Analgesic effects of botulinum toxin A: a randomized, placebo-controlled clinical trial

Barwood, S., Baillieu, C., Boyd, R., Brereton, K., Low, J., Nattrass, G. and Graham, H. K. (2000) Analgesic effects of botulinum toxin A: a randomized, placebo-controlled clinical trial. Developmental Medicine and Child Neurology, 42 2: 116-121. doi:10.1111/j.1469-8749.2000.tb00056.x

Author Barwood, S.
Baillieu, C.
Boyd, R.
Brereton, K.
Low, J.
Nattrass, G.
Graham, H. K.
Title Analgesic effects of botulinum toxin A: a randomized, placebo-controlled clinical trial
Journal name Developmental Medicine and Child Neurology   Check publisher's open access policy
ISSN 0012-1622
Publication date 2000-02
Sub-type Article (original research)
DOI 10.1111/j.1469-8749.2000.tb00056.x
Volume 42
Issue 2
Start page 116
End page 121
Total pages 6
Language eng
Abstract Postoperative pain in children with spastic cerebral palsy (CP) is often attributed to muscle spasm and is difficult to manage using opiates and benzodiasepines. Adductor-release surgery to treat or prevent hip dislocation in children with spastic CP is frequently performed and is often accompanied by severe postoperative pain and spasm. A double-blinded, randomized, placebo-controlled clinical trial of 16 patients (mean age 4.7 years) with a mainly spastic type of CP (either diplegic or quadriplegic in distribution) was used to test the hypothesis that a significant proportion of postoperative pain is secondary to muscle spasm and, therefore, might be reduced by a preoperative chemodenervation of the target surgical muscle by intramuscular injection of botulinum toxin A (BTX/A). Compared with the placebo, BTX/A was found to be associated with a reduction in mean pain scores of 74% (P < 0.003), a reduction in mean analgesic requirements of approximately 50% (P < 0.005), and a reduction in mean length of hospital admission of 33% (P < 0.003). It was concluded that an important component of postoperative pain in the patient population is due to muscle spasm and this can be managed effectively by preoperative injection with BTX/A. These findings may have implications for the management of pain secondary to muscle spasm in other clinical settings.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Created: Thu, 10 Mar 2011, 10:15:05 EST