title: A Comparative Pilot Study to Evaluate the Adjunctive Role of Levosulpride with Trigger Point Injection Therapy in the Management of Myofascial Pain Syndrome of Orofacial Region.
abstract: OBJECTIVE
  To evaluate the effect of therapy with levosulpride combined with conventional trigger point injection therapy in terms of pain and depression in the chronic myofascial pain syndrome patients.
  
  
  METHODS
  This was a comparative prospective study in which subjects with at least one trigger point and symptom duration of at least 3 months were recruited and randomized into two groups. Group A subjects received trigger point injections with 0.5 % bupivacaine and tablet levosulpride and group B received trigger point injections and a placebo. Subjects were assessed for pain with visual analog scale (VAS) and depression with Beck's depression inventory (BDI) at the follow-up periods of 1, 4, 6 and 12 weeks. The treatment effect was measured in terms of mean difference of BDI and VAS scores at various studied intervals from the baseline values.
  
  
  RESULTS
  The sample was composed of 15 subjects with 8 in group A (6 females and 2 males, with a mean age of 41.88 ± 15.13 years, disease duration of 12.37 ± 16.11 months) and 7 in group B (6 females and 1 male, with a mean age of 43.86 ± 12.34 years, disease duration of 9.64 ± 9.34 months). The mean baseline VAS score and BDI score was 6.75 ± 1.03 in group A and 6.86 ± 1.06 in group B and 24.25 ± 10.20 in group A and 24.43 ± 11.16 in group B respectively. The mean difference of VAS scores at 12th week interval from the baseline values was highly significant. Although the mean difference of VAS scores at all the other intervals and mean difference of BDI scores at all the intervals was statistically nonsignificant, there was improvement in the mean differences at all the follow-up intervals in terms of both pain as well as depression.
  
  
  CONCLUSIONS
  The combined therapy with conventional trigger point injection and levosulpride as antidepressant significantly reduce pain and depression in the study subjects suffering from chronic myofascial pain with moderate to severe depression in the orofacial region.
authors.affiliation: Department of Oral and Maxillofacial Surgery, PGIDS, Pt. B.D. Sharma University of Health Sciences, Rohtak, 124001 Haryana India.
authors.forename: Pranav
authors.initials: P
authors.lastname: Gupta
authors.affiliation: Department of Oral and Maxillofacial Surgery, PGIDS, Pt. B.D. Sharma University of Health Sciences, Rohtak, 124001 Haryana India.
authors.forename: Virendra
authors.initials: V
authors.lastname: Singh
authors.affiliation: Department of Psychiatry, PGIMS, Pt. B.D. Sharma University of Health Sciences, Rohtak, 124001 Haryana India.
authors.forename: Sujata
authors.initials: S
authors.lastname: Sethi
authors.affiliation: Department of Community Medicine, SKHM Medical College, Mewat, Haryana India.
authors.forename: Arun
authors.initials: A
authors.lastname: Kumar
keywords: Myofascial pain syndrome; Orofacial pain; Trigger points