Estudio Comparativo entre la Técnica de Anestesia Local Controlada por Computador y la Técnica de Anestesia Local Convencional / Comparative Study Between the Conventional Local Anesthetic Technique and the Computer-controlled Local Anesthetic

El control del dolor es uno de los aspectos más importantes para propiciar al paciente un comportamiento positivo en la consulta odontológica. Sin embargo, esto aún constituye un desafío para el cirujano dentista cuando trata pacientes ansiosos, ya que la administración de la anestesia local es lo que determina que muchos pacientes eviten el tratamiento odontológico. Con el propósito de disminuir la sensación dolorosa en pacientes y promover mayor comodidad, los profesionales han desarrollado un método de anestesia computarizada. El objetivo de esta investigación fue comparar la técnica de anestesia local convencional con la técnica de anestesia local controlada por computador. Participaron 30 pacientes voluntarios adultos que tenían indicación para exodoncia de terceros molares inferiores de ambos lados. Los pacientes, elegidos de forma aleatoria, fueron sometidos a las dos técnicas anestésicas mencionadas (convencional y controlada por computador). Aunque el grado de satisfacción de los profesionales con la técnica anestésica controlada por computador fue significativa, la mayoría declaró preferir el método convencional. No hubo cambios hemodinámicos significativos en cualquiera de los dos métodos utilizados en este estudio. La técnica anestésica controlada por computador se mostró sencilla, eficaz y segura. Los pacientes que participaron en este estudio respondieron mejor al método de anestesia controlada por computador, reportando menos dolor.

Pain control is one of the most important aspects contributing that the patient has a positive behavior in the dental office. However, this still constitutes a challenge for the dentist when treating anxious patients, because the administration of local anesthesia is the cause of many patients to avoid dental treatment. With the purpose of reducing pain sensation for patients and promote greater comfort for patients and professionals was developed a computerized anesthesia injection method. The aim of this investigation was to compare the conventional local anesthetic technique with the computer-controlled local anesthetic. Participated in this study 30 volunteers patients who had indication for bilateral surgical extraction of lower third molars. The patients, randomly selected, were subjected to each of the two mentioned anesthetic techniques (conventional and computer-controlled). Although the degree of professional satisfaction with the computer-controlled local anesthetic technique has been significant, the most of them reported to prefer the conventional method. There was no significant hemodynamic changes in any of the two methods used in this study. The computer-controlled local anesthetic technique was simple, effective and safe. The patients enrolled in this study responded better to the computer-controlled local anesthetic technique, reporting less pain.

Massaging over the greater occipital nerve reduces the intensity of migraine attacks: evidence for inhibitory trigemino-cervical convergence mechanisms

Activation of the trigemino-cervical system constitutes one of the first steps in the genesis of migraine. The objective of this study was to confirm the presence of trigemino-cervical convergence mechanisms and to establish whether such mechanisms may also be of inhibitory origin. We describe a case of a 39-years-old woman suffering from episodic migraine who showed a significant improvement in her frontal headache during migraine attacks if the greater occipital nerve territory was massaged after the appearance of static mechanical allodynia (cortical sensitization). We review trigemino-cervical convergence and diffuse nociceptive inhibitory control (DNIC) mechanisms and suggest that the convergence mechanisms are not only excitatory but also inhibitory.

Ativação do sistema trigemino-cervical constitui um dos primeiros passos na gênese da crise de migrânea. O objetivo do estudo foi descrever um caso clínico que sugere a existência de mecanismos de convergência trigemino-cervical (CTC) e que esses possam ser do tipo inibitórios. Nós descrevemos o caso de mulher de 39 anos com migrânea episódica que mostrou significante melhora em sua cefaléia frontal durante suas crises quando realizava massagem sobre o território do nervo occipital maior ipsilateral a dor. A melhora clínica só ocorria quando a paciente apresentava alodinia mecânica estática (sensibilização cortical). Neste estudo nós revisamos os conceitos de CTC e de mecanismos de controle inibitório nociceptivo difuso (MCIN), sugerindo que este último é um elemento comprobatório da presença de CTC do tipo inibitório durante as crises de migrânea.