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Recruiting NCT07571889

Topical Intranasal Anesthetic Block for Reducing the Pain of Botulinum Toxin Injections for Chronic Migraine

No phase Interventional Pain From onabotulinumtoxinA Injections

For patients and families

In plain language

An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.

What is being studied
The protocol lists: onabotulinumtoxinA prophylaxis with Lidocaine, OnabotulinumtoxinA prophylaxis with Saline.
Who it may be relevant to
Registry conditions: Pain From onabotulinumtoxinA Injections. Basic parameters: from 18 years · All.
What needs checking
Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
Where it takes place
United States
Next step
Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →

Unsure about the terms? Read our patient guide →

Official title

Topical Intranasal Anesthetic Block for Reducing the Pain of Botulinum Toxin Injections for Chronic Migraine: A Randomized, Double-Blind, Placebo-Controlled Crossover Pilot Study

Overview

People find the injections used in onabotulinumtoxinA (Botox®) uncomfortable. This study will test whether putting a small piece of cotton soaked with 4% lidocaine (a numbing medicine) inside the front of each nostril for 5 minutes before the injections reduces injection pain compared with cotton soaked in saline (salt water).

Interventions

  • Procedure onabotulinumtoxinA prophylaxis with Lidocaine
    The onabotulinumtoxinA prophylaxis procedure is the modified PREEMPT protocol consisting of 56 injections; 200 Units. The solution from the vial (lidocaine) will be dripped onto 2 small pieces of cotton. One piece of cotton will be placed in the anterior portion of the nasal cavity on each side of the nose. The cotton will be removed after 5 minutes. The clinician will then perform the various series of injections while assessing pain of the injection site following each series of injections.
  • Procedure OnabotulinumtoxinA prophylaxis with Saline
    The onabotulinumtoxinA prophylaxis procedure is the modified PREEMPT protocol consisting of 56 injections; 200 Units. The solution from the vial (Saline) will be dripped onto 2 small pieces of cotton. One piece of cotton will be placed in the anterior portion of the nasal cavity on each side of the nose. The cotton will be removed after 5 minutes. The clinician will then perform the various series of injections while assessing pain of the injection site following each series of injections.

Primary outcome measures

  • Overall patient-reported injection pain [Time frame: Immediately before and immediately following the procedure at Study Visit 1 and again 12 weeks later at Study Visit 2.]
Secondary outcome measures (1)
  • Patient-reported injection pain at each region [Time frame: At Study Visit 1 and 12 weeks later at Study Visit 2. Ratings will occur within 1 minute of injection for each injection region during the procedure.]

Eligibility criteria

Inclusion criteria

  • Aged ≥18 years
  • Any gender
  • Able to provide informed consent
  • Meets clinical criteria for onabotulinumtoxinA for chronic migraine (minimum of 2 days of disability per month due to facial or headache pain, or 8 headache days per month, or more than 15 headaches per month)
  • Scheduled for modified PREEMPT injections at the clinical site

Exclusion criteria

  • Aged < 18 years
  • Trigeminal neuralgia, cluster headache, or other primary headache disorders as dominant diagnosis
  • Not able to provide informed consent
  • Known allergy/hypersensitivity to lidocaine or amide anesthetics
  • Pregnancy/lactation
  • Inability to tolerate intranasal nasal cotton pledgets
  • Significant nasal pathology at placement site

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation
Randomized
Model
Crossover
Masking
Triple blind
Primary purpose
Prevention

Study locations

United States · 1 center
  • University Otolaryngology — East Providence

Publications

  • Aurora SK, Winner P, Freeman MC, Spierings EL, Heiring JO, DeGryse RE, VanDenburgh AM, Nolan ME, Turkel CC. OnabotulinumtoxinA for treatment of chronic migraine: pooled analyses of the 56-week PREEMPT clinical program. Headache. 2011 Oct;51(9):1358-73. doi: 10.1111/j.1526-4610.2011.01990.x. Epub 2011 Aug 29. PMID 21883197
  • Blumenfeld A, Silberstein SD, Dodick DW, Aurora SK, Turkel CC, Binder WJ. Method of injection of onabotulinumtoxinA for chronic migraine: a safe, well-tolerated, and effective treatment paradigm based on the PREEMPT clinical program. Headache. 2010 Oct;50(9):1406-18. doi: 10.1111/j.1526-4610.2010.01766.x. PMID 20958294
  • Comite S, Greene A, Cieszynski SA, Zaroovabeli P, Marks K. Minimizing discomfort during the injection of Radiesse with the use of either local anesthetic or ice. Dermatol Online J. 2007 Jul 13;13(3):5. PMID 18328199
  • Hamilton HK, Arndt KA. Techniques for minimizing pain with injections. J Am Acad Dermatol. 2013 Sep;69(3):e117. doi: 10.1016/j.jaad.2013.05.024. No abstract available. PMID 23957989

Identifiers

NCT: NCT07571889 · Lidocaine Block Study

Primary sources (government registries)

View this study on ClinicalTrials.gov ↗