McGrath Patricia A, Sharav Yair, Dubner Ronald, Gracely Richard H
Neurobiology and Anesthesiology Branch, National Institute of Dental Research, National Institutes of Health, 9000 Rockville Pike, Bethesda, Md. 20205 U.S.A.
Pain. 1981 Feb;10(1):1-17. doi: 10.1016/0304-3959(81)90041-5.
The masseter inhibitory period and sensations evoked by electrical tooth pulp stimulation were assessed in 30 human subjects. Five intensities of electrical stimuli, producing sensations varying from below sensory detection threshold to suprathreshold pain, were applied to upper central incisors. At each stimulus intensity a train of 30, 1-msec, cathodal pulses with an interpulse interval of 2 sec was applied. The averaged masseter activity evoked by the 30 pulses at a fixed stimulus intensity was compared to the quality of the sensation elicited. The threshold for the masseter inhibitory period coincided approximately with an individual's detection threshold for the tooth pulp stimulation. Three configurations of masseter inhibitory periods (single, double and merged) were produced by different stimulus intensities. However, no particular configuration was associated unequivocally with pain sensation. Increases in stimulus intensity evoked changes both in the configuration of the masseter inhibitory period and in the quality of the sensation produced. Chi square analyses showed significant, but progressively weaker, associations between: (1) masseter inhibitory period configuration and stimulus intensity; (2) quality of sensation and stimulus intensity; and (3) quality of sensation and masseter inhibitory period configuration. The weakness of the association between the quality of sensation and masseter inhibitory period configuration also was demonstrated in a double-blind study of the effects of a narcotic analgesic, fentanyl. Although the strengths of non-pain and pain sensations were reduced significantly after fentanyl, there were no changes in the masseter inhibitory periods.
在30名人类受试者中评估了咬肌抑制期以及电刺激牙髓所诱发的感觉。将五种强度的电刺激施加于上颌中切牙,这些刺激产生的感觉从低于感觉检测阈值到阈上疼痛不等。在每个刺激强度下,施加一串30个1毫秒的阴极脉冲,脉冲间隔为2秒。将固定刺激强度下30个脉冲诱发的平均咬肌活动与所诱发感觉的性质进行比较。咬肌抑制期的阈值大约与个体对牙髓刺激的检测阈值一致。不同的刺激强度产生了三种咬肌抑制期构型(单一、双重和合并)。然而,没有一种特定构型与疼痛感觉明确相关。刺激强度增加会引起咬肌抑制期构型以及所产生感觉性质的变化。卡方分析表明,在以下方面存在显著但逐渐减弱的关联:(1)咬肌抑制期构型与刺激强度;(2)感觉性质与刺激强度;(3)感觉性质与咬肌抑制期构型。在一项关于麻醉性镇痛药芬太尼作用的双盲研究中也证实了感觉性质与咬肌抑制期构型之间关联的薄弱性。尽管芬太尼给药后非疼痛和疼痛感觉的强度显著降低,但咬肌抑制期没有变化。