Document Detail


Effect of a preemptive femoral nerve block on cytokine release and hyperalgesia in experimentally inflamed skin of human volunteers.
MedLine Citation:
PMID:  20975465     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: Tissue injury is associated with the local release of inflammatory and nociceptive mediators and the development of hyperalgesia. It is unclear whether interrupting neuronal signaling using regional anesthetic techniques at the time of the injury modifies local nociceptive and inflammatory processes. The aim of this study was to determine whether a peripheral nerve block at the time of tissue injury could modify the development of wound hyperalgesia and the local release of inflammatory and nociceptive mediators.
METHODS: Twelve healthy volunteers participated in this controlled, crossover, randomized study. A femoral nerve block or a sham block was established before inducing an experimental UVB burn on the thigh. Twenty-four hours later, the interstitial wound fluid was sampled, and mechanical and heat pain thresholds were assessed. Wound fluid concentrations of an array of cytokines, chemokines, nerve growth factor, prostaglandin E2, and substance P were determined.
RESULTS: Skin inflammation was associated with the release of inflammatory and nociceptive mediators and resulted in significant tissue hyperalgesia (P < 0.001). However, the presence of a fully established peripheral nerve block at the time of tissue injury did not alter the development of hyperalgesia after regression of the block. Similarly, the presence of a peripheral nerve block did not modify the release of inflammatory or nociceptive mediators.
CONCLUSIONS: These findings suggest that a preemptive, single-shot peripheral nerve block minimally affects wound hyperalgesia and inflammation. Continuous nerve block techniques may be better suited to alter nociceptive and inflammatory events in wounds beyond the duration of the block.
Authors:
Brendan Carvalho; Pedram Aleshi; Damian J Horstman; Martin S Angst
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Regional anesthesia and pain medicine     Volume:  35     ISSN:  1532-8651     ISO Abbreviation:  Reg Anesth Pain Med     Publication Date:    2010 Nov-Dec
Date Detail:
Created Date:  2010-10-26     Completed Date:  2011-02-03     Revised Date:  2012-01-31    
Medline Journal Info:
Nlm Unique ID:  9804508     Medline TA:  Reg Anesth Pain Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  514-9     Citation Subset:  IM    
Affiliation:
Department of Anesthesia, Stanford University School of Medicine, Stanford, CA 94305, USA. bcarvalho@stanford.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Cross-Over Studies
Cytokines / metabolism*
Femoral Nerve*
Hot Temperature
Humans
Hyperalgesia / immunology,  physiopathology,  prevention & control*
Inflammation Mediators / metabolism*
Microdialysis
Nerve Block / methods*
Pain Measurement
Pain Threshold
Physical Stimulation
San Francisco
Sunburn / immunology,  physiopathology,  therapy*
Thigh
Time Factors
Treatment Outcome
Young Adult
Chemical
Reg. No./Substance:
0/Cytokines; 0/Inflammation Mediators
Comments/Corrections
Comment In:
Reg Anesth Pain Med. 2011 Jan-Feb;36(1):4-6   [PMID:  21455081 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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