P-3-07-09
Auriculotemporal nerve block like diagnostic test in Myofascial pain disfunction syndrome with origin at temporomandibular joint.
L. C. Dominguez. (Guanajuato University, Leon, Mexico).
We evaluated 100 selectionated patients of Myofascial pain disfunction syndrome (MPDS) with origin at temporomandibular joint (TMJ) in a randomised double blind crossover study, with infiltration of auriculo-temporal nerve with either mepivacaine or normal saline solution in aleatory way. Sample characteristics were: 100 women, age mean 25 years (range 17-36); evaluated by phisiatrist, neurologist and dentist to discard others pathologys; all of them presented the next inclusion criteria: unilateral pain with localization on temporo/cervical zones, pain intensity on analogue visual scale (0-10) upper of 7; evolution time of one year, with sleep and emotional problems; trigger points on TMJ and pterigoid internal muscle, joint click in opening and/or close mouth; bucal opening limited under 38 nun. (digital Vernier measure).
Results: The group who recibed mepivacaine (n=34) showed disappear of pain in 88% of cases and bucal opening was incremented in 90% of them; the group with saline solution did not show changes in pain in 40 cases (75%) and just 9 patients presented bucal opening increment upper of 40 mm.
Conclusion: The auriculotemporal nerv block has utility to confirm the diagnostic of MPDS with origin at TMJ. p 0.05.
P-3-07-10
USE OF SYNTHETIC ENKEPHALIN ANALOG DALARGIN IN CHRONIC PAIN
Zoloyev G.K., Filatov Y.V., Leontier M.A., Khvostova L.A., (Orthopaedic Centre for Rehabilitation of Disabled People, Novokuznetsk, Russia)
Aim of the study was to investigate analgetic properties of enkephalin analog Dalargin in patients with persistent pain syndrome.
We observed 283 patients with severe chronic ischemia of the lower extremity. Dalargin was injected i.v. or i.a. in the single dose of 2.0-5.0mg every 24 hour during 7-10 days along with the infusion of isotonic solution 400mi. Other drugs were not administered during the study. In 64 % a decrease of pain at rest and by exertion was accompanied with marked improvement of peripheral hemodynamics and regression of ischemia signs. We surmise that Dalargin efficacy is not attributed to the direct analgetic effect but possibly resulted from its vasoactive effect due to what ischemia is arrested.
There were seventeen patients with spinal pain syndrome following trauma or vascular disease of spinal cord involved in the study in whom after i.v. or i.m. injections of Dalargin, however, no analgetic effect was observed and it did not influence the consumption of other analgetics. But, 9 patients who were subarachnoidly injected with Dalargin 1.0-1.5mg demonstrated stable analgetic effect and decrease of spasticity. Regression of neurologic signs was observed in 2 patients.
Thus, we conclude that Dalargin may be considered a drug of choice for management of chronic pain but it is necessary to evaluate indications and ways for its administration.
