Reduction in injection pain with botulinum toxin type B further diluted using saline with preservative: a double-blind, randomized controlled trial.

Abstract

BACKGROUND:

Injection with botulinum A exotoxin reconstituted with preserved saline has been shown to be less uncomfortable than injection with the same toxin reconstituted with preservative-free saline.

OBJECTIVE:

We sought to determine whether injection with botulinum toxin type B is similarly less painful when preservative-containing saline is used to further dilute the product.

METHODS:

We conducted a double-blind, randomized controlled trial. A total of 15 consecutive adult patients presenting for treatment of upper face dynamic lines received treatment to one side (left or right) of the face with toxin type B further diluted with preservative-containing saline, and to the other side with toxin type B further diluted with preservative-free saline.

RESULTS:

Of 15 patients, 13 (87%) reported less pain in the halves of their faces treated with the preservative-containing saline (P =.0006). Pain on the preservative-containing side was on average 32% less among patients as a whole, and 39% less among patients noting some reduction. The 95% confidence interval for pain reduction associated with preservative-containing injection was -46.9% to -16.1%. Neither investigators nor patients observed any difference in clinical efficacy between the 2 treatment sides.

CONCLUSIONS:

Use of preservative-containing saline to further dilute botulinum toxin type B can significantly decrease patient discomfort on injection.

• Authors: S van Laborde, Jeffrey S Dover, Megan Moore, Brigitte Stewart, Kenneth A Arndt, Murad Alam
• Journal: Journal of the American Academy of Dermatology (J Am Acad Dermatol) Vol. 48 Issue 6 Pg. 875-7 (Jun 2003) ISSN: 0190-9622 [Print] United States
• PMID: 12789177 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Preservatives, Pharmaceutical
• rimabotulinumtoxinB
• Sodium Chloride
• Metalloendopeptidases
• Botulinum Toxins
• Botulinum Toxins, Type A

Topics

• Botulinum Toxins (administration & dosage)
• Botulinum Toxins, Type A
• Double-Blind Method
• Female
• Humans
• Injections (adverse effects)
• Male
• Metalloendopeptidases (administration & dosage)
• Middle Aged
• Pain (prevention & control)
• Preservatives, Pharmaceutical
• Prospective Studies
• Sodium Chloride