Chorney Stephen R, Villwock Jennifer A, Suryadevara Amar C
1 Department of Otolaryngology and Communication Sciences, SUNY Upstate Medical University, Syracuse, New York, USA.
2 Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA.
Ear Nose Throat J. 2019 Jul;98(6):351-355. doi: 10.1177/0145561319839839. Epub 2019 May 9.
Botulinum toxin is the most commonly performed facial cosmetic procedure and pain at the injection site is a frequent patient concern. While various topical interventions have been described for analgesia, there have not been any studies comparing different techniques. We compared the use of a vibratory stimulus, ice pack application, and no intervention on injection site pain for cosmetic botulinum toxin injection. A prospective-, randomized-, individual-controlled study was conducted using a visual analog scale to assess pain. Patients received bilateral glabellar injections, with randomization into unilateral vibration, unilateral ice application, or vibration and ice on either side. We analyzed 88 injections on 22 patients. Mean visual analog scores were 26.5 (standard deviation [SD]: 23.1) among injections with vibration, 24.4 (SD: 22.9) with ice, and 29.4 (SD: 27.1) without analgesia. There was no significant difference in pain scale scores with the use of vibration, ice, or no topical anesthesia ( = .737). Further, pain scale scores did not differ significantly between medial and lateral injections nor did patients have a reduction in pain on either side of the forehead regardless of which method was used. While there may be a role for topical interventions to improve injection site analgesia, we maintain that consistently proper technique plays a greater role in improving patient tolerance. Future studies will continue to investigate the role of topical anesthesia in cosmetic facial injections and address patient-specific factors contributing to discomfort.
肉毒杆菌毒素注射是最常见的面部美容手术，注射部位疼痛是患者常关注的问题。虽然已有多种局部干预措施用于镇痛，但尚无比较不同技术的研究。我们比较了振动刺激、冰敷及不采取任何干预措施对美容用肉毒杆菌毒素注射部位疼痛的影响。采用视觉模拟评分法进行前瞻性、随机、个体对照研究以评估疼痛。患者接受双侧眉间注射，随机分为单侧振动、单侧冰敷或双侧振动加冰敷。我们分析了22例患者的88次注射情况。振动注射组的平均视觉模拟评分为26.5（标准差[SD]：23.1），冰敷组为24.4（SD：22.9），未采取镇痛措施组为29.4（SD：27.1）。使用振动、冰敷或不进行局部麻醉时，疼痛量表评分无显著差异（P = 0.737）。此外，内侧和外侧注射的疼痛量表评分无显著差异，无论采用哪种方法，患者前额两侧的疼痛均未减轻。虽然局部干预措施可能有助于改善注射部位镇痛，但我们认为始终正确的操作技术在提高患者耐受性方面发挥着更大作用。未来的研究将继续探讨局部麻醉在面部美容注射中的作用，并关注导致不适的患者个体因素。
