Abstract AAPM The American Academy of Pain Management neuralgia by mikeholy


									Lizu X, Hui H.
Therapeutic effect of botulinum toxin A in the treatment of postherpetic neuralgia by
subcutaneous injection
26th Annual Meeting of the American Academy of Pain Medicine (AAPM) (San Antonio,
TX: February 3, 2010)
Objective: To explore the effect of botulinum toxin A(BTA)in the treatment of postherpetic
neuralgia by subcutaneous injection.
Methods: 60 patients of postherpetic neuralgia were randomly distributed into group A,
group B, and group C. All patients were treated by subcutaneous injection in the affected
area, 0.9% saline liquor with 100u BTA was administered to the surface of the affected
dermatomere in group A, 0.9% saline with 100 mg lidocaines was used in the group B and
0.9% saline was injected in group C as control. VAS evaluation was taken before therapy,
one day after therapy, on the seventh day after therapy and 3 months follow-up. Allodynia,
disfunction of sleep and the usage of opioids were observed pre-injection and post-
Results: VAS decreased significantly when discharged and three months later in all three
groups (P < 0.01); however, VAS in group A reduced more significantly compared to
group B and group C when discharged and 3 months after therapy in three groups (P <
0.01); The dose of opioids used in group A was the lowest (21.1%) compared with group B
(52.6%) and group C (66.7%). The difference between group A and group B was
significant (P < 0.05), as well as between group A and group C (P < 0.01).
Conclusion: The intractable pain of postherpetic neuralgia could be relieved significantly
by the subcutaneous injection with BTA, the effect was more significant on the seventh
day after therapy. It can also reduce the usage of opioids.
References: 1) Bach-Rojecky L, Relja M, Lackovic Z. Botulinum toxin type A in
experimental neuropathic pain. J Neural Transm, 2005, 112(2):215-219. 2) Liu HT, Tsai
SK,Kao MC, et al. Botulinum toxin A relieved neuropathic pain in a case of post-herpetic
neuralgia. Pain Med 2006, 7(1):89-91.
Funding: None
Author Affiliation: Nanshan Hospital, Shenzhen, Guandong Province, China

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