Cryosurgery of eyelid actinic keratosis and basal cell carcinoma and the effect of adrenaline in local anesthetics – temperature mapping using IR technology
Author: Anna Wiktorin
Base Hospital / Institution: St. Erik Eye Hospital, Karolinska Institutet
ePoster presentation
Abstract ID: 24-196
Purpose
Efficacy of cryosurgery is believed to depend on the thaw time. The presence of adrenaline in local anesthetics affects blood perfusion and may thus be important for the thaw time. However, detailed mapping of thawing after cryosurgery in humans has not been done before. The aim of the present study is to employe modern technology for temperature monitoring, using a high-precision IR camera, during cryosurgery of basal cell carcinoma and actinic keratosis, and to assess the effect of adrenaline in local anesthetics.
Methods
Twelve patients with actinic keratosis and nine patients with basal cell carcinoma in the periorbital region underwent cryosurgery. Temperature during thawing was continuously mapped using an IR camera and was also visually assessed by the surgeon. The results were compared when employing local anesthetics with and without adrenaline.
Results
The change in temperature during thawing displayed a triphasic pattern, with an initial swift temperature surge, a plateau phase at around 0°C, and a subsequent rapid temperature elevation to align with that of the neighboring tissue. In cryosurgery for actinic keratosis, the thawing time was prolonged in the presence of adrenaline, as evidenced by an extended plateau phase at 0°C. This was true both when measured by thermography and as observed visually. However, in cryosurgery for basal cell carinomas no differences were seen in the thawing time when using local anesthetics with and without adrenaline.
Conclusion
Thermography provides reliable information on the thawing following cryosurgery. For actinic keratosis, the absence of adrenaline in local anesthetics resulted in a shorter thaw time, which indicates that a longer freezing time may be needed for the same cryo-effect. On the contrary, for basal cell carinomas the presence of adrenaline in local anesthetics did not have any clinical effect on thawing time. A future large clinical trial on treatment effects on actinic keratosis and basal cell carcinomas, concerning recurrence rate, needs to be performed before treatment recommendations about local anesthetics and adrenaline additives can be made.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Elin | Bohman | St. Erik Eye Hospital, Karolinska Institutet |
| Johanna | Berggren | Skåne University Hospital, Lunds University |
| John | Albinson | Skåne University Hospital, Lunds University |
| Rafi | Sheikh | Skåne University Hospital, Lunds University |
| Malin | Malmsjö | Skåne University Hospital, Lunds University |
