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[Comparative study between botulin toxin and bupivacaine for triggering-points infiltration in chronic myofascial syndrome.].

BACKGROUND AND OBJECTIVES
There are controversies about the efficacy of botulin toxin as compared to local anesthetics for triggering-points infiltration. This study aimed at comparing the analgesic effect of botulin toxin and bupivacaine for triggering-points infiltration in chronic myofascial syndrome.


METHODS
Participated in this study 20 patients divided in two groups. G1 patients (n = 10) received 25U botulin toxin and G2 patients (n = 10) received 0.25% bupivacaine in one to three triggering-points, being 0.5 mL per point. Patients were weekly evaluated for 8 weeks. Orphenadrine (35 mg) and dipirone (300 mg) were associated every 8 hours and patients were submitted to transcutaneous electrical stimulation twice a week during 1 hour. Pain intensity was evaluated through verbal numeric scale and quality of analgesia was evaluated by patients in moments zero (before injection), 30 minutes after, and at 1, 2, 3, 4, 5, 6, 7 and 8 weeks. Results were submitted to statistical analysis (Mann-Whitney and Fisher Exact tests).


RESULTS
After 30 minutes, 1 and 4 weeks, pain intensity was lower for G1 as compared to G2. After 2, 3, 5, 7 and 8 weeks, there was no significant difference between groups. Quality of analgesia was considered better by G1 patients as compared to G2, except after 2 weeks.


CONCLUSIONS
Analgesic effect was better with botulin toxin (25U) as compared to 0.25% bupivacaine for triggering-points infiltration.