Evaluating the Effects of Ice Application on the Pain Felt During Botulinum Toxin Type-A Injections

Abstract

The pain felt during botulinum toxin type-A injections and the troubled and distressed treatment it induces is common and well known for the patient and the doctor applying the treatment. This problem is further intensified on the patients who have needle phobia. The effect of ice application on the treatment zone before botulinum toxin type-A treatment on the pain felt during injections is investigated. Totally, 24 patients who underwent botulinum toxin type-A treatment in upper face region for esthetic purposes are included in the study. Ice was applied 5 minutes before the injections on the right lateral orbital zones (crow's feet area) of the patients, whereas on their left sides, toxin was injected without applying any ice. All the drugs were diluted by normal saline; 5 U of active botulinum toxin type-A was used in each diziem (0.1 mL). Total injection number was determined both in right and left areas as 8. Visual analog scale (VAS) was used for pain intensity and evaluation. On the side where ice was applied, the treatment was completed in 1 session and lasted shorter when compared with that of the control side. However, the average VAS values defining the pain that the patients felt in their right and left sides were found as 1.1 and 5.9, respectively. The clinical findings obtained indicated that pain is significantly reduced on the side where ice is applied. The statistical significance of the test results were evaluated by Student's t test, and the difference between VAS values was found statistically significant (P = 0.000).

Non-Pharmacological Therapies in Pain Management

“…Thus, the edema and the pain will reduce and the tissue will be nourished with vasodilatation that will develop 15 minutes later (Karagözlüoğlu, 2001). Results of the studies made in the area have shown that the cold treatment has increased the pain threshold (Koç et al 2006;Raynor et al 2005;Sarifakioğlu & Sarifakioğlu 2004). So, the cold treatments that are applied locally are used to reduce the edema and treat the pain by taking the inflammation process under control (Saeki 2002;Sarifakioğlu & Sarifakioğlu 2004;Van der Westhuijzen et al 2005).…”

“…Results of the studies made in the area have shown that the cold treatment has increased the pain threshold (Koç et al 2006;Raynor et al 2005;Sarifakioğlu & Sarifakioğlu 2004). So, the cold treatments that are applied locally are used to reduce the edema and treat the pain by taking the inflammation process under control (Saeki 2002;Sarifakioğlu & Sarifakioğlu 2004;Van der Westhuijzen et al 2005). It has been stated that cold treatment over the area where surgical sutures are found after lumbar disc surgery reduces both the pain during first 24 hours and the need for morphine (Brandner et al 1996).…”

Abordagem da Dor em Dermatologia (Parte I)

“…Em doentes com hiperhidrose palmo-plantar, o tratamento com toxina botulínica foi menos doloroso nos doentes aos quais foi aplicado gelo no local da picada cinco minutos antes do procedimento. 26,27 -Associação de adjuvantes: A maioria dos anestésicos locais são ácidos fracos, pelo que a neutralização da solução através da adição de bicarbonato de sódio aumenta a fricção não-ionizada de anestésico local e facilita a difusão até aos canais iónicos localizados nas membranas nervosas. Este mecanismo produz uma aceleração do efeito anestésico e redução da dor durante a picada.…”

Injectable Multiple Sclerosis Medications

“…Some techniques-such as use of an autoinjector, 32 EMLA (eutectic mixture of local anesthetics) cream, 33 massage, 34,35 and a cooling pack 36 -are supported by at least small studies. However, evidence in the literature on use of other techniques (eg, nonsteroidal anti-inflammatory agents 37 or oral antihistamines 38 ) is either nonsupportive or conflicting.…”