Pain Sensation during Intradermal Injections of Three Different Botulinum Toxin Preparations in Different Doses and Dilutions
Authors: KRANZ, GOTTFRIED1; SYCHA, THOMAS1; VOLLER, BERNHARD1; GLEISS, ANDREAS2; SCHNIDER, PETER1; AUFF, EDUARD1
Source: Dermatologic Surgery, Volume 32, Number 7, July 2006 , pp. 886-890(5)
Publisher: Blackwell Publishing
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Abstract:
BACKGROUND Pain sensation associated with injections of botulinum neurotoxin (BoNT) is commonly reported. To date differences in pain sensation between the commercially available products containing BoNT have not been quantified. OBJECTIVES The pain sensations during injection of Dysport, Botox, Neurobloc, and pure saline (control) were compared. In addition, the nociceptive effect of different volumes used for the dilution of the same BoNT dose was investigated. METHODS In a prospective, double-blind, controlled trial, 10 healthy subjects were injected intradermally with Dysport (12 U), Botox (3 and 4 U), Neurobloc (150 and 300 U) reconstituted in 0.9% saline, and pure saline. Pain sensation was quantified during injections. RESULTS Neurobloc injections caused significantly more injection pain than Botox, Dysport, and saline. No significant differences between Dysport, Botox, and saline were found, although there was a trend toward less pain with pure saline injections. Higher pain levels with higher volumes could not be demonstrated significantly. CONCLUSION Our data demonstrate that BoNT type B injections are associated with substantial pain. There is a considerable difference between the commercially available BoNT type B compared to the two BoNT type A preparations. Therefore, considering mitigation of injection pain seems necessary when using BoNT type B.Gottfried Kranz, MD, Thomas Sycha, MD, Bernhard Voller, MD, Andreas Gleiss, PhD, Peter Schnider, MD, and Eduard Auff, MD, have indicated no significant interest with commercial supporters.Document Type: Research article
DOI: 10.1111/j.1524-4725.2006.32191.x
Affiliations: 1: Department of Neurology, Division of Neurorehabilitation and 2: Core Unit for Medical Statistics and Informatics, Medical University of Vienna, Austria
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