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 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 B for Complex Regional Pain Syndrome: A Case Study

2015 ◽  
Vol 5;18 (5;9) ◽  
pp. E911-E916 ◽  
Author(s):  
Francis Sahngun Nahm
Keyword(s):  
Botulinum Toxin ◽  
Complex Regional Pain Syndrome ◽  
Skin Color ◽  
Pain Syndrome ◽  
Sympathetic Nerves ◽  
Botulinum Toxin Type ◽  
Sympathetic Ganglia ◽  
Sympathetic Block ◽  
Type B ◽  
Botulinum Toxin Type B

Lumbar sympathetic block (LSB) is an effective method for relief of sympathetically mediated pain in the lower extremities. To prolong the sympathetic blockade, sympathetic destruction with alcohol or radiofrequency has been used. The preganglionic sympathetic nerves are cholinergic, and botulinum toxin (BTX) has been found to inhibit the release of acetylcholine at the cholinergic nerve terminals. Moreover, BTX type B (BTX-B) is more convenient to use than BTX type A. Based on these findings, we performed LSB on the 2 patients with complex regional pain syndrome (CRPS) in the lower extremity. Levobupivacaine 0.25% 5 mL mixed with BTX-B 5,000 IU was given under fluoroscopic guidance. Two months after LSB with BTX-B, pain intensity and the Leeds assessment of neuropathic symptoms and signs (LANSS) score were significantly reduced. Allodynia and coldness disappeared and skin color came back to normal. In conclusion, BTX-B can produce an efficacious and durable sympathetic blocking effect on patients with CRPS. Key words: Botulinum toxins, complex regional pain syndrome, chemical sympathectomy, sympathetic ganglia

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).

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