P146 Vibration as analgesia for keloid intralesional corticosteroid injections in the clinic setting

Abstract Intralesional corticosteroid injections for the treatment of keloids can cause a substantial amount of pain [British Association of Dermatologists. Intralesional steroid therapy. Available at: https://www.bad.org.uk/pils/intralesional-steroid-therapy (last accessed 19 February 2025)]. A cost-effective, reusable, reliable and sustainable form of analgesia is required in the clinic setting for keloid corticosteroid injections. Vibration from nonpainful stimuli selectively activates the A-beta fibres in the skin, which transmit sensory input to the brain, overriding the painful sensory stimuli transmitted by C-fibres of the same dermatome (Casale R, Hansson P. The analgesic effect of localized vibration: a systematic review. Part 1: the neurophysiological basis. Eur J Phys Rehabil Med 2022; 58: 306–15). Localized vibration offers a promising solution to control pain by overriding the transmission of painful stimuli to the brain. This study aims to assess the effectiveness and patient experience of vibratory analgesia during intralesional corticosteroid injections for treatment of keloids in a clinic setting. The study included 35 patients who were referred for varying doses of intralesional corticosteroid injections depending on the size, location and number of keloids. A commercially available vibrator was masked in a nitrile glove and used as the intervention with the vibration turned on, and as the placebo with the vibration turned off. Consenting patients were randomized to receive corticosteroid injections with the device placed adjacent to the injection site in vibration mode (test group) or with the vibration turned off (control group). The participants were asked to fill out a pre- and postinjection questionnaire describing their experience via visual analogue scale and numeric rating score (NRS). The mean difference in expected and experienced pain NRS for patients receiving placebo during intralesional injections was −0.125. Patients from the test group who received vibratory analgesia demonstrated a mean NRS difference of −1.89, with 21% of patients experiencing a significant reduction in pain of −3 or more. Vibratory analgesia offers an efficient, practical, reusable and cost-effective solution to reduce pain and improve patient experience during intralesional corticosteroid injections for keloids.