AI Article Synopsis

  • Botulinum A exotoxin is used for treating dynamic forehead lines, and the study aimed to compare pain levels between two types of saline used for reconstitution.
  • The study included a retrospective analysis of 20 patients and a double-blind trial with 15 patients, assessing discomfort during treatment with preservative-containing versus preservative-free saline.
  • Results indicated that a majority (90% in the retrospective study and 100% in the prospective study) found the treatment with preservative-containing saline to be less painful, with reported pain reduction of 54%.

Article Abstract

Context: Botulinum A exotoxin is used for various indications, including the treatment of dynamic forehead lines.

Objective: To determine whether injection with botulinum A exotoxin reconstituted with preservative-containing normal saline (isotonic sodium chloride) is less painful than injection with exotoxin that has been reconstituted with preservative-free saline.

Design: Two arms: (1) retrospective study; (2) double-blind, randomized controlled trial.

Setting: A multiple-physician dermatology practice.

Patients: (1) Retrospective study-20 consecutive adult patients presenting for treatment of upper-face dynamic lines; (2) prospective study-15 consecutive adult patients presenting for treatment of upper-face dynamic lines.

Intervention: In prospective study only, one side (left or right) of the face was treated with exotoxin reconstituted with preservative-containing saline, and the other side, with exotoxin reconstituted with preservative-free saline.

Main Outcome Measures: (1) Retrospective study-discomfort at current treatment (with preservative-containing saline) compared with discomfort with most recent prior treatment (with preservative-free saline); (2) prospective study-discomfort on the side treated with preservative-containing saline compared with discomfort on the side treated with preservative-free saline.

Results: (1) Retrospective study-18 (90%) of 20 patients reported that treatment with exotoxin reconstituted with preserved saline was less painful than prior treatment with exotoxin reconstituted with preservative-free saline; (2) prospective study-15 (100%) of 15 patients reported less pain in the side of their face treated with exotoxin reconstituted with preservative-containing saline (P<.001). Pain on the preservative-containing side was 54% less. No difference in treatment efficacy between the sides was observed by investigators or patients.

Conclusion: Use of preservative-containing saline to reconstitute botulinum A exotoxin can significantly decrease patient discomfort on injection.

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Source
http://dx.doi.org/10.1001/archderm.138.4.510DOI Listing

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