Quantitative and selective evaluation of differential sensory nerve block after transdermal lidocaine
Quantitative and selective evaluation of differential sensory nerve block after transdermal lidocaine
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DOI：
10.1213/01.ane.0000093232.72967.76
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发表时间：
2004-01-01
影响因子：
5.7
通讯作者：
Sumikawa, K
中科院分区：
文献类型：
--
作者：
Sakai, T;Tomiyasu, S;Sumikawa, K
我们在15名健康志愿者身上评价了利多卡因透皮贴剂对差别感觉神经阻滞的影响。将10%利多卡因凝胶局部应用于前臂，并用塑料膜覆盖。三种类型的感觉神经纤维（Abeta，Adelta和C纤维）进行了评估与一系列的2000-，250-和5-Hz的刺激，使用电流感知阈值（CPT）测试。还测量了触觉、针刺、冷和热的感觉。这些测量在局部利多卡因（基线）之前、铺巾后60 min（T0）以及T0后1 h至5 h（T1至T5）间隔进行。与基线相比，观察到CPT显著增加，直至T2（5 Hz）和T4（250 Hz），而在整个研究期间，CPT在2000 Hz下持续增加。在研究期间，所有受试者都经历了针刺感和冷感的消失，而触摸和温暖的感觉是可检测的。我们的结论是，当利多卡因经皮应用时，神经对局麻药的敏感性与轴突直径成正比。然而，针刺感和冷感比受体部位的其他感觉受到的影响更强烈。
We evaluated the effect of transdermal lidocaine on differential sensory nerve block in 15 healthy volunteers. Lidocaine 10% gel was applied topically to a forearm and covered with a plastic film. Three types of sensory nerve fibers (Abeta, Adelta, and C fibers) were evaluated with a series of 2000-, 250-, and 5-Hz stimuli using current perception threshold (CPT) testing. Sensations of touch, pinprick, cold, and warmth were also measured. These measurements were made before the topical lidocaine (baseline), 60 min after the draping (T0), and at 1-h intervals until 5 h after T0 (T1 to T5). A significant increase in CPT compared with baseline was observed until T2 at 5 Hz and T4 at 250 Hz, whereas the increase in CPT at 2000 Hz continued throughout the study period. All subjects experienced the disappearance of pinprick and cold sensations, whereas touch and warmth sensations were detectable during the study period. We conclude that when lidocaine is applied transdermally, the sensitivity of nerves to local anesthetics is proportional to the axon diameters. However, pinprick and cold sensation are affected more strongly than other sensations at receptor sites.