E-ISSN 1858-8360 | ISSN 0256-4408
 

Review Article 


Analgesia and sedation modalities used with botulinum toxin injections in children with cerebral palsy: a literature review

Ahmed Nugud, Shahad Alhoot, Maha Agabna, Mohamed O. E. Babiker, Haitham El Bashir.

Abstract
Cerebral palsy (CP) is a non-progressive motor dysfunction leading to multiple morbidities, including spasticity, which can be managed with botulinum toxin injection (BTI). This literature review aims to examine published studies on the efficacy and safety of different interventions used to reduce pain and anxiety associated with BTI in children with CP. A literature review of all published evidence in English language, or with an English translation between 1999 and 2019, using PubMed, EBSCO host, and Medline databases was carried out. All identified papers were screened for inclusion criteria. Data from included papers were entered and analyzed on an Excel database. Twenty-one studies conducted in multiple clinical settings identified 10 different analgesia and sedation modalities including intravenous ketamine, midazolam, inhaled nitrous oxide, general anesthesia, and Eutectic Mixture of Local Anesthetics (EMLAŽ) cream. Most of the studies were descriptive with the exception of two clinical trials and one qualitative study. All interventions had some adverse effects, but they were generally mild and no long-term sequelae were reported. The combination of inhaled nitrous oxide with EMLAŽ cream showed promising primary results. However, ketamine and midazolam combination could be a safe alternative. Currently, there is no sufficient data to draw on the superiority of any modality. Further high-quality studies are warranted.

Key words: Analgesia; Botulinum toxin injection; Cerebral palsy; General anesthesia; Spasticity.


 
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How to Cite this Article
Pubmed Style

Nugud A, Alhoot S, Agabna M, Babiker MOE, Bashir HE. Analgesia and sedation modalities used with botulinum toxin injections in children with cerebral palsy: a literature review. Sudan J Paed. 2021; 21(1): 6-12. doi:10.24911/SJP.106-1604549033


Web Style

Nugud A, Alhoot S, Agabna M, Babiker MOE, Bashir HE. Analgesia and sedation modalities used with botulinum toxin injections in children with cerebral palsy: a literature review. http://www.sudanjp.com/?mno=26480 [Access: June 22, 2021]. doi:10.24911/SJP.106-1604549033


AMA (American Medical Association) Style

Nugud A, Alhoot S, Agabna M, Babiker MOE, Bashir HE. Analgesia and sedation modalities used with botulinum toxin injections in children with cerebral palsy: a literature review. Sudan J Paed. 2021; 21(1): 6-12. doi:10.24911/SJP.106-1604549033



Vancouver/ICMJE Style

Nugud A, Alhoot S, Agabna M, Babiker MOE, Bashir HE. Analgesia and sedation modalities used with botulinum toxin injections in children with cerebral palsy: a literature review. Sudan J Paed. (2021), [cited June 22, 2021]; 21(1): 6-12. doi:10.24911/SJP.106-1604549033



Harvard Style

Nugud, A., Alhoot, . S., Agabna, . M., Babiker, . M. O. E. & Bashir, . H. E. (2021) Analgesia and sedation modalities used with botulinum toxin injections in children with cerebral palsy: a literature review. Sudan J Paed, 21 (1), 6-12. doi:10.24911/SJP.106-1604549033



Turabian Style

Nugud, Ahmed, Shahad Alhoot, Maha Agabna, Mohamed O. E. Babiker, and Haitham El Bashir. 2021. Analgesia and sedation modalities used with botulinum toxin injections in children with cerebral palsy: a literature review. Sudanese Journal of Paediatrics, 21 (1), 6-12. doi:10.24911/SJP.106-1604549033



Chicago Style

Nugud, Ahmed, Shahad Alhoot, Maha Agabna, Mohamed O. E. Babiker, and Haitham El Bashir. "Analgesia and sedation modalities used with botulinum toxin injections in children with cerebral palsy: a literature review." Sudanese Journal of Paediatrics 21 (2021), 6-12. doi:10.24911/SJP.106-1604549033



MLA (The Modern Language Association) Style

Nugud, Ahmed, Shahad Alhoot, Maha Agabna, Mohamed O. E. Babiker, and Haitham El Bashir. "Analgesia and sedation modalities used with botulinum toxin injections in children with cerebral palsy: a literature review." Sudanese Journal of Paediatrics 21.1 (2021), 6-12. Print. doi:10.24911/SJP.106-1604549033



APA (American Psychological Association) Style

Nugud, A., Alhoot, . S., Agabna, . M., Babiker, . M. O. E. & Bashir, . H. E. (2021) Analgesia and sedation modalities used with botulinum toxin injections in children with cerebral palsy: a literature review. Sudanese Journal of Paediatrics, 21 (1), 6-12. doi:10.24911/SJP.106-1604549033





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