Frequently Asked Questions

What can I do using Electronic Local Analgesia?

ELA can be used for onychocryptosis, cryosurgery, verruca treatments, and many other minor surgical procedures for which an injection of local anaesthetic would normally be given. In addition, because ELA is inexpensive and easy to administer, it is ideal for procedures which may cause discomfort but are not generally considered to justify chemical anaesthesia. If a procedure is outside the scope of ELA, the technique can still be used to remove the discomfort of administering a local anaesthetic.

How does it work?

There are two mechanisms involved in the production of analgesia by electronic means:

1. Competition between thick and thin nerves carrying signals to the brain. According to the Gate Theory of Pain, stimulating the large-diameter afferent nerve fibres (which carry information about touch and pressure) "closes the gate" to the pain signals travelling along the small-diameter nerves and prevents them from reaching the brain.
2. In addition, the special electric currents stimulate the production of the body's natural chemical defences against pain. These endorphins circulate in the bloodstream and can remain effective for several hours after the stimulus has been removed, dulling pain but leaving touch sensations unaffected. Thus there is no inconvenient post-operative numbness with ELA.

How long does it take to work?

The "gate" effect is virtually instantaneous, although in practice the level of stimulation is turned up over a period of three or four minutes as the nervous system habituates to the signal. The endorphins also build up during this period.

How easy is it to use?

Administering ELA is simplicity itself, and consists of placing two small, self-adhesive conductive rubber pads on the surface of the foot in the positions indicated by the chart supplied. The pads are then connected to the unit and the signal is turned up until the patient feels a buzzing sensation. Within a few moments this begins to subside as the nervous system habituates to the stimulus, and so the signal is "topped up". This process is repeated until no further habituation is taking place and work can begin. The strength of the signal can be increased further to counteract any perceived threat of discomfort.

How safe is it?

ELA uses no drugs and involves no penetration of the skin, and the signals are far too small to give cause for concern. However, electrical stimulation should not be used on patients fitted with a cardiac pacemaker or with a history of epilepsy, or who are pregnant.

Is it just another TENS machine?

The Dentron Painaway uses the principle of Transcutaneous Electrical Nerve Stimulation ("TENS"), but unlike the kind of TENS machine used to combat back or labour pains it produces a continuous - not pulsed - asymmetric, biphasic modified square wave. The resulting greater power is needed to counteract the discomfort of surgery.

The PAINAWAY carries a one-year return-to-base warranty against defects in manufacture or materials.

Do I have to plug it in to the mains?

No. The Painaway is powered by a PP3-size battery. Either replaceable or special rechargeable batteries (obtainable from Dentron Limited) can be used.

When is ELA better than a local anaesthetic?

Electronic Local Analgesia (ELA) is particularly useful when an injection of local anaesthetic is contra-indicated, for example when tissue is infected. Since it is non-invasive, the method also greatly decreases the possibility of cross-infection.

Who adjusts the painkilling signal?

The patient is in the best position to judge how far to turn up the single control on the Painaway: so the machine is designed to be held and adjusted by patients themselves, once the chiropodist has placed the self-adhesive conductive pads in the correct position.

How accurately do the pads have to be placed?

Generally speaking, there is quite a lot of leeway in the placement of the pads. The chart supplied with each machine gives suggested positions for various areas of the foot: each area is numbered, and the pads are placed as indicated by corresponding numbers followed by the letters "B" or "R", denoting the pads connected to the black and red output plugs respectively. So, for example, to "knock out" the area of the foot marked "2", the pad with the black plug attached is placed in position "2B", while the pad with the red plug attached is placed in position "2R".

Can the pads be used more than once?

Yes - although to be certain of avoiding cross-infection you should use a different pair of pads for each patient. After use the pads can be returned to their backing sheet and labelled with the patient's name, ready for use next time.

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