Article

OBJECTIVE: To compare pain perception using 3 anesthetics (eutectic mixture of
local anesthetics [EMLA], vapocoolant spray, and ice) compared with a control (no
anesthetic) during botulinum toxin type A (BTX-A) injections for lower limb
spasticity. DESIGN: A placebo-controlled, single-blinded study where each study
patient served as their own control. SETTING: Spasticity clinic. PARTICIPANTS:
Subjects (N=30) with ankle spasticity who visited the clinic for BTX-A injections
in the gastrocnemius muscle were consecutively sampled. INTERVENTION: The
gastrocnemius muscle was divided into 4 quadrants and 1 of the 3 different
anesthetic agents was applied to each quadrant with 1 quadrant using no
anesthetic, control.
MAIN OUTCOME MEASURES: Numerical Rating Scale (NRS) and the
Wong-Baker FACES scale. RESULTS: Pain perception using the NRS and FACES scale
was significantly lower using ice and EMLA compared with control and spray
conditions (P<.05). Pain perception using EMLA and ice was similar. These results
indicate that patients experience minimal to moderate pain during BTX-A injections. CONCLUSIONS: Pain relief offered by EMLA and ice was comparable,
suggesting that ice is a more convenient option because of brief application time
(compared with EMLA). Spray may have made the patients more sensitive to pain and
alternative approaches for using vapocoolant should be considered.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS