评估肉毒杆菌毒素 A 用于治疗多动性尿路功能障碍的情况:单盲研究:评估使用不同注射针头注射肉毒杆菌毒素减少疼痛的效果

IF 3.9 3区 医学 Q2 FOOD SCIENCE & TECHNOLOGY Toxins Pub Date : 2024-09-14 DOI:10.3390/toxins16090395
Heinrich Schulte-Baukloh, Catarina Weiss, Thorsten Schlomm, Sarah Weinberger, Hendrik Borgmann, Dirk Höppner, Kathrin Haberecht, Jörg Neymeyer
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引用次数: 0

摘要

膀胱过度活动症(OAB)对患者的生活质量有很大影响,因此需要长期坚持治疗,同时避免不必要的副作用。目前使用抗胆碱能药物或 β-3 激动剂的治疗方法可能无法改善症状,而且有副作用,导致停药率很高。OnabotulinumtoxinA(OnabotA)解肌注射剂已被批准用于特发性 OAB 的二线治疗,具有良好的有效性和耐受性。本研究使用视觉模拟量表(VAS)评估了在局部麻醉下进行奥那博特注射对每次注射后疼痛程度的影响。这项研究包括 68 名女性患者。我们使用了三种不同的针头,厚度从 22 号到 27 号不等,长度从 4 毫米到 5 毫米不等,切口也各不相同。我们对每个标准注射位置的疼痛感进行了评分。无论使用哪种针头,患者在手术开始时的疼痛感都被评为低于随后的注射。大多数疼痛感觉被评为低度至中度。总体而言,所有患者和所用针头的 VAS 平均痛感为 2.5 ± 0.3。只有在膀胱的某些位置(膀胱后壁和右侧),疼痛感才有明显的统计学差异。单针的平均疼痛评分如下:A针(20 G,4 毫米)为 2.8 ± 0.3,B针(27 G,5 毫米)为 2.1 ± 0.3,C针(20 G,4 毫米,锐切 15°)为 2.6 ± 0.4。27 号针头造成的疼痛明显较小,而且它的长度比其他针头长 1 毫米,因此没有负面影响。因此,针的粗细是影响患者疼痛感的决定性因素。
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Assessing the Use of BotulinumtoxinA for Hyperactive Urinary Tract Dysfunction a Decade after Approval: A Single-Blind Study to Evaluate the Reduction in Pain in OnabotulinumtoxinA Detrusor Injection Using Different Injection Needles
Overactive bladder (OAB) has a significant impact on the quality of life; thus, it requires treatment that can be adhered to over a long period without undue side effects. The current treatment which uses an anticholinergic or β-3 agonist may fail to improve symptoms and has side effects, leading to high discontinuation rates. OnabotulinumtoxinA (OnabotA) detrusor injection has been approved for idiopathic OAB as a second-line treatment with good effectiveness and tolerability. This study used a visual analog scale (VAS) to assess the impact of the type of needle used for OnabotA detrusor injections under local anesthesia on the pain levels after each injection. This study included 68 female patients. We used three different needles with thicknesses ranging from 22 to 27 gauge, lengths between 4 and 5 mm, and different cuts. The sensation of pain was rated at each standardized injection location. Regardless of the needle used, the patients’ perceptions of pain at the beginning of the procedure were rated as being less than the subsequent injections. Most pain sensations were rated as low to moderate. The mean pain sensation on the VAS was 2.5 ± 0.3 overall, i.e., for all patients and needles used. Statistically significant differences in pain sensation were rated only at some locations of the bladder (on the back wall and the right side of the bladder). The single needles averaged the following pain scores: 2.8 ± 0.3 for needle A (20 G, 4 mm), 2.1 ± 0.3 for needle B (27 G, 5 mm), and 2.6 ± 0.4 for needle C (20 G, 4 mm, sharp cut 15°). The 27-gauge needle caused significantly less pain, and it had no negative impact due to its length, which was 1 mm longer than the other needles. Thus, the needle thickness was a decisive factor in the patients’ perceptions of pain.
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来源期刊
Toxins
Toxins TOXICOLOGY-
CiteScore
7.50
自引率
16.70%
发文量
765
审稿时长
16.24 days
期刊介绍: Toxins (ISSN 2072-6651) is an international, peer-reviewed open access journal which provides an advanced forum for studies related to toxins and toxinology. It publishes reviews, regular research papers and short communications. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced.
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