Clinical Biomechanics and Ergonomics Research Center, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Islamic Republic of Iran.
Department of Physiotherapy, Faculty of Rehabilitation, Semnan University of Medical Sciences and Health Services, Semnan, Islamic Republic of Iran.
Scand J Pain. 2021 Mar 10;21(4):707-715. doi: 10.1515/sjpain-2020-0154. Print 2021 Oct 26.
Granisetron and lidocaine injections have been used for the management of myofascial pain syndrome. This study was aimed to compare the efficacy of granisetron and lidocaine injections to trigger points of upper trapezius in the management of myofascial pain syndrome.
We performed a double-blind randomized clinical trial in an outpatient clinic of physical medicine and rehabilitation at a teaching hospital. A total of 40 patients aged ≥18 with neck pain due to myofascial pain syndrome were included. They had pain for at least one month with the intensity of at least 30 mm on a 100 mm visual analog scale. Each participant received a single dose of 1 mL lidocaine 2% or 1 mg (in 1 mL) granisetron. The solutions were injected into a maximum of three trigger points of the upper trapezius. We instructed all patients to remain active while avoiding strenuous activity for three or four days, and to perform stretch exercise and massage of their upper trapezius muscles. We assessed the patients before the interventions, and one month and three months post-injection. The primary outcome was the Neck Disability Index and the secondary outcome was the Neck Pain and Disability Scale.
Both interventions were successful in reducing neck pain and disability (all p-values <0.001). However, the neck pain and disability responded more favorably to lidocaine than granisetron (p=0.001 for Neck Disability Index, and p=0.006 for Neck Pain and Disability Scale). No significant side-effect was recognized for both groups.
Both lidocaine and granisetron injections to trigger points are effective and safe for the management of the syndrome and the benefits remain at least for three months. However, lidocaine is more effective in reducing pain and disability. The injections are well-tolerated, although a transient pain at the site of injections is a common complaint. One mL of lidocaine 2% is more effective than 1 mg (in 1 mL) granisetron for injecting into the trigger points of the upper trapezius in myofascial pain syndrome.
格拉司琼和利多卡因注射已被用于肌筋膜疼痛综合征的治疗。本研究旨在比较格拉司琼和利多卡因注射至上斜方肌触发点治疗肌筋膜疼痛综合征的疗效。
我们在一所教学医院的物理医学和康复门诊进行了一项双盲随机临床试验。共纳入 40 名年龄≥18 岁、因肌筋膜疼痛综合征而出现颈痛的患者。他们的疼痛至少持续一个月，视觉模拟评分（VAS）至少为 30mm。每位患者接受 1ml 2%利多卡因或 1mg（1ml）格拉司琼的单次剂量。将溶液注射到最多三个上斜方肌触发点。我们指导所有患者在三到四天内保持活动，避免剧烈活动，并进行上斜方肌伸展运动和按摩。我们在干预前、注射后一个月和三个月评估患者。主要结局是颈部残疾指数（NDI），次要结局是颈部疼痛和残疾量表（NPDS）。
两种干预措施均能有效减轻颈痛和残疾（p 值均<0.001）。然而，利多卡因比格拉司琼更能有效地减轻颈痛和残疾（NDI：p=0.001，NPDS：p=0.006）。两组均未发现明显的副作用。
利多卡因和格拉司琼注射至上斜方肌触发点治疗该综合征均有效且安全，疗效至少可维持三个月。然而，利多卡因在减轻疼痛和残疾方面更有效。注射后，虽然注射部位有短暂疼痛，但患者通常能耐受。1ml 2%利多卡因比 1mg（1ml）格拉司琼更有效地注射至上斜方肌触发点治疗肌筋膜疼痛综合征。
