Breast Surgery Patients May Benefit From Botox

Botox Found To Ease Pain

A study by researchers at the University of Arkansas for Medical Sciences found that using the toxin that's popular for reducing wrinkles greatly diminished the morphine doses of women undergoing breast reconstruction after mastectomy.

In breast reconstruction, tissue expanders are temporarily implanted beneath the chest muscle and slowly inflated over several weeks to stretch the tissue in preparation for permanent implants.

In the study, researchers compared pain levels of 30 women who received Botox and 26 women who did not receive the injections.

They found that women who got Botox used 89 percent less morphine in the first 24 hours after surgery, and less morphine overall. They also stayed one day less in the hospital.

The study was presented recently at the Plastic Surgical Forum of the American Society of Plastic Surgeons in Philadelphia and was published in the October issue of the Annals of Surgery.

"The reconstruction process can be painful for some women, and we are happy to find a way to ease that pain," said Dr. Julio Hochberg, study co-author and professor of surgery at the university.

One of the researchers said the study took no funding from the manufacturer of Botox, and that the company did not know the study was taking place.

http://www.foxreno.com/health/3958117/detail.html

Abstract:
Introduction: We hypothesized botulinum toxin (BT) infiltration of the chest wall musculature after mastectomy would create a prolonged inhibition of muscle spasm and postoperative pain, facilitating tissue expander reconstruction.

Methods: An Institutional Review Board (IRB)-approved prospective study was conducted of all patients undergoing mastectomy with tissue expander placement during a 2-year period. Study patients versus controls had 100 units of diluted BT injected into the pectoralis major, serratus anterior, and rectus abdominis insertion. Pain was scored using a visual analog scale of 0 to 10. Wilcoxon rank sum test was used for continuous variables and the [chi]2 test for nominal level data to test for significance.

Results: Forty-eight patients were entered into the study; 22 (46%) with and 26 (54%) without BT infiltration. Groups were comparable in terms of age (55 +/- 11 years versus 52 +/- 10 years; P = 0.46), bilateral procedure (59% versus 61%; P = 0.86), tumor size (2 +/- 2 cm versus 2 +/- 3 cm; P = 0.4), expander size and volume (429 +/- 119 mL versus 510 +/- 138 mL; P = 0.5). The BT group did significantly better with pain postoperatively (score of 3 +/- 1 versus 7 +/- 2; P < 0.0001), during initial (score of 2 +/- 2 versus 6 +/- 3; P = 1.6 x 10-6), and final expansion (1 +/- 1 versus 3 +/- 2; P = 0.009). Volume of expansion per session was greater thus expansion sessions required less in the BT group (5 +/- 1 versus 7 +/- 3; P = 0.025). There was a significant increase in narcotic use in control patients in the first 24 hours (17 +/- 10 mg versus 3 +/- 3 mg; P < 0.0001), initial as well as final expansion periods (P = 0.0123 and 0.0367, respectively). One expander in the BT group versus 5 in the control group required removal (P = 0.13). There were no BT-related complications.

Conclusion: Muscular infiltration of botulinum toxin for mastectomy and tissue expander placement significantly reduced postoperative pain and discomfort without complications.

(C) 2004 Lippincott Williams & Wilkins, Inc.

http://www.annalsofsurgery.com/pt/re/annos/abstract.00000658-200410000-00006.htm;jsessionid=B4agp541QG2jGpolGuK2CqajuJ29wJlrWPDS3B9T2774UkQQnaKp!925374346!-949856032!9001!-1