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I'd love to hear some opinions and experience on LA vs GA/sedation for very sensitive pts with low pain tolerance (young, scared kids, or the mentally impaired), where there are multiple lesions (VP). let us not debate the choice of treatment (Cautery)...

How do you make the LA experience less traumatic?
Or would you rather do bedside sedation or hospital GA (with an anaesthetist, of course)?

I am struggling with the ethics around this issue...:confused:

 

Patient and presentation dependent. You cannot avoid choice of treatment in a VP context since the ideal treatment is Old Father Time but if you really must intervene then cautery is not treatment of choice in young scared kids or the mentally impaired - something like sal acid might be. In cases of surgery, the question could more profitably be discussed with an anaesthetist.

Bill Liggins

 

When there is a genuine need, IV sedation (Propofol) with LA works very well. We would do so in the ER, for example, in trauma cases. And very occasionally (one in three years) for the IGTN. For VPs .... there are so many other more benign treatment options, why make life more complicated.