A Possible New Concept in the Mechanism of Action of Local Anesthesia

Maha T. Al–Saffar¹, Tahani A. AL-Sandook^1, and Mahmoud Y-Taha¹

¹Department of Dental Basic Science, College of Dentistry, Mosul University, Iraq

Cite this paper:
Maha T. Al–Saffar, Tahani A. AL-Sandook and Mahmoud Y-Taha. A Possible New Concept in the Mechanism of Action of Local Anesthesia. American Journal of Medical and Biological Research. 2013; 1(4):134-137. doi: 10.12691/ajmbr-1-4-5

Abstract

Background: Local anesthetics act by different mechanisms to produce their effects in control acute and chronic pain. Methods: A total of 22 patients (14 female, 8 male) who need tooth apisectomy under infiltration local anesthesia were examined in two situations: Before and after administration of local anesthesia. For all patients salivary sample has been collected by salivette to estimate the level of opiorphin using ELISA Kits, the pain was assessed after administration of local anesthesia using Visual Analogue Scale (VAS). Results: the results showed a significant differences of salivary opiorphin before and after administration of local anesthesia (5.96+5.38) ng/ml and (14.49±3.66) ng/ml respectively with p<0.05, the results also showed that the pain assessment by VAS was (0.831±0.4587) with inverse correlation between the VAS and salivary opiorphin levels but with no significant difference (p>0.05). Conclusions: local anesthetics (xylocaine 2%+adrenalin 1:80,000) used in apisectomy by infiltration technique produce a significant effects on salivary opiorphin (p<0.05) which may suggest a possible effects of local anesthetic on enkephalin pathway and the possibility of using this parameter for measurements of local anesthetic effects.

Keywords:
salivary opiorphin local anesthesia dental pain

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

Figures

References:

[1]	Gaffen AS, Haas DA. Survey of local anesthetic use by Ontario dentists. JCDA 2009;75 (9):649.
[2]	Heavner JE. Local anesthetics. Current Opinion in Anaesthesiology 2007; 20:336-342.
[3]	Malamend ST. (2013). Technique of maxillary anesthesia In Malamed ST. Hand book of local anesthesia. 6th edition .Mosby Elsevir Inc, New York, 2013.
[4]	Shaban B, Moradi E, Nejat AH. Hemodynamic effect of 2% lidocaine with 1:80,000 epinephrin infiltration in maxillofacial surgeries under general anesthesia. JDMT 2013;2(1):17-20.
[5]	Logothetis RM. (2011). Local anesthetic agent: A review of the current options for dental hygienistis. Journal of the California dental hygienists association 2011; 27(2):1-10.
[6]	Dufour E, Villard-Saussine S, Mellon V. Opiorphin secretion pattern in healthy volunteers: gender difference and organ specificity. Biochem Anal Biochem 2013; 2(3):2-11.
[7]	Monaco G, Dapril G, Tavern L. Mandibular third molar removal in young patients, an evaluation of 2 different flap designs. J Oral Maxillo Fac Surg, 2009; 67:15-21.
[8]	Martin W, Heymans M, Skorpil N. Can a single pain rating replace a multiple pain rating in third molar surgery studies. Int J Oral Maxillo Fac Surg 2012; 41:1010-1013.
[9]	Kanegane K, Penha S, Borsatti M. Dental anxiety in an emergency dental service.Rev Saude Publica 2003; 37:786-792.
[10]	Nater YM, Rohleder N, Gaab J. Human salivary alpha – amylase reactivity in a psychosocial stress paradiagn. Int J Psychophysiol 2005; 55(3):333-341.
[11]	Nayyar MS, Yates C. Bupivacaine as preemptive analgesia in third molar surgery, randomized control trail. Br J Oral Maxillo Fac Surg 2006; 44:501-503.
[12]	Brkljacic LL, Sabalic MM, Salaric II. Development and validation of a liquid chromatography- tandem mass spectrometry method for the quantification of opiorphin in human saliva. J Chromatogr B Analyt Technol Biomed Life Sci 2011; 879 (32):3920-3926.
[13]	Malamend SF. Buffering local anesthetics in dentistry. The pulse 2011; 44(1):8-9.
[14]	American Academy of Pediatric Dentistry AADP. Clinical guide lines in guideline on use of local anesthesia for pediatric patient 2009; 34(6):182-186.
[15]	Rougeot C, Robert F, Menz L. Systemically active human opiorphin is a potent yet non – addective analgesic without drug tolerance effects. Journal of Physiology and Pharmacology 2010; 61(4):483-490.
[16]	Wisner A, Dufour E, Messaoudi M. Human opiorphin, a natural antinociceptive modulator of opiod– dependent pathways .PNAS 2006;103(47):17979-17984.
[17]	Noble F, Banisadr G, Jardinand F. First discrete autoradiographic distribution of aminopeptidase N in various structures of rat brain and spinal cord using the selective iodinated inhibitor. Neuroscience 2001; 105:479-488.
[18]	Noble F, Roques BP. Protection of endogenous enkephalin catabolism as natural approach to novel analgesic and antidepressant drug. Expert Opin Ther Trget 2007; 11:145-159.
[19]	Pinto M, Rougeot C, Gracia L et. al. Proposed bioactive conformation of opiorphin, an endogenous dual APN/NEP inhibitor. Medicinal Chemistry 2012;3 (1):20-24.
[20]	Thanawala V, Kadam VJ, Ghosh R. Enkephalin inhibitors: potential agents for the management of pain .Current Drug Targets 2008; 9(10):887-894.