title: Local neural block at the wrist for treatment of palmar hyperhidrosis with botulinum toxin: technical improvements.
abstract: BACKGROUND
  Wrist blockage of median and ulnar nerves before treatment of palmar hyperhidrosis with botulinum toxin (BTX-A) reduces discomfort and improves accuracy of BTX-A injections, but can be associated with mechanical/chemical injury.
  
  
  OBJECTIVE
  We sought to compare locoregional anesthesia of median and ulnar nerves using conventional 25-G x 0.50 x 13 mm gauge needle with short 30-G x 0.40 x 6 mm gauge needle.
  
  
  METHODS
  In all, 37 patients with idiopathic, recalcitrant palmar hyperhidrosis were treated with BTX-A after median and ulnar nerve blockage. In 18 patients, a conventional needle was used to achieve nerve blockage and in 19 the short needle was used. The 2 groups of patients were compared for analgesic effects and lag phase.
  
  
  RESULTS
  No differences were found between groups for lag phase (P=.26) and discomfort of subsequent BTX-A treatment (P=1.0).
  
  
  CONCLUSIONS
  The use of a short-gauge needle to block median and ulnar nerves is a suitable method to anesthetize the palm before treatment with BTX-A.
authors.affiliation: Department of Dermatology, Ancona, Italy. campana@freefast.it
authors.forename: Anna
authors.initials: A
authors.lastname: Campanati
authors.forename: G
authors.initials: G
authors.lastname: Lagalla
authors.forename: L
authors.initials: L
authors.lastname: Penna
authors.forename: R
authors.initials: R
authors.lastname: Gesuita
authors.forename: A
authors.initials: A
authors.lastname: Offidani
mesh_terms: D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006945:Hyperhidrosis / Q000188:drug therapy*; D007267:Injections / Q000009:adverse effects; D008297:Male; D008475:Median Nerve; D009339:Needles; D009407:Nerve Block / Q000295:instrumentation; D010146:Pain / Q000517:prevention & control*; D010342:Patient Acceptance of Health Care; D014459:Ulnar Nerve; D014953:Wrist
chemical_list: D019274:Botulinum Toxins, Type A