scholarly journals Botulinum Toxin Type A for Lumbar Sympathetic Ganglion Block in Complex Regional Pain Syndrome: A Randomized Trial

2021 ◽  
Author(s):  
Yongjae Yoo ◽  
Chang-Soon Lee ◽  
Jungsoo Kim ◽  
Dongwon Jo ◽  
Jee Youn Moon
Keyword(s):  
Botulinum Toxin ◽  
Complex Regional Pain Syndrome ◽  
Sympathetic Ganglion ◽  
Botulinum Toxin Type A ◽  
Pain Syndrome ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Control Group ◽  
Ganglion Block ◽  
Relative Temperature

Background The present study was designed to test the hypothesis that botulinum toxin would prolong the duration of a lumbar sympathetic block measured through a sustained increase in skin temperature. The authors performed a randomized, double-blind, controlled trial to investigate the clinical outcome of botulinum toxin type A for lumbar sympathetic ganglion block in patients with complex regional pain syndrome. Methods Lumbar sympathetic ganglion block was conducted in patients with lower-extremity complex regional pain syndrome using 75 IU of botulinum toxin type A (botulinum toxin group) and local anesthetic (control group). The primary outcome was the change in the relative temperature difference on the blocked sole compared with the contralateral sole at 1 postoperative month. The secondary outcomes were the 3-month changes in relative temperature differences, as well as the pain intensity changes. Results A total of 48 participants (N = 24/group) were randomly assigned. The change in relative temperature increase was higher in the botulinum toxin group than in the control group (1.0°C ± 1.3 vs. 0.1°C ± 0.8, respectively; difference: 0.9°C [95% CI, 0.3 to 1.5]; P = 0.006), which was maintained at 3 months (1.1°C ± 0.8 vs. –0.2°C ± 1.2, respectively; P = 0.009). Moreover, pain intensity was greatly reduced in the botulinum toxin group compared with the control group at 1 month (–2.2 ± 1.0 vs. –1.0 ± 1.6, respectively; P = 0.003) and 3 months (–2.0 ± 1.0 vs. –0.6 ± 1.6, respectively; P = 0.003). There were no severe adverse events pertinent to botulinum toxin injection. Conclusions In patients with complex regional pain syndrome, lumbar sympathetic ganglion block using botulinum toxin type A increased the temperature of the affected foot for 3 months and also reduced the pain. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

scholarly journals Lumbar Sympathetic Block with Botulinum Toxin Type A and Type B for the Complex Regional Pain Syndrome

Toxins ◽  
2018 ◽  
Vol 10 (4) ◽  
pp. 164 ◽  
Author(s):  
Yongki Lee ◽  
Chul Lee ◽  
Eunjoo Choi ◽  
Pyung Lee ◽  
Ho-Jin Lee ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Complex Regional Pain Syndrome ◽  
Botulinum Toxin Type A ◽  
Pain Syndrome ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Sympathetic Block ◽  
Type B

scholarly journals Botulinum toxin type A in the treatment of bladder pain syndrome in women: initial results

2018 ◽  
Vol 8 (2) ◽  
pp. 5-10
Author(s):  
Salman H Al-Shukri ◽  
Igor V Kuzmin ◽  
Margarita N Slesarevskaya ◽  
Yuriy A Ignashov
Keyword(s):  
Botulinum Toxin ◽  
Interstitial Cystitis ◽  
Botulinum Toxin Type A ◽  
Pain Syndrome ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Bladder Pain Syndrome ◽  
Visual Analogue Pain Scale ◽  
Bladder Pain ◽  
Initial Results

We present the results of botulinum toxin type A (BT-A) treatment in 49 women (aged 41-65 years) with bladder pain syndrome. Previously, all patients underwent oral and intravesical drug therapy in addition to hydrodistention of the bladder without significant clinical effect. BT-A at a dose of 100 U (20 points at 5 units) was injected into the bladder under general anesthesia. Treatment results were evaluated 3 months after the treatment using specialized questionnaires such as the Pelvic Pain and Urgency/Frequency (PUF) Scale, O’Leary-Sant Symptom Index and Interstitial Cystitis Scale, visual analogue pain scale (VAS), and urinary diaries. Remarkably, the treatment was effective in 46 (93.8%) patients. By the end of the third month after the BT-A injection, the PUF Scale score, the O’Leary-Sant Symptom and Interstitial Cystitis Scale, and VAS reduced by 41.3%, 32%, and 34%, respectively, and urination frequency decreased by 38.5%. Thus, BT-A is an effective method for treating bladder pain syndrome in patients who are refractory to other treatment methods. (For citation: Al-Shukri SH, Kuzmin IV, Slesarevskaya MN, Ignashov YuA. Botulinum toxin type A in the treatment of bladder pain syndrome in women: initial results. Urologicheskie vedomosti. 2018;8(2):5-10. doi: 10.17816/uroved825-10).

scholarly journals The use of Botulinum toxin type A for the treatment of refractory chronic migraine

2021 ◽  
Author(s):  
Gabrielle Torres Oliveira Lemos ◽  
Gabriel das Chagas Benevenuto ◽  
Gabriela Guy Duarte ◽  
Bruno Alves Pinto ◽  
Ivan Magalhães Viana
Keyword(s):  
Botulinum Toxin ◽  
Chronic Migraine ◽  
Botulinum Toxin Type A ◽  
Clinical Excellence ◽  
Type A ◽  
Infiltration Rate ◽  
Botulinum Toxin Type ◽  
Control Group ◽  
Pubmed Database ◽  
Refractory Chronic Migraine

Background: Chronic migraine is a neurological disorder described as refractory to preventive treatments. Based on the PREEMPT study, the National Institute for Health and Clinical Excellence (NICE) and the FDA approved, in 2010, the use of Botulinum Toxin type A (BoNT/A) to treat refractory chronic migraine. Objectives: To review the effectiveness of the use of BoNT/A in the treatment of refractory migraine. Methods: Bibliographic review based on PubMed database, using the descriptors “migraine” and “botulinum toxin”. Clinical trials, meta-analyzes and randomized controlled tests, from the last five years, were defined as inclusion criteria. Results: Sanz et al., (2016) infiltrated BoNT/A in 69 patients - mean age 43 years old, 88.4% women, mean infiltration rate was 2,0. The reduction of headache days and pain intensity was 48.5% and 20.5%, respectively, both statistically significant (p <0.006). Ion et al., (2018) intervened 61 patients - mean age 50 years old, 87% women, mean infiltration of 3.5. 73% showed a reduction greater than 50% for the frequency of migraine episodes, 48% for headache days and 48% for drug use. Dodick et al., (2019) applied BoNT/A in 688 patients - 696 received placebo. The severity and frequency of pain showed a statistically significant reduction (p < 0.001) after the first week of treatment in relation to the control group. Conclusions: The use of BoNT/A to treat refractory chronic migraine proves to be effective, although there is need for studies with larger samples to ensure its effectiveness.

scholarly journals THE TREATMENT OF CHRONIC ANAL FISSURES WITH FISSURE EXCISION AND BOTULINUM TOXIN TYPE A INJECTION (ISRCTN97413456)

2020 ◽  
Vol 19 (1) ◽  
pp. 80-99 ◽  
Author(s):  
O. V. Tkalich ◽  
A. A. Ponomarenko ◽  
O. Yu. Fomenko ◽  
K. I. Arslanbekova ◽  
R. Yu. Khryukin ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Anal Fissure ◽  
Anal Sphincter ◽  
Chronic Anal Fissure ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Main Group ◽  
Control Group ◽  
Pneumatic Balloon Dilatation

AIM: to assess the efficacy of botulinum toxin type A for chronic anal fissure.PATIENTS AND METHODS: the study included 80 patients randomized by random number generation in 2 groups. Forty patients underwent fissure excision in combination with injections of botulinum toxin type A into the internal sphincter (main group) and 40 – in combination with pneumatic balloon dilatation of the anal sphincter (control group).RESULTS: there were no statistically significant differences in the intensity of postoperative pain after defecation and during the day between the groups, p=0.45 and p=0.39, respectively. The groups were comparable in the complications such as perianal skin hematomas (p=0.84), external hemorrhoid thrombosis (p=0.1), urinary retention (p=0.46), long-term non-healing wounds (p=0.76). Transitory weakening of the anal sphincter was significantly more often in the control group. On day 30, the transitory anal incontinence in the main group was detected in 6 (21%), in the control group – in 18 (75%) patients, p=0.0002. On day 60, the weakness of the anal sphincter remained in the main group in 3 (10.7%), in the control group – in 10 (41%) patients, p=0.02.CONCLUSION: botulinum toxin type A and pneumatic balloon dilatation have equal effectiveness in the treatment of chronic anal fissure. The use of botulinum toxin type A can reduce the incidence of transitory weakening of the anal sphincter function in patients with chronic anal fissure.

Efficacy of Botulinum Toxin Type A in Improving Scar Quality and Wound Healing: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 40 (5) ◽  
pp. NP273-NP285 ◽  
Author(s):  
Xiaoshuang Guo ◽  
Guodong Song ◽  
Dong Zhang ◽  
Xiaolei Jin
Keyword(s):  
Wound Healing ◽  
Botulinum Toxin ◽  
Adverse Events ◽  
Meta Analysis ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Control Group ◽  
The Face ◽  
Scar Quality

Abstract Background Botulinum toxin type A-induced “chemoimmobilization” has long been utilized for improved scar quality and wound healing; however, current evidence is limited to small studies, and evidence-based information is inadequate to make well-informed decisions. Objectives The purpose of this study was to evaluate the efficacy of botulinum toxin type A (BTA) to improve scars and wound healing. Methods The authors searched databases, including Pubmed, Embase, and Cochrane Library, to identify randomized clinical trials (RCTs) that compared outcomes of surgical scars and wounds treated with BTA vs those treated with blank or placebo controls. The Visual Analog Scale, Vancouver Scar Score, scar width, and reported patient satisfaction were utilized in evaluating outcomes. Adverse events were also recorded. Results Eleven RCTs involved a total of 486 cases (374 patients). Quantitative synthesis suggested that compared with the control group, patients in the BTA treatment group had significantly higher Visual Analog Scale scores (mean difference [MD] = 1.30, 95% confidence interval [CI]: 1.05 to 1.55), lower Vancouver Scar Scores (MD = −1.62, 95% CI: −2.49 to −0.75, P = 0.0003), and thinner scars (MD = −0.15, 95% CI: −0.20 to −0.11, P &lt; 0.00001). Patient satisfaction was higher in the BTA group than in the control group (risk ratio: 1.25, 95% CI: 1.06 to 1.49, P = 0.01). Trivial adverse events were reported. Conclusions This meta-analysis of RCTs provides reliable evidence that BTA injection is superior to placebo or blank control group in improving scar quality and wound healing in the face and neck for Asians, and negative outcomes for BTA treatment in these patients include only trivial adverse events. However, inadequate evidence supports utilization of BTA in Caucasians for primary surgical scars or for scars in locations other than the face and neck. Further studies on the standardized injection regimen and technique of BTA are warranted for clinical practice. Level of Evidence: 1

scholarly journals Effects of Botulinum Toxin Type A on Microvessels in Hypertrophic Scar Models on Rabbit Ears

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Na Zhou ◽  
Dongping Li ◽  
Yanzhu Luo ◽  
Junping Li ◽  
Yuhong Wang
Keyword(s):  
Botulinum Toxin ◽  
Hypertrophic Scar ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Treated Group ◽  
Hematopoietic Progenitor Cell ◽  
Control Group ◽  
Vegf Expression ◽  
Rabbit Ears

Background. Although Botulinum Toxin Type A (BTXA) has been applied to scar prevention and treatment, the mechanisms still require further exploration. Objective. To investigate the effects of BTXA on microvessels in the hypertrophic scar models on rabbit ears. Methods. Eight big-eared New Zealand rabbits (males or females) were selected to establish scar models. One ear of each rabbit (4 models in each ear) was selected randomly to be injected with BTXA immediately after modeling and included in the treated group, while the opposite ear was untreated and included in the control group. The growth of scars in each group was observed and recorded, and 4 rabbits were sacrificed on days 30 and 45 after modeling. Then, scar height was measured by hematoxylin-eosin (HE) staining, vascular endothelial growth factor (VEGF) expression was detected by immunohistochemical (IHC) testing, and microvessel density (MVD) was calculated based on CD34 (human hematopoietic progenitor cell antigen). Results. The wounds in each group were well healed and free from infection or necrosis. On days 30 and 45, the scar height, MVD value, and VEGF expression in the treated group were lower than those in the control group (P<0.05). For the treated group, the above indicators on day 45 were lower than on day 30 (P>0.05). Besides, there was a positive correlation between the MVD value and the VEGF expression in the treated group (P<0.05). Conclusion. The injection of BTXA immediately after modeling inhibits VEGF expression and reduces angiogenesis, thereby inhibiting hypertrophic scar formation.

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