SciELO - Scientific Electronic Library Online

vol.59 issue3Post-mastectomy pain syndrome: the magnitude of the problem author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand




Related links


Revista Brasileira de Anestesiologia

Print version ISSN 0034-7094On-line version ISSN 1806-907X


COLHADO, Orlando Carlos Gomes; BOEING, Marcelo  and  ORTEGA, Luciano Bornia. Botulinum toxin in pain treatment. Rev. Bras. Anestesiol. [online]. 2009, vol.59, n.3, pp.366-381. ISSN 0034-7094.

BACKGROOUND AND OBJECTIVES: Botulinum toxin (BTX) is one of the most potent bacterial toxins known and its effectiveness in the treatment of some pain syndromes is well known. However, the efficacy of some of its indications is still in the process of being confirmed. The objective of this study was to review the history, pharmacological properties, and clinical applications of BTX in the treatment of pain of different origins. CONTENTS: Botulinum toxin is produced by fermentation of Clostridium botulinum, a Gram-positive, anaerobic bacterium. Commercially, BTX comes in two presentations, types A and B. Botulinum toxin, a neurotoxin with high affinity for cholinergic synapses, blocks the release of acetylcholine by nerve endings without interfering with neuronal conduction of electrical signals or synthesis and storage of acetylcholine. It has been proven that BTX can selectively weaken painful muscles, interrupting the spasm-pain cycle. Several studies have demonstrated the efficacy and safety of BTX-A in the treatment of tension headaches, migraines, chronic lumbar pain, and myofascial pain. CONCLUSIONS: Botulinum toxin type A is well tolerated in the treatment of chronic pain disorders in which pharmacotherapy regimens can cause side effects. The reduction in the consumption of analgesics and length of action of 3 to 4 months per dose represent other advantages of its use. However, further studies are necessary to establish the efficacy of BTX-A in chronic pain disorders and its exact mechanism of action, as well as its potential in multifactorial treatments.

Keywords : DRUGS [Botulinum toxin type A]; PAIN, chronic.

        · abstract in Portuguese | Spanish     · text in English | Portuguese     · English ( pdf epdf ) | Portuguese ( pdf epdf )


Creative Commons License All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License