Forearm Anesthesia Technique Effective in Palm Procedure

Study looks at technique for palmar hyperhidrosis treatment with botulinum toxin injection

MONDAY, Aug. 23 (HealthDay News) -- Prilocaine administered in the forearm provides effective anesthesia without adverse events or nerve damage among patients receiving botulinum toxin (BTX) for the treatment of palmar hyperhidrosis, according to a study in the September issue of the Journal of the American Academy of Dermatology.

Sofia Bosdotter Enroth, M.D., of Uppsala University in Sweden, and colleagues administered intravenous regional anesthesia with prilocaine (5 mg/mL) in the forearms of 166 patients with palmar hyperhidrosis treated bilaterally with intracutaneous BTX type A injections in the palms. In a subgroup of the patients, the researchers used neurophysiologic methods to study forearm nerves, and also measured serum concentrations of prilocaine. Evaluation of pain was done using a visual analog scale and a questionnaire about the treatment.

Overall, 95 percent of the patients responding to the questionnaire said they were satisfied with the anesthetic effect; there were no serious adverse events reported and no subclinical signs of sensory nerve damage. The researchers found that recovery of motor function occurred in a median six minutes, and sensory function returned in a median 20 minutes.

"In conclusion, bilateral forearm intravenous regional anesthesia using prilocaine provides an effective anesthesia during BTX treatment of palmar hyperhidrosis. The anesthesia was well tolerated with minimal side effects and did not affect the toxin treatment effect. Patients particularly appreciated the fast recovery and the anesthetic effect," the authors write.

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