Does wrist nerve block influence the result of botulinum toxin A treatment in palmar hyperhidrosis?

Treatment of palmar hyperhidrosis with intracutaneous injections of botulinum toxin type A is painful, making anesthesia desirable. However, nerve blocks may be associated with reduced efficacy. In 20 patients with idiopathic palmar hyperhidrosis both palms were treated with intracutaneous injections of botulinum toxin type A after having randomly chosen one hand for anesthesia by median und ulnar nerve block and the other hand for cooling. There was no difference in efficacy of botulinum toxin A treatment between both palms but significantly greater injection pain after cooling compared with nerve block.