Intravenous Regional Anesthesia (Bier's Block) for Botulinum Toxin Therapy of Palmar Hyperhidrosis is Safe and Effective

Blaheta, Hans-Juergen; Vollert, B.; Zuder, D.; Rassner, G.

doi:10.1046/j.1524-4725.2002.02009.x

Cited by 41 publications

(32 citation statements)

References 34 publications

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“…The topical anesthetic agent EMLA was less effective than other methods including application of ice immediately before injection, nerve blocks, and intravenous regional anesthesia (Bier's block). [68][69][70][71] Potential side effects of anesthesia such as damaging peripheral nerves or vessels (wrist block or plexus block) have to be discussed with the patients.…”

Section: Discussionmentioning

confidence: 99%

Recognition, diagnosis, and treatment of primary focal hyperhidrosis

Hornberger¹,

Grimes²,

Naumann³

et al. 2004

Journal of the American Academy of Dermatology

411

328

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Section: Discussionmentioning

confidence: 99%

Recognition, diagnosis, and treatment of primary focal hyperhidrosis

Hornberger¹,

Grimes²,

Naumann³

et al. 2004

Journal of the American Academy of Dermatology

411

328

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“…Attempts to reduce injection-related pain have included topical anesthetics (e.g. lidocaine [lignocaine] [155] or tetracaine [158] ); cryoanalgesia with ice, [159] cold air, [148] or dichlorotetrafluoroethane; [160,161] regional nerve blocks; [162][163][164][165] intravenous regional anesthesia (IVRA; Bier's block); [166,167] needle-free injection (e.g. MED-JET Ò ); [157,168] and vibration anesthesia.…”

Section: Palmar Hhmentioning

confidence: 99%

“…Topical anesthesia with creams alone is rarely sufficient to reduce discomfort. [155,166] Small (30-gauge) needles can be used to inject 2% plain lidocaine to block the median, ulnar, and radial nerves (for a wrist block [186] ) or the tibial and sural nerves (for an ankle block [162] ). Care should be taken to keep the injection pressure slow and steady.…”

Section: Anesthesiamentioning

confidence: 99%

Botulinum Toxin for Hyperhidrosis

Grunfeld

Murray

Solish

2009

American Journal of Clinical Dermatology

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Primary focal hyperhidrosis is a disorder of idiopathic excessive sweating that typically affects the axillae, palms, soles, and face. The disorder, which affects up to 2.8% of the US population, is associated with considerable physical, psychosocial, and occupational impairments. Current therapeutic strategies include topical aluminum salts, tap-water iontophoresis, oral anticholinergic agents, local surgical approaches, and sympathectomies. These treatments, however, have been limited by a relatively high incidence of adverse effects and complications. Non-surgical treatment complications are typically transient, whereas those of surgical therapies may be permanent and significant. Recently, considerable evidence suggests that botulinum toxin type A (BTX-A) injections into hyperhidrotic areas can considerably reduce focal sweating in multiple areas without major adverse effects. BTX-A has therefore shown promise as a potential replacement for more invasive treatments after topical aluminum salts have failed. This article reviews the epidemiology, diagnosis, and management of primary focal hyperhidrosis, with an emphasis on recent research evidence supporting the use of BTX-A injections for this indication.

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“…However, patients find these injections quite painful. Strategies to make the injections more tolerable in the treatment of palmar hyperhidrosis have been described 2 , but no effective pain-reducing strategy has yet been devised for the treatment of axillary hyperhidrosis. The aim of this study was to determine the effectiveness of pretreatment with a topical anaesthetic cream in reducing the discomfort associated with botulinum toxin injections for axillary hyperhidrosis.…”

Section: Introductionmentioning

confidence: 99%