Efficacy and adverse effects of intravenous lignocaine therapy in fibromyalgia syndrome

BACKGROUND: To investigate the effects of intravenous lignocaine infusions (IV lignocaine) in fibromyalgia. METHODS: Prospective study of the adverse effects of IV lignocaine in 106 patients with fibromyalgia; retrospective questionnaire study of the efficacy of IV lignocaine in 50 patients with fibromyalgia. RESULTS: Prospective study: Two major (pulmonary oedema and supraventricular tachycardia) and 42 minor side-effects were reported. None had long-term sequelae. The commonest was hypotension (17 cases). Retrospective study: Pain and a range of psychosocial measures (on single 11-point scales) improved significantly after treatment. There was no effect of the treatment on work status. The average duration of pain relief after the 6-day course of treatment was 11.5 ± 6.5 weeks. CONCLUSIONS: Intravenous lignocaine appears to be both safe and of benefit in improving pain and quality of life for patients with fibromyalgia. This needs to be confirmed in prospective randomised controlled trials

Efeito da acupuntura na melhora da dor, sono e qualidade de vida em pacientes fibromiálgicos: estudo preliminar Effect of acupuncture on pain, sleep and quality of life improvement in fibromyalgia patients: preliminary study

A fibromialgia é uma síndrome definida por dor crônica generalizada e em pelo menos 11 dos 18 tender points, pontos dolorosos específicos. Este ensaio clínico randômico visou verificar a eficácia da acupuntura na melhora da dor, sono e qualidade de vida de pacientes fibromiálgicas. Dentre 20 mulheres com média de idade 44 anos, com diagnóstico de fibromialgia segundo critérios do Colégio Americano de Reumatologia, finalizaram o estudo 12, distribuídas aleatoriamente em dois grupos: A (GA, n=5), que recebeu acupuntura segundo a medicina tradicional chinesa; e B (GB, n=7), que teve a inserção de agulhas nos tender points base do occipital, trapézio, supraespinhoso e epicôndilo lateral. A dor foi avaliada por escala visual analógica e dolorimetria; o sono, pelo Inventário do Sono; e a qualidade de vida, pelo Questionário de Impacto da Fibromialgia (QIF). Os grupos receberam acupuntura uma vez por semana, durante oito semanas, com inserção de oito agulhas por 25 minutos. Os dados foram tratados estatisticamente, adotando-se o nível de significância ±=0,05. No GA, houve melhora estatisticamente significante do sono; e no GB, na dor, limiar de dor nos tender points, no sono e nos itens do QIF dor, cansaço matinal, ansiedade e depressão (p<0,05). Os resultados sugerem que a acupuntura, especialmente com inserção de agulhas nos tender points, promove a diminuição da dor e melhora da qualidade de vida e do sono em indivíduos com fibromialgia.<br>Fibromyalgia is a syndrome defined by chronic widespread pain and sensitivity to pressure at at least 11 of 18 tender points. The aim of this random blind clinical trial was to assess the effectiveness of acupuncture on pain relief, on quality of sleep and life in fibromyalgia patients. From 20 female fibromyalgic patients (diagnosed according to the American College of Rheumatology), mean aged 44 years, 12 completed the study, randomly assigned into two groups: group A (GA, n=5) received acupuncture according to the traditional Chinese medicine; and group B (GB, n=7) received acupuncture at eight tender points: at the occiput, trapezius muscle, supraspinatus muscle, and lateral epicondyle. Pain was assessed by a visual analogue scale and by dolorimetry; quality of life, by the Fibromyalgia Impact Questionnaire (FIQ); and sleep, by the Post Sleep Inventory. Both groups received acupuncture once a week for eight weeks, with insertion of eight needles for 25 minutes. Data were statistically analysed and significance level set at ±=0.05. Results show significant sleep improvement in GA; and, in GB, lesser pain as detected by VAS, higher pain threshold on tender points, better sleep and improvement in FIQ items pain, morning tiredness, anxiety, and depression (p<0.05). These data suggest that acupuncture, especially that with tender point needle insertion, provides pain relief, better quality of life and of sleep in fibromyalgic patients