Bilateral forearm intravenous regional anesthesia with prilocaine for botulinum toxin treatment of palmar hyperhidrosis - 24/04/13
Reprint requests: Carl Swartling, MD, PhD, Sophiahemmet, Box 5605, SE-114 86 Stockholm, Sweden.Abstract |
Background |
Treatment of palmar hyperhidrosis with botulinum toxin (BTX) requires effective anesthesia, but previous methods have not provided enough pain relief or have resulted in a prolonged impaired hand function.
Objective |
This is a study of bilateral forearm intravenous regional anesthesia using prilocaine for BTX treatment of palmar hyperhidrosis.
Methods |
In all, 166 patients (100 female and 66 male) were treated bilaterally with intracutaneous BTX type A injections using intravenous regional anesthesia with prilocaine (5 mg/mL). In a subgroup of patients, forearm nerves were studied with neurophysiologic methods and blood concentrations of prilocaine were measured. Pain evaluation with a visual analog scale was accompanied with a questionnaire about the treatment.
Results |
In all, 95% of the patients answering the questionnaire (response rate 89%) were satisfied with the anesthetic effect. No serious adverse events occurred. There was a fast recovery of motor function (in median 6 minutes) and sensory function (in median 20 minutes). No subclinical signs of sensory nerve damage were found.
Limitations |
Recall and reporting bias are potential sources of limitations in this study.
Conclusion |
Bilateral forearm intravenous regional anesthesia provides an effective and well-tolerated anesthesia during BTX treatment of palmar hyperhidrosis.
Le texte complet de cet article est disponible en PDF.Key words : botulinum toxin, hyperhidrosis, intravenous regional anesthesia, prilocaine
Abbreviations used : BTX, IVRA, SNAP, VAS
Plan
| Funding sources: None. |
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| Conflicts of interest: None declared. |
Vol 63 - N° 3
P. 466-474 - septembre 2010 Retour au numéro
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