title: Ethyl chloride spray for sensory relief for botulinum toxin injections of the hands and feet.
abstract: BACKGROUND
  Botulinum toxin injections are effective in the treatment of palmar and plantar hyperhidrosis, but discomfort has limited its use.
  
  
  OBJECTIVE
  To study the use of ethyl chloride medium-stream spray in reducing injection discomfort.
  
  
  METHODS
  We used ethyl chloride medium-stream spray, in conjunction with precooling by frozen ice packs, in our No Sweat Clinic for our most recent 51 consecutive cases of botulinum toxin injection.
  
  
  RESULTS
  Ethyl chloride spray greatly facilitated the injection procedure, and all patients completed the injections without hesitation or delay.
  
  
  CONCLUSIONS
  Ethyl chloride medium-stream spray, in conjunction with precooling by frozen ice packs, is highly effective in reducing painful injection sensations. Its use is safe, economical, and easy to learn and does not require special equipment.
authors.affiliation: Department of Medicine, North York General Hospital, University of Toronto, Toronto, ON. revrichards@hotmail.com
authors.forename: Robert N
authors.initials: RN
authors.lastname: Richards
mesh_terms: D000293:Adolescent; D000328:Adult; D000698:Analgesia / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D005018:Ethyl Chloride / Q000008:administration & dosage*; D005260:Female; D005528:Foot; D006225:Hand; D006801:Humans; D006945:Hyperhidrosis / Q000188:drug therapy*; D007271:Injections, Intradermal / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000008:administration & dosage; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D009465:Neuromuscular Agents; D005018:Ethyl Chloride; D019274:Botulinum Toxins, Type A