Reduction in maximum pain after surgery in temporomandibular joint patients is associated with decreased beta-endorphin levels - a pilot study

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• 作者：A. Feldreich¹ ; ^{anna.feldreich@ki.se} ; M. Ernberg² ; A. Rosé ; n³
• 关键词：central sensitization ; beta-endorphin ; pain intensity ; discectomy
• 刊名：International Journal of Oral and Maxillofacial Surgery
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：46
• 期：1
• 页码：97-103
• 全文大小：477 K
• 卷排序：46

文摘

The mechanisms of relief from persistent pain after temporomandibular joint (TMJ) surgery are not well studied. It was hypothesized that if persistent pain is relieved by TMJ surgery, up-regulated parts of the central nervous system will be desensitized and the neuroendocrine opioid release will decrease back to normal levels. Eleven female patients with a mean age of 47.4 ± 19.4 years and with TMJ pain due to chronic closed lock were examined before and 6–24 months after TMJ discectomy. The effects on plasma β-endorphin levels, pain intensity, and pain thresholds were analyzed. Plasma β-endorphin levels (P = 0.032), pain at rest (P = 0.003), and movement-evoked pain (P = 0.008) were all significantly reduced at follow-up. The reduction in plasma β-endorphin levels correlated with a reduction in maximum pain intensity (P = 0.024) and with a longer time after surgery (P = 0.041). Seven out of eight patients who reported a substantial reduction in maximum pain intensity presented a decrease in β-endorphin levels in the plasma. In conclusion, this pilot study showed a significant reduction in plasma β-endorphin levels and pain intensity at 6–24 months after TMJ surgery; plasma β-endorphin levels were correlated with time after surgery. However, the results must be interpreted with caution since this was a single-centre observational study with a small sample size. If replicated in larger sample sets, the measurement of β-endorphin levels may be of prognostic value for the treatment outcome.