[Contralateral local anesthesia in stump, phantom and post-traumatic pain].
[Contralateral local anesthesia in stump, phantom and post-traumatic pain].
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残肢痛、幻肢痛和创伤后痛的对侧局部麻醉[J].
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发表时间：
1984
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影响因子：
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通讯作者：
D. Gross
中科院分区：
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作者：
D. Gross
在慢性（n = 42）和急性（n = 8）疼痛综合征患者中采用单侧局部麻醉（见表1）。I.幻肢和残端痛：n = 10; II.面部和耳部疼痛：n = 10; III.颈部和躯干疼痛：n = 14; IV.髋关节疼痛：n = 6; V.四肢疼痛：n = 10：Sa。= 50例患者。其中包括n例急性疼痛综合征：I.：n = 0; II.：n = 1; III.：n = 1; IV.：n = 1; V.：n = 5（Sa.：n = 8）。对42例慢性疼痛综合征患者采用对侧局部麻醉（CLA）治疗。27例患者中，CLA对慢性疼痛显示出明显的效果，8例患者疼痛缓解超过50%，15例患者疼痛缓解小于50%。3例患者再次出现疼痛症状。CLA对12例患者无任何积极影响。两组的治疗频率中位数为5 - 6次。平均治疗时间分别为6个月和7个月。在8例急性疼痛综合征的患者中，对侧局部麻醉产生了以下结果：6例患者永久性地从疼痛中解脱出来; 2例患者的CLA仍然没有任何成功。平均治疗次数为1.25次，平均观察时间为2.3个月。因此，我们建议在急性或慢性创伤后或术后疼痛综合征中应尽早使用CLA。对侧疼痛治疗对对侧急性和慢性疼痛状况的影响是可以肯定的，其机制仍有待澄清。显然，可以从对侧对外周、脊髓、网状和丘脑区域施加抑制影响，这可以导致对侧的急性和慢性疼痛状况的消失。根据我们的经验，除了创伤性损伤之外，脊髓神经系统必须是完整的，并且疼痛综合征不是由精神障碍维持的。
Contralateral local anaesthesia was employed in patients with chronic (n = 42) and acute (n = 8) pain syndromes (see Table 1). I. Phantom limb and stump pain: n = 10; II. Pain of face and ear: n = 10; III. Pain of neck and trunk: n = 14; IV. Pain of the hip joint: n = 6; V. Pain of the extremities: n = 10: Sa. = 50 patients. Among these were n acute pain syndromes: I.: n = 0; II.: n = 1; III.: n = 1; IV.: n = 1; V.: n = 5 (Sa.: n = 8). 42 patients with chronic pain syndromes were treated with contralateral local anaesthesia (CLA). In 27 patients CLA displayed a clear effect upon the chronic pain; in 8 patients pain release was more than 50%, in 15 patients pain release was less than 50%. 3 patients relapsed into their former condition of pain. CLA was without any positive influence in 12 cases. The medium frequency of treatments was between 5 and 6 in both groups. The average time of treatment amounted to 6 and 7 months respectively. In 8 patients with acute pain syndromes contralateral local anaesthesia produced the following results: 6 patients were permanently released from their pain; in 2 patients CLA remained without any success. The average frequency of treatment was 1.25; the average time of observation was 2.3 months. Hence we suggest that CLA should be employed as early as possible in acute or chronic posttraumatic or postoperative pain syndromes. The influence of contralateral pain therapy on acute and chronic pain conditions of the opposite side can be affirmed; its mechanism remains to be clarified. Obviously it is possible to exert an inhibitory influence from the contralateral side upon peripheral, spinal, reticular and thalamic regions, which can lead to the extinction of acute and chronic pain conditions on the opposite side. According to our experiences it is necessary that the cerebro-spinal nerve system - apart from the traumatic lesion - is intact and that the pain syndrome is not maintained by a psychic disturbance.