Paracka Lejla, Kollewe Katja, Dengler Reinhard, Dressler Dirk
Movement Disorders Section, Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
J Neural Transm (Vienna). 2015 Sep;122(9):1279-82. doi: 10.1007/s00702-015-1372-x. Epub 2015 Feb 4.
Injection site pain (ISP) reduces compliance of botulinum toxin (BT) therapy considerably. We wanted to study whether nitrous oxide/oxygen (NOO, Livopan(®), Linde Gas Therapeutics, Unterschleißheim, Germany) can reduce ISP in patients receiving intracutaneous BT injections for axillary or palmar hyperhidrosis (HH). The study followed an open-label design comparing intraindividually ISP in both axillae and/or both palms when NOO was applied or not during BT injections. BT efficacy was measured by the Hyperhidrosis Disease Severity Scale (HDSS) and by a 4-point Self-Assessment Scale. ISP was documented by a Visual Analogue Scale (VAS) and the Verbal Scale of Pain Intensity (VSPI), adverse effects by a Structuralised Interview (SI). Altogether 13 patients (age 34.1 ± 12.4 years, 9 females, 4 males) were studied. 11 BT treatments were for biaxillary and 3 for bipalmar HH. BT reduced biaxillary HH from HDSS 3.7 ± 0.5 to 1.0 ± 0 and bipalmar HH from 3.6 ± 0.6 to 1.0 ± 0. All patients reported ISP reduction by NOO. In axillary HH, NOO reduced ISP from 55.7 ± 12.7 to 12.8 ± 7.5 on the VAS (p < 0.05) and from 4.1 ± 0.3 to 0.7 ± 0.5 on the VSPI (p < 0.05), in bipalmar HH from 60.0 ± 10.0 to 13.3 ± 5.8 on the VAS (p < 0.05) and from 5.0 ± 0 to 1.3 ± 0.5 on the VSPI (p < 0.05). Adverse effects were not identified. NOO is a potent, non-sedative, quickly reversible and safe inhalative analgesic which reduces ISP considerably in patients receiving BT therapy for axillary and palmar HH thus substantially improving compliance of BT therapy.
注射部位疼痛（ISP）显著降低了肉毒杆菌毒素（BT）治疗的依从性。我们想研究一氧化二氮/氧气（NOO，利沃潘（®），林德气体治疗公司，德国 Unterschleißheim）是否能减轻接受皮内注射 BT 治疗腋窝或手掌多汗症（HH）患者的 ISP。该研究采用开放标签设计，比较在 BT 注射期间应用或不应用 NOO 时双侧腋窝和/或双侧手掌内个体的 ISP。通过多汗症疾病严重程度量表（HDSS）和 4 点自我评估量表来衡量 BT 的疗效。通过视觉模拟量表（VAS）和疼痛强度言语量表（VSPI）记录 ISP，通过结构化访谈（SI）记录不良反应。共研究了 13 名患者（年龄 34.1±12.4 岁，9 名女性，4 名男性）。11 次 BT 治疗用于双侧腋窝多汗症，3 次用于双侧手掌多汗症。BT 使双侧腋窝多汗症的 HDSS 从 3.7±0.5 降至 1.0±0，双侧手掌多汗症从 3.6±0.6 降至 1.0±0。所有患者均报告 NOO 减轻了 ISP。在腋窝多汗症中，NOO 使 VAS 上的 ISP 从 55.7±12.7 降至 12.8±7.5（p<0.05），VSPI 上从 4.1±0.3 降至 0.7±0.5（p<0.05）；在双侧手掌多汗症中，VAS 上从 60.0±10.0 降至 13.3±5.8（p<0.05），VSPI 上从 5.0±0 降至 1.3±0.5（p<0.05）。未发现不良反应。NOO 是一种强效、非镇静、快速可逆且安全的吸入性镇痛药，可显著减轻接受 BT 治疗腋窝和手掌多汗症患者的 ISP，从而大幅提高 BT 治疗的依从性。
