October 15, 2009
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No difference in pain between 30-, 32-gauge needles for periocular botulinum toxin type A injections

Ophthal Plast Reconstr Surg. 2009;25(5):376-377.

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With no statistical difference in pain level in use of 30-gauge or 32-gauge needles in periocular botulinum toxin type A injections, other differences should be considered when selecting the appropriate needle for those injections, a study found.

"There is no difference in perceived pain when comparing periocular botulinum toxin type A injections with 30- and 32-gauge needles," the authors said. "In addition, smaller gauge needles require special order and result in greater cost. The authors recommend continued use of 30-gauge needles for botulinum toxin injection in the office setting."

The prospective, randomized, masked study looked at 30 patients who received injections of Botox (botulinum toxin type A, Allergan) to treat benign essential blepharospasm. Patients received an injection with a 30-gauge needle on one side of the face and an injection with a 32-gauge needle on the other side of the face. An equal number of injections and amount of botulinum toxin were used for each patient.

A standardized 11-point visual analogue pain scale rated patients' pain level; no statistical difference was found in pain level for the needle sizes.