Martin M D, Ramsay D S, Whitney C, Fiset L, Weinstein P
Department of Dental Public Health Sciences, University of Washington School of Dentistry, Seattle 98195, USA.
Anesth Prog. 1994;41(2):40-7.
Pain can be influenced by both pharmacologic and psychologic factors. The purpose of this study was to investigate the pharmacologic and psychologic factors. The purpose of this study was to investigate the pharmacologic and psychologic processes that may play a role when topical anesthesia is used to reduce the pain of dental injections. Subjects were assigned to one of two belief manipulation conditions: one-half of the subjects were led to believe they would receive a placebo, while the remaining subjects were told they would receive the active agent. In reality, all subjects received two separate injections at contralateral sites, one preceded by a placebo and the other by a 20% benzocaine gel. The order in which injections were given was associated with differences in pain report. Second injections were more painful than first injections. Whether injections were preceded by an active or placebo agent did not alter subjects' experienced pain. Likewise, the belief manipulation did not affect the pain report. However, subjects who believed they would receive the active agent anticipated significantly less pain than subjects who thought they would receive placebo. The widespread belief that topical anesthetics are effective at reducing injection pain may serve to reduce the anticipatory anxiety associated with an impending dental injection, thus making the injection experience less aversive.
疼痛会受到药理学和心理学因素的影响。本研究的目的是调查药理学和心理学因素。本研究的目的是调查在使用局部麻醉来减轻牙科注射疼痛时可能起作用的药理学和心理学过程。受试者被分配到两种信念操纵条件之一：一半受试者被引导相信他们会接受安慰剂，而其余受试者被告知他们会接受活性剂。实际上，所有受试者在对侧部位接受两次单独注射，一次注射前使用安慰剂，另一次注射前使用20%苯佐卡因凝胶。注射顺序与疼痛报告的差异有关。第二次注射比第一次注射更疼。注射前使用活性剂还是安慰剂并未改变受试者感受到的疼痛。同样，信念操纵也未影响疼痛报告。然而，相信自己会接受活性剂的受试者预期的疼痛明显少于认为自己会接受安慰剂的受试者。局部麻醉剂能有效减轻注射疼痛这一普遍观念可能有助于减少与即将进行的牙科注射相关的预期焦虑，从而使注射体验不那么令人厌恶。
