Effect of local anesthesia on atypical odontalgia - A randomized controlled trial
2006 (English)In: Pain, ISSN 0304-3959, Vol. 122, no 3, 306-314 p.Article in journal (Refereed) Published
The aim of the study was to evaluate the analgesic effect of lidocaine in a double-blind, controlled multi-center study on patients with atypical odontalgia (AO) - a possible orofacial neuropathic pain condition. Thirty-five consecutive AO patients (range 31-81 years) with a mean pain duration of 7.2 years (range 1-30 years) were recruited from four different orofacial pain clinics in Sweden. In a randomized cross-over design, 1.5 ml local anesthesia (20 mg/ml lidocaine and 12.5 μg/ml adrenaline) or 1.5 ml saline (9 mg/ml NaCl solution) (placebo) was injected to block the painful area. The VAS pain scores showed an overall effect of time (ANOVA: P < 0.001) and treatment (ANOVA: P = 0.018) with a significant interaction between the factors (ANOVA: P < 0.001). Overall, VAS pain relief was significantly greater at 15-120 min following the lidocaine injections compared to the placebo injections (Tukey: P < 0.05). All patients demonstrated significant disturbances in somatosensory function on the painful side compared to the non-painful side as revealed by quantitative sensory tests, however, only one significant inverse correlation was found between percentage pain relief and the magnitude of brush-evoked allodynia (Spearman: P < 0.01). In conclusion, AO patients experienced significant, but not complete, pain relief from administration of local anesthetics compared with placebo. The findings indicate that the spontaneous pain in AO patients only to some extent is dependent on peripheral afferent inputs and that sensitization of higher order neurons may be involved in the pathophysiology of AO. © 2006 International Association for the Study of Pain.
Place, publisher, year, edition, pages
2006. Vol. 122, no 3, 306-314 p.
Atypical facial pain; Lidocaine; Neuropathic pain; RCTM; Trigeminal pain mechanisms
National CategoryMedical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-36274DOI: 10.1016/j.pain.2006.02.005Local ID: 30785OAI: oai:DiVA.org:liu-36274DiVA: diva2:257122