PAIN CONTROL IN RECOVERING ALCOHOLICS - EFFECTS OF LOCAL-ANESTHESIA

Objective: The medical literature suggests that alcoholics may present greater challenges to achieving clinical pain control than nonalcohol ics. This study was undertaken to test the hypotheses that: (1) signif icant differences exist between alcoholics and nonalcoholics on detect ion and pain thresholds during electric tooth stimulation; (2) group d ifferences exist in the depth and time course of pulpal anesthesia; an d (3) responses to tooth stimulation are associated with severity of a lcoholism and/or other psychological factors. Method: Male alcoholics (n = 22) in aftercare treatment (mean length of sobriety = 113 days) a nd age-matched nonalcoholics (n = 22) received 1.0 ml of 3% mepivicain e at the apex of a maxillary lateral incisor and saline placebo at the of the contralateral incisor. Results: At baseline no group differenc es were found on sensory thresholds. During drug intervention signific ant drug and time effects for both detection threshold (p <.0001) and pain threshold (p <.0001) were found, but group differences and intera ctive effects were not significant. By exploratory regression analysis of alcoholic subjects, history of depression/unhappiness was signific antly associated with shallower pulpal anesthesia, whereas high need f or control/low actual control and frequency of treatment for detoxific ation were associated with deeper anesthesia. Conclusions: Our finding s suggest alcoholics in recovery are not at increased risk for inadequ ate pain control with local anesthesia.