The Efficiency of Cold Compression before Botulinum Toxin Injection for Pain Relief in Hemifacial Spasm Patients at Chiang mai Neurological Hospital

Abstract

Hemifacial spasm patients must receive consistent treatment. Patients will receive Botulinum toxin injections and continuously inject every three months. According to Gate Control Theory, cold compression performed to the injection site can help relieve patient’s pain.

This quasi-experimental research study: one group pretest - posttest design aims to compare the average of pain scale between the first injection without cold compression before Botulinum Toxin Injection and the second injection with cold compression before giving the medication. The sample was the Hemifacial Spasm patients received Botulinum Toxin injections every 3 months at Botox Clinic, Chiang Mai Neurological Hospital, between October 2014 and March 2015. The processes of the study included: in their first injection, patients did not receive cold compression before injection but in the second injection, cold compress was applied on patients’ eye socket and cheekbone for 5-10 minutes before injection. The cold compress was developed by the Botox Clinic using soaked gauze pad contained in a plastic bag. It was refrigerated in a freezer and controlled temperature between 10-15 degrees Celsius before applied. Pain level was accessed with a numeric scale by the nurse after the injection. All data was analyzed by using mean and standard deviation and paired-t-test.

The results showed that the majority of samples were females, aged between 46 – 60 years old, received primary education, married, suffered from the Hemifacial spasm for more than 3 months, having the spasm on the right side of their faces and receiving Botulinum Toxin Injections 10-20 unit/dose. The mean score of pain scale after receiving cold compression in the second injection was significantly less than the first injection without cold compression (p < 0.001).

Therefore, cold compression should be perform to Hemifacial spasm patients before Botulinum Toxin Injection for pain relief. In particular, the first injection. To alleviate the suffering of pain. Reduce the rejection rate to maintain continuity and not to be loss follow up. This will have an impact on the treatment and quality of life of patients.