Objectives

There are many treatment modalities for myofascial pain, and recent findings reported in the literature highlight the superiority of using local anesthetics as the treatment of choice. The objective of the present study was to compare the effectiveness of two of the most used local anesthetic agents—lidocaine and mepivacaine—in the management of myofascial pain.

Materials and methods

Thirty patients (20 females, 10 males) were randomly assigned to one of two groups: 50% received lidocaine and 50% received mepivacaine. Trigger point injections in the orofacial region were administered 4 times, 10 days between each injection, with 4 weeks of follow-up after the end of the treatment course. Pain levels were recorded using a visual analog scale (VAS) at the time of follow-up and 30 min after injection.

Results

All patients exhibited statistically significant improvement when comparing pre- and post-treatment mean values. Both local anesthetics (i.e., lidocaine and mepivacaine) were similarly effective for the management of myofascial pain (p = 0.875). The mepivacaine-treated group exhibited significantly lower post-injection tenderness than the lidocaine group (p = 0.038). There was no relationship between sex and treatment response. Female and male patients both reported similar responses in terms of VAS scores (p = 0.818).

Conclusion

No drug was superior in the long term; thus, the clinician’s choice can be based on drug availability and patient medical history.

中文翻译：

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利多卡因与甲哌卡因治疗肌筋膜疼痛的疗效对比

目标

肌筋膜疼痛有多种治疗方式，最近文献报道的研究结果强调了使用局部麻醉剂作为首选治疗的优越性。本研究的目的是比较两种最常用的局部麻醉剂——利多卡因和甲哌卡因——在治疗肌筋膜疼痛方面的有效性。

材料和方法

30 名患者（20 名女性，10 名男性）被随机分配到两组中的一组：50% 接受利多卡因，50% 接受甲哌卡因。口面部触发点注射4次，每次注射间隔10天，疗程结束后随访4周。在随访时和注射后 30 分钟使用视觉模拟量表 (VAS) 记录疼痛水平。

结果

在比较治疗前和治疗后的平均值时，所有患者都表现出统计学上的显着改善。两种局部麻醉剂（即利多卡因和甲哌卡因）在治疗肌筋膜疼痛方面同样有效（p = 0.875）。与利多卡因组相比，甲哌卡因治疗组的注射后压痛显着降低（p = 0.038）。性别与治疗反应之间没有关系。女性和男性患者在 VAS 评分方面都报告了相似的反应 (p = 0.818)。

结论

从长远来看，没有药物是优越的；因此，临床医生的选择可以基于药物可用性和患者病史。