INTRODUCTION
There is a continuously increasing demand for non-invasive skin lifting and tightening procedures.1 One such procedure is micro-focused ultrasound with visualization (MFU-V), which uses low ultrasound energy to elevate the temperature of the dermal and subdermal layers of the skin.1 This causes both collagen contraction and formation, resulting in lifting and tightening of sagging skin.1 The most commonly reported adverse event associated with this treatment is procedural discomfort and pain.1 One study reported pain scores of 5.68, 6.09, and 6.53 for the cheek, submental, and submandibular regions, respectively, based on a visual analog scale from 0 (no pain) to 10 (maximal pain).2 One of the suggested methods to decrease treatment discomfort is the use of oral acetaminophen.1 One practice reports that most patients receive a combination of topical anesthesia, oral diazepam, and an intramuscular injection of meperidine and hydroxyzine4; however, it is important to offer pain management that is both effective and does not have lasting effects following treatment.
The use of an analgesic is useful in cosmetic procedures to help patients feel more comfortable, increasing patient satisfaction. One proposed treatment is nitrous oxide, which can be administered as a system of a fixed 50%-50% nitrous oxide and oxygen mixture.5 There are many benefits of using nitrous oxide for pain management. It has a rapid onset due to its low solubility in the blood, as well as rapid clearance through the lungs.5 This means patients are able to drive immediately following the procedure and return to daily activities immediately, unlike with narcotics and other controlled substances.6-7 Additionally, nitrous oxide is a safe treatment, with the most frequent adverse event being nausea and vomiting.5 More serious events are only seen with high exposure or abuse.5
The primary objective of this study is to evaluate the efficacy of the nitrous oxide system in reducing pain experienced by patients during treatment with MFU-V treatment. The secondary objectives include safety of MFU-V treatment with the nitrous oxide system, patient satisfaction with MFU-V treatment
The use of an analgesic is useful in cosmetic procedures to help patients feel more comfortable, increasing patient satisfaction. One proposed treatment is nitrous oxide, which can be administered as a system of a fixed 50%-50% nitrous oxide and oxygen mixture.5 There are many benefits of using nitrous oxide for pain management. It has a rapid onset due to its low solubility in the blood, as well as rapid clearance through the lungs.5 This means patients are able to drive immediately following the procedure and return to daily activities immediately, unlike with narcotics and other controlled substances.6-7 Additionally, nitrous oxide is a safe treatment, with the most frequent adverse event being nausea and vomiting.5 More serious events are only seen with high exposure or abuse.5
The primary objective of this study is to evaluate the efficacy of the nitrous oxide system in reducing pain experienced by patients during treatment with MFU-V treatment. The secondary objectives include safety of MFU-V treatment with the nitrous oxide system, patient satisfaction with MFU-V treatment
