PAIN RESPONSES TO PERINEUROMAL INJECTION OF NORMAL SALINE, GALLAMINE, AND LIDOCAINE IN HUMANS
PAIN RESPONSES TO PERINEUROMAL INJECTION OF NORMAL SALINE, GALLAMINE, AND LIDOCAINE IN HUMANS
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DOI：
10.1016/0304-3959(89)90091-2
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发表时间：
1989-03-01
期刊：
影响因子：
7.4
通讯作者：
BURCHIEL, KJ
中科院分区：
文献类型：
--
作者：
CHABAL, C;JACOBSON, L;BURCHIEL, KJ
大鼠神经瘤已经显示出增加的自发活动的纤维，全身给予钾通道阻断剂，如四乙基氯化铵（TEA）和gallamine。神经瘤的形成和自发活动与大鼠的自切术和人类的疼痛有关。为了评估人类神经元对钾通道阻滞剂的化学敏感性，9名患有神经瘤疼痛的受试者以单盲方式接受了神经周注射生理盐水、加拉胺和利多卡因。氯化钠对控制疼痛水平没有影响，而加拉明显着增加，利多卡因显着降低疼痛从控制水平。4例伴有幻肢痛的患者中有3例在注射加拉明后疼痛加重。这些数据表明，外周输入在神经瘤和幻肢痛中起着调节作用，而不是孤立的作用。增加钾通道渗透性或减少钠内流的药物预计会减少感知疼痛。
Rat neuromas have shown an increase of spontaneously active fibers to systemically administered potassium channel blocking agents such as tetraethylammonium chloride (TEA) and gallamine. Neuroma formation and spontaneous activity have been associated with autotomy in rats and pain in humans. To evaluate the chemosensitivity of human neurons to potassium channel blocking agents, 9 subjects with neuroma pain underwent perineuromal injection in a single-blinded fashion of normal saline, gallamine, and lidocaine. Sodium chloride had no effect on control pain levels, while gallamine significantly increased and lidocaine significantly decreased pain from control levels. Three of 4 patients with accompanying phantom limb pain noted an increase in pain after the injection of gallamine. The data suggest that peripheral input plays a modulating but not solitary role in both neuroma and phantom limb pain. Agents which increase potassium channel permeability or decrease sodium influx would be predicted to decreased perceived pain.