Laser Treatments for Port Wine Stains

I had one day of quite unusual cases; we provided anesthesia for pulsed dye laser treatments for port wine stains like the one shown above. Performed by dermatologists, the treatments themselves take just five minutes, but many pediatric patients don't tolerate it, especially if they have extensive skin lesions. So it was a quick turnover day where I would meet my patient and her parents, induce anesthesia by mask, start an IV, give propofol, dexmedetomidine, tylenol, and toradol, and prepare for the next patient while the dermatologist treated the rash. The laser was pretty remarkable; with a flash and a little smoke, it would create small bruises or welts in the skin. It looked quite painful, though I've been told it's like having a rubber band snap on your skin. Apparently it works wonders as some parents whose children had been through multiple treatments reassured me that the port wine stains had improved dramatically with each session.

Image from UpToDate, shown under Fair Use.