an effective treatment for scars, but most patients complain about sharp burning pain, even after the application of lidocaine ointment. This study analyzed the impact of a vibrating device to nonpharmacologically reduce the acute pain of laser treatment, in accordance with the gate control theory of pain management. Methods This is a prospective study performed from May 2013 through March 2014. Fifty-three patients (mean age, 26.7 years; range, 16-44 years) who had donated livers for liver transplantation were treated with a fractional $CO_2$ laser (10,600 nm; model $eCO_2$, Lutronic Corp) for their abdomen scars. Laser treatment was applied 4 months after surgery. A commercially available, locally applied vibrating device (model UM-30M, Unix Electronics Co. Ltd.) was used, in an on-and-off pattern, together with the $CO_2$ laser. A visual analogue scale (VAS; 0, no pain; 10, most severe pain) of pain sensation was assessed and statistically analyzed using a paired t-test. Results The average VAS score for pain with the vibrating device was 4.60 and the average VAS score without the vibrating device was 6.11. The average difference between scores was 1.51 (P=0.001). Conclusions A locally applied vibrating device was demonstrated to be effective in reducing pain when treating with a fractional $CO_2$ laser. Vibration treatment could be helpful when treating scars with fractional $CO_2$ laser in pain-sensitive patients, particularly children.