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Anesth Analg 2004;98:248-251
© 2004 International Anesthesia Research Society

REGIONAL ANESTHESIA

Quantitative and Selective Evaluation of Differential Sensory Nerve Block After Transdermal Lidocaine

Tetsuya Sakai, MD, Shiro Tomiyasu, MD, Hiroyuki Yamada, MD, Takeshi Ono, MD, and Koji Sumikawa, MD

Department of Anesthesiology, Nagasaki University School of Medicine, Nagasaki, Japan

Address correspondence and reprint requests to Tetsuya Sakai, MD, Department of Anesthesiology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki-City, Nagasaki, 852-8501, Japan. Address e-mail to tscat{at}fb3.so-net.ne.jp

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 (Aß, A{delta}, 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.

IMPLICATIONS: We evaluated the effect of transdermal lidocaine on differential sensory nerve block in healthy volunteers. Our results show that the sensitivity of nerves to local anesthetics is proportional to the axon diameter.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2004 by the International Anesthesia Research Society.