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Efficacy of botulinum toxin type a after topical anesthesia.

AbstractPURPOSE:
To determine whether the use of topical anesthesia has an impact on botulinum toxin type A (BTX-A) efficacy.
METHODS:
Forty patients (20 receiving BTX-A for facial cosmetic rhytid reduction and 20 for benign essential blepharospasm) were evaluated in a double-blind, randomized, triple-crossover study at 2.5- to 4.5-month intervals. The discomfort and efficacy of BTX-A injections after betacaine application to half the face (random assignment) were compared against the discomfort and efficacy of a placebo ointment on the other half of the face. This was followed by cryoanalgesia to the entire face.
RESULTS:
Patients ranged from 27 to 81 years of age (mean, 53 years), and 34 were female. Of the 120 total injection comparisons, a better BTX-A effect on one side of the face was reliably identified by 80% and 77% of blepharospasm and cosmetic patients, respectively, with the placebo-treated side providing better BTX-A effect approximately 90% of the time (p < 0.001). Patients reported a more painful side during injection in just 18 of the 120 trials, and only 1 of 40 patients believed the administration of analgesia was worth the trouble.
CONCLUSIONS:
Pretreatment with topical betacaine followed by skin cooling seems to have a deleterious impact on BTX-A effect without a significantly beneficial patient-perceived reduction in injection discomfort.
AuthorsMirwat S Sami, Charles N S Soparkar, James R Patrinely, Lisa M Hollier, Larry H Hollier
JournalOphthalmic plastic and reconstructive surgery (Ophthalmic Plast Reconstr Surg) Vol. 22 Issue 6 Pg. 448-52 ( 2006) ISSN: 0740-9303 [Print] United States
PMID17117100 (Publication Type: Journal Article, Randomized Controlled Trial)
Chemical References
  • Anesthetics, Local
  • Neuromuscular Agents
  • Botulinum Toxins, Type A
Topics
  • Administration, Topical
  • Adult
  • Aged
  • Aged, 80 and over
  • Anesthesia, Local (methods)
  • Anesthetics, Local (administration & dosage)
  • Blepharospasm (drug therapy)
  • Botulinum Toxins, Type A (administration & dosage, therapeutic use)
  • Cross-Over Studies
  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • Humans
  • Injections
  • Male
  • Middle Aged
  • Neuromuscular Agents (administration & dosage, therapeutic use)
  • Rhytidoplasty (methods)
  • Treatment Outcome

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