title: Increased patient comfort utilizing botulinum toxin type a reconstituted with preserved versus nonpreserved saline.
abstract: OBJECTIVE
  To demonstrate that injection of botulinum toxin type A is less painful when mixed with preserved saline compared with the suggested preservative-free saline reconstitution.
  
  
  METHODS
  Two different injections were compared on 20 patients who had prior botulinum toxin type A treatments. Each side was injected with toxin reconstituted with either preserved or nonpreserved (0.9%) saline. The investigators and patients were blinded, and outcome was assessed with a verbal scale. Clinical outcome was subjectively and informally assessed by patient questioning and physician observation.
  
  
  RESULTS
  Injection of botulinum toxin type A was noted to be less painful with the use of the preserved compared with the nonpreserved preparation (P<0.0001). The preserved reconstitution appeared to have no effect on clinical outcome.
  
  
  CONCLUSIONS
  Injection of botulinum toxin reconstituted with preserved saline is less painful than nonpreserved saline preparations.
authors.affiliation: Department of Ophthalmology, University of Missouri, Kansas City, Missouri, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Kwiat
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Bersani
authors.forename: Adam
authors.initials: A
authors.lastname: Bersani
mesh_terms: D001764:Blepharospasm / Q000188:drug therapy*; D019274:Botulinum Toxins, Type A / Q000009:adverse effects*; D004311:Double-Blind Method; D006801:Humans; D009465:Neuromuscular Agents / Q000009:adverse effects*; D010146:Pain / Q000139:chemically induced / Q000517:prevention & control*; D011310:Preservatives, Pharmaceutical; D012965:Sodium Chloride
chemical_list: D009465:Neuromuscular Agents; D011310:Preservatives, Pharmaceutical; D012965:Sodium Chloride; D019274:Botulinum Toxins, Type A