Prevention and treatment of pediatric pain and anxiety caused by botulinum neurotoxin A injections: Inadmissible without nitrous oxide analgesia and sedation?

Friedrichsdorf, Stefan J.

doi:10.1111/dmcn.15389

Cited by 2 publications

(2 citation statements)

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“…Nonetheless, caution is warranted in younger children because botulinum toxin has the potential to cause systemic side effects such as dysphagia and dyspnea, 47 especially with shorter durations between treatments and higher injection doses 48,49 . Unique considerations regarding BTX in pediatric patients include using topical anesthetics, nitrous oxide gas, and distraction techniques to minimize the pain and anxiety associated with injections 50 …”

Section: Discussionmentioning

confidence: 99%

“…48,49 Unique considerations regarding BTX in pediatric patients include using topical anesthetics, nitrous oxide gas, and distraction techniques to minimize the pain and anxiety associated with injections. 50 NPWT and HBOT were used as adjunct wound healing therapies in pediatric patients with HS. NPWT decreases skin bacteria, increases tissue perfusion, induces granuloma tissue formation, promotes angiogenesis, and reduces edema.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of procedural treatments for pediatric hidradenitis suppurativa: A systematic review

Masson

Parvathala

et al. 2023

Pediatric Dermatology

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Hidradenitis suppurativa (HS) is a painful, inflammatory skin disease that has historically been understudied in the pediatric population. Procedural interventions, such as surgical excisions, skin grafts, and lasers, are important for comprehensive HS disease management. However, there is a lack of data on procedural treatments for HS in pediatric patients. The purpose of this study was to conduct a systematic review of the literature on the efficacy and safety of procedural treatments for HS in pediatric patients. In April 2022, MEDLINE and EMBASE databases were searched for articles on the efficacy of procedural treatments for HS in patients <18 years of age. Two independent reviewers extracted data from relevant studies. From 1974 to 2021, 23 articles with 81 patients were identified. Patients' Hurley stages included stage I (9.1%, 1/11), II (36.4%, 4/11), and III (54.5%, 6/11). The most extensively studied procedural interventions include negative pressure wound therapy (n = 30), surgical excision with skin graft/flap (n = 19),and endoscopic electrode or laser treatment (n = 11). In all, promising response rates for procedural management strategies were observed in the literature but the findings were largely based on case reports/series. Randomized controlled trials (RCTs), especially those geared toward minimally invasive procedural treatments, are needed to help guide clinicians on the most efficacious treatment modalities for pediatric patients with HS.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Efficacy of procedural treatments for pediatric hidradenitis suppurativa: A systematic review

Masson

Parvathala

et al. 2023

Pediatric Dermatology

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Pain Management Strategies for Botulinum Toxin Type A Injections in Children: A Comprehensive National Survey and Procedural Protocol

Moreira,

Rodrigues,

Beça

2023

Cureus

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Introduction: Botulinum toxin type A injections are a first-line treatment for spasticity in children. Our purpose is to delineate the national landscape concerning pain management for botulinum toxin type A injections in pediatric patients and to formulate a protocol grounded in current scientific evidence. Methods: We conducted a nationwide survey targeting physical medicine and rehabilitation specialists performing botulinum toxin type A injections for focal spasticity in children in Portugal. We conducted a literature review to compare the survey results with clinical guidelines, good practice manuals, and protocols published in the literature. Finally, we developed a procedural protocol for pain management in botulinum toxin procedures. Results: The survey was completed by 17 out of 18 identified specialists. All but one use some form of periprocedural analgesia. Five do not use any type of sedation. The majority do not assess pain during the procedures. From the reviewed articles, we obtained 23 articles, 19 of which provided data for detailed analysis. Conclusions: A prevailing concern centers around pain management during botulinum toxin procedures in children. Nevertheless, a distinct absence of uniformity persists in appraising and managing procedure-related pain. This notion is further underscored by the marked heterogeneity and paucity of published literature within this realm. The systematic implementation of a procedural protocol thus becomes highly crucial.

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Prevention and treatment of pediatric pain and anxiety caused by botulinum neurotoxin A injections: Inadmissible without nitrous oxide analgesia and sedation?

Abstract: This commentary is on the original article by Ostojic et al. on pages 1507–1516 of this issue.

Cited by 2 publications

References 4 publications

Efficacy of procedural treatments for pediatric hidradenitis suppurativa: A systematic review

Efficacy of procedural treatments for pediatric hidradenitis suppurativa: A systematic review

Pain Management Strategies for Botulinum Toxin Type A Injections in Children: A Comprehensive National Survey and Procedural Protocol

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