Article

Efficacy of skin cooling and EMLA cream application for pain relief of periocular botulinum toxin injection.

Kocaeli University, Faculty of Medicine, Ophthalmology Department, Kocaeli, Turkey.
Ophthalmic Plastic and Reconstructive Surgery (impact factor: 0.69). 23(2):130-3. DOI:10.1097/IOP.0b013e318030459c pp.130-3
Source: PubMed

ABSTRACT To investigate the efficacy of EMLA cream and local dry cold application for pain relief before periocular botulinum toxin injection, and to compare these two methods.
In this prospective study, 40 patients underwent bilateral periocular botulinum injections for blepharospasm treatment or wrinkle reduction. Patients were divided into three treatment groups. In the first group (n = 12), cold was applied to the periocular area on one side before injection; the other side served as the control. In the second group (n = 12), topical anesthetic cream (EMLA) was applied to one side and the other side served as the control. In the third group (n = 16), cold was applied to one side and EMLA was applied to the other side. A visual analog scale was used for pain intensity, and patients in the third group were asked which treatment they preferred.
In the first group, the average pain score on the side where cold was applied was 3.00 +/- 1.70, whereas it was 5.83 +/- 1.40 on the control side (p < 0.001). In the second group, the average pain score on the side receiving EMLA was 3.25 +/- 1.86, and on the control side was 5.83 +/- 1.89 (p < 0.001). In the third group, the average pain score was 3.18 +/- 1.68 for the EMLA side and 3.12 +/- 1.31 for the cooled side (p > 0.05); nine of the 16 patients (56.2%) preferred EMLA.
Skin cooling and EMLA applications significantly decrease the pain associated with periocular botulinum toxin injections. Clinically or statistically significant difference in pain scores between the two methods was not noted. Patients had a slight preference for EMLA cream over skin cooling.

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    Article: Botulinum toxin injection pain relief using a topical anesthetic skin refrigerant.
    Scott J Engel, Ahmed M Afifi, James E Zins
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    ABSTRACT: This study was performed to determine if pretreatment application of a topical anesthetic skin refrigerant reduced discomfort during botulinum toxin injection. Twenty patients were assigned to four groups determined by side of the face pretreated with skin refrigerant and side receiving the first injection. On a Visual Analog Scale of 0-10 patients rated discomfort levels after injections in the glabellar complex with and without pretreatment. Mean discomfort rating for the pretreated side was 3.1, while the mean discomfort rating for the non-pretreated side was 4.5. Discomfort was not affected by the side sprayed (p=0.33) nor by administering the injection to the sprayed side first (p=0.37). The paired t-test revealed a significant difference between discomfort levels on the pretreated and non-pretreated sides (p=0.038) yielding a 95% confidence interval of (-2.71, -0.09). Topical anesthetic skin refrigerant significantly reduces discomfort in a cost-effective manner for reported by patients undergoing botulinum injections.
    Journal of Plastic Reconstructive & Aesthetic Surgery 09/2009; 63(9):1443-6. · 1.49 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

16 patients
 
40 patients
 
bilateral periocular botulinum injections
 
control side
 
cooled side
 
EMLA cream
 
EMLA side
 
first group
 
pain intensity
 
pain relief
 
periocular area
 
periocular botulinum toxin injection
 
periocular botulinum toxin injections
 
second group
 
slight preference
 
statistically significant difference
 
third group
 
topical anesthetic cream
 
two methods
 
wrinkle reduction