title: [Ultrasound-guided peripheral nerve block at wrist level for the treatment of idiopathic palmar hyperhidrosis with botulinum toxin].
abstract: OBJECTIVE
  Evaluation of pain and degree of satisfaction in patients undergoing ultrasound-assisted peripheral regional block for the treatment of idiopathic palmar hyperhidrosis with botulinum toxin.
  
  
  METHODS
  A descriptive, observational study of patients with palmar hyperhidrosis treated with botulinum toxin A, who underwent ultrasound-guided peripheral regional block of the median and ulnar nerves with 3 ml of mepivacaine 1% in each one. The radial nerve block was injected in the anatomical snuffbox. After establishing blocking, the dermatologist performed a mapping and injected around 100 IU of botulinum toxin across the whole palm. The pain experienced during the injection of botulinum toxin was evaluated by verbal numerical scale (from 0 to 10), along with the degree of satisfaction with the anesthetic technique, and the post-anesthetic complications.
  
  
  RESULTS
  A total of 40 patients were enrolled in the study, 11 men and 29 women with no significant differences. The pain intensity assessed with verbal numerical scale was 1.03 (standard deviation of 1.37). No patients had a value greater than 5. The degree of patient satisfaction with the anesthetic technique was very good for 85% of the patients, and good for 7.5%. There were no complications related to type of anesthesia.
  
  
  CONCLUSIONS
  The ultrasound-assisted peripheral regional block could be a simple, effective and safe technique for patients undergoing palmar injection of botulinum toxin. Pain intensity was very low, and it provided a very good level of satisfaction in most patients.
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario de Álava, Vitoria-Gasteiz, Álava, España. Electronic address: Erika.olea@osakidetza.net.
authors.forename: E
authors.initials: E
authors.lastname: Olea
authors.forename: A
authors.initials: A
authors.lastname: Fondarella
authors.forename: C
authors.initials: C
authors.lastname: Sánchez
authors.forename: I
authors.initials: I
authors.lastname: Iriarte
authors.forename: M V
authors.initials: MV
authors.lastname: Almeida
authors.forename: A
authors.initials: A
authors.lastname: Martínez de Salinas
mesh_terms: D000293:Adolescent; D000328:Adult; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D005260:Female; D006225:Hand; D006801:Humans; D006945:Hyperhidrosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D017060:Patient Satisfaction; D010525:Peripheral Nerves; D018084:Ultrasonography, Interventional; D014953:Wrist / Q000294:innervation; D055815:Young Adult
chemical_list: D019274:Botulinum Toxins, Type A
keywords: Bloqueo regional periférico guiado por ultrasonidos; Botulinum toxin; Hiperhidrosis palmar idiopática; Idiopathic palmar hyperhidrosis; Toxina botulínica; Ultrasound-guided peripheral regional block