scholarly journals Treatment of Post-Breast Surgery Pain Syndrome with Botulinum Toxin: Analysis of The Response to the Addition of Levobupivacaine and to the Type of Surgery

2021 ◽  
pp. 115-118
Author(s):  
Ana-Belén Puentes-Gutiérrez ◽  
María García-Bascones ◽  
Marcelino Sánchez-Casado ◽  
Laura Fernández-García ◽  
Rebeca Puentes-Gutiérrez ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Breast Surgery ◽  
Botulinum Toxin Type A ◽  
Pain Syndrome ◽  
Conservative Surgery ◽  
Botulinum Toxin Type ◽  
Pectoralis Major ◽  
Breast Conservative Surgery ◽  
Surgical Pain ◽  
Type Of Surgery

Background: The spasm and/or contracture of the pectoralis major contribute to the post-breast surgery pain. The purpose of our study was to evaluate changes in the post-breast surgical pain syndrome after the infiltration of botulinum-toxin type-A (BTX-A), according to the type of surgery and the reconstitution of the botulinum-toxin. Methods: This retrospective study was conducted at the Rehabilitation Department with two cohorts: BTX-A reconstituted with saline solution (SS group) or with levobupivacaine (LV group). Data about pectoralis major contracture and pain (global, at night, at rest and during activity) before the infiltration and six weeks after that were collected from the medical records and compared between SS and LV groups, and between conservative breast surgery and mastectomy cases. Results: in the study, 48 women aged 53.3 (±11.10) years were included, with 26 (54.2%) in SS group and 22 (45.8%) in LV group. There were no differences between both groups except transitory paresis (3.8% vs 22.7%; P=0.022). In all patients, baseline circumstances vs after 6 weeks were compared, and we found significant differences in contracture (1,77 (±0.57) vs 0.97 (±0.79)), VAS global (5.45 (±1.92) vs 3.46 (±2.48)), VAS night (3.17 (±3.13) vs 1.61 (±2.29)), VAS rest (2.14 (±2.56) vs 1.21 (±1.98)) and VAS activity (4.31 (±2.55) vs 2.78 (±2.58)). We found higher improvements in the breast conservative surgery. Conclusion: A significant lower pain and contracture after BTX-A injection in the pectoralis major was observed, but its reconstitution in levobupivacaine may not be an effective method to increase the analgesic effect. There were higher improvements in the breast conservative surgery than in the mastectomy.

scholarly journals TREATMENT OF PAIN SYNDROM AFTER AESTHETIC BREAST SURGERY WITH BOTULINUM TOXIN TYPE A

2020 ◽  
pp. 28-34
Author(s):  
E. V. Ermilova ◽  
E. V. Zinovev ◽  
E. N. Yampolskaya
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin Type A ◽  
Pectoralis Major Muscle ◽  
Pain Syndrome ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Mammary Glands ◽  
Pectoralis Major ◽  
Silicone Implants ◽  
Nacl Solution

Objective. To justify the possibility of using botulotoxin type A for the prevention of pain syndrome after aesthetic endoprosthesis of the mammary glands.Material and methods. The study included 72 women aged between 21 and 45 to whom were scheduled to perform breast endoprosthesis with silicone implants. All patients were divided into two groups: the first group included 38, the second group – 34 people. Two weeks before the expected date of surgery, botulotoxin type A in an amount of 100 U was injected into the patients of the first group to reduce pain syndrome in the pectoralis major muscle. Patients of the second (control) group were injected with a 0.9% NaCl solution (placebo effect) into the pectoralis major muscle. All patients underwent electroneuromyography (ENMG) to assess the denervation of the pectoralis major muscle before drug administration and two weeks after.Results. The intensity of pain syndrome was evaluated on the 1st-2nd day after surgery using a special questionnaire. In women of the first group, who were injected with botulinum toxin type A two weeks prior the intended surgery, a decrease in the intensity of the pain syndrome was observed, which in most cases allowed not to take analgesics at all. In women of the second group who were injected with a 0.9% NaCl solution, the severity of the pain syndrome reached its maximum values (according to the questionnaire), which required the prescription of analgesics, including narcotic ones, to reduce the severity of the pain syndrome. According to ENMG, when using botulotoxin type A by injecting into the pectoralis major muscle, denervation indices reached 55% compared to the initial ones, while using the saline solution, the ENMG indices did not change.Conclusion. Clinical use of botulotoxin type A injections into the pectoralis major muscle will improve the results of pain syndrome treatment after endoprosthetics of the mammary glands with implants in aesthetic surgery. 

Subcutaneous Botulinum Toxin Injection for Post-Thoracotomy Pain Syndrome in Palliative Care: A Case Report

2017 ◽  
Vol 35 (3) ◽  
pp. 511-513 ◽  
Author(s):  
Saima Rashid ◽  
Amanda R. Fields ◽  
Steven J. Baumrucker
Keyword(s):  
Botulinum Toxin ◽  
Symptom Management ◽  
Pain Control ◽  
Clostridium Botulinum ◽  
Botulinum Toxin Injection ◽  
Botulinum Toxin Type A ◽  
Pain Syndrome ◽  
Botulinum Toxin Type ◽  
Improve Symptom ◽  
Traumatic Neuropathy

Post-thoracotomy pain syndrome (PTPS) is a traumatic neuropathy that can affect as many as 50% of patients undergoing thoracotomy. Patients are often refractory to conservative management and may require multiple analgesics for adequate pain control. Botulinum toxin, derived from Clostridium botulinum, has many uses in treating conditions involving spasticity, dystonia, chronic migraine, and a variety of pain disorders including neuropathies. Botulinum toxin type A injections may provide an alternative or adjunct to improve symptom management in patients with PTPS.

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 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).

Optimization of diagnosing and treatment of cervical dystonia

2020 ◽  
Vol 18 (5) ◽  
pp. 110-116
Author(s):  
С. М. М. СЕХВЕЙЛ ◽  
◽  
З. А. ГОНЧАРОВА ◽  
И. М. БЛИНОВ ◽  
◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cervical Spine ◽  
Botulinum Toxin ◽  
Cervical Dystonia ◽  
Rating Scale ◽  
Botulinum Toxin Type A ◽  
Pain Syndrome ◽  
Botulinum Toxin Type ◽  
Botulinum Toxin Therapy ◽  
Before And After

The purpose is to optimize diagnostics of cervical dystonia using multispiral computed tomography (MSCT) of the cervical spine to improve the results of botulinum toxin therapy. Material and methods. 27 patients diagnosed with the idiopathic CD (21 females among them) were examined. The age of patients ranged from 25 to 72 years old (the average age was 40 (3,3)). All the patients were scanned with 3D multispiral computed tomography (MSCT) of the cervical spine in order to verify the dystonic muscles and determine the degree of head and neck rotation. MSCT helped to identify the cervical spine deformation, the level of its displacement and the state of dystonic muscles. The Tsui et al. rating scale was used for assessing the severity of CD before and after the treatment. Also the intensity of pain syndrome was assessed according to the visual analogue scale (VAS) before and after the treatment. All the patients had injections of botulinum toxin type A, in the dose 200–300 U. The time period between the injections was 3,5–4 months. Results. The study revealed that women tend to have cervical dystonia more often (77,8%). Late diagnostics of the disease still remains. The duration of the disease lasted from 1 month to 18 years. Before the treatment the pain syndrome intensity amounted to 5,6 (0,8) points, according to VAS, whereas after the treatment it was 1,9 (0,8) points. The 3D MSCT revealed the deformation of the cervical spine. MSCT helped to verify the dystonic muscles (a bigger surface of the dystonic muscle in comparison with the healthy part, a more «round» image of the muscle). MSCT of the cervical spine enabled to verify the form of dystonia (caput, collis or their combination). Conclusions. Late diagnostics of CD remains. Botulinum toxin therapy is a highly effective way of CD treatment. The efficiency of the botulinum toxin therapy in the given category of patients depends on the right choice of target muscles, the verification of the form of CD and adherence to the early treatment principle.

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