Intra- and Postoperative Botulinum Toxin Injection in Postsurgical Pain Management: A Literature Review.

Postoperative pain remains a significant challenge in surgical services, which necessitates improving analgesic strategies to enhance patient outcomes. Botulinum neurotoxin (BoNT), which was primarily approved for the treatment of strabismus and blepharospasm, has demonstrated a promising impact on pain reduction through mechanisms such as neurotransmitter inhibition, receptor modulation, glial activity suppression, and interactions with opioidergic and GABAergic systems. A number of studies have investigated BoNT's impact on postsurgical pain. However, there is a lack of evaluation of its efficacy, safety, and optimal administration protocols across different surgical settings. This study aims to provide a comprehensive overview of the existing literature on the efficacy and complications of intra- and postoperative BoNT injections in managing postsurgical pain across various surgical procedures, including orthopedic and head and neck surgeries, mastectomy, hemorrhoidectomy, and fissurectomy.