Increased patient comfort utilizing botulinum toxin type a reconstituted with preserved versus nonpreserved saline

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.

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.

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.

Injection of botulinum toxin reconstituted with preserved saline is less painful than nonpreserved saline preparations.