Altered perceptions after upper and lower extremity blocks: An initial investigation

被引:4
作者
Klein, SM
Dimitrov, D
Steele, SM
Nielsen, KC
Warner, DS
Martin, A
Pietrobon, R
机构
[1] Duke Univ, Med Ctr, Dept Anesthesiol, Div Neurosurg,Div Ambulatory Anesthesiol, Durham, NC 27710 USA
[2] Duke Univ, Med Ctr, Dept Surg, Div Neurosurg,Div Ambulatory Anesthesiol, Durham, NC 27710 USA
[3] Duke Univ, Med Ctr, Dept Surg, Durham, NC 27710 USA
关键词
anesthesia; regional; perception; central nervous system; plasticity;
D O I
10.1016/S1098-7339(03)00233-5
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Background and Objectives: Nerve blocks frequently produce unusual altered perceptions in the extremities. We examined perceptual changes experienced after peripheral blocks. Methods: Fifty consecutive patients having an upper or lower extremity block for surgery participated in this prospective study. Patients were divided into 2 groups: upper extremity (n = 20) and lower extremity (n = 30). Each group was asked a list of questions about perceptions of limb sensation, length, weight, and location and given a detailed 2-point discrimination test over the V-1-V-3 divisions of the trigeminal nerve prior to block and sedation. While the extremity was still blocked, the exam was repeated before postanesthesia care unit discharge. Results: in both groups, 98% of patients described altered limb perception. The perceptions in the upper extremity were: heaviness, 60%; numbness, 50%; warmth, 40%; pain, 30%; full or fat, 20%; floating, 5%; shorter, 0%; or thinner, 10%. The perceptions in the lower extremity were: numbness, 75%; heaviness, 46%; warmth, 33%; pain, 32%; full or fat, 36%; floating, 25%; shorter, 18%, or thinner, 7%. Upper extremity block patients were more likely to describe the limb as lighter (P < .0001); the lower extremity group was more likely to describe the limb as numb (P = .01) or floating (P = .0002). There was no difference in the ability to correctly identify the location of the limb between the groups. There was no difference in 2-point discrimination between each assessment for either group. Conclusion: The results of this study confirm and quantify the perceptions experienced by patients undergoing upper and lower extremity blocks. These perceptions are prevalent. This knowledge is helpful in providing patients with accurate preoperative preparation. Further investigation is warranted to determine the neurologic etiology of these observations.
引用
收藏
页码:433 / 438
页数:6
相关论文
共 13 条
  • [1] Birbaumer N, 1997, J NEUROSCI, V17, P5503
  • [2] GARRAGTHY R, 1990, SOC NEUR ABSTR, V16, P831
  • [3] The effect of tactile and visual sensory inputs on phantom limb awareness
    Hunter, JP
    Katz, J
    Davis, KD
    [J]. BRAIN, 2003, 126 : 579 - 589
  • [4] JONG RD, 1963, ANESTHESIOLOGY, V24, P628
  • [5] Immediate thalamic sensory plasticity depends on corticothalamic feedback
    Krupa, DJ
    Ghazanfar, AA
    Nicolelis, MAL
    [J]. PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, 1999, 96 (14) : 8200 - 8205
  • [6] EXPERIMENTAL PHANTOM LIMBS
    MELZACK, R
    BROMAGE, PR
    [J]. EXPERIMENTAL NEUROLOGY, 1973, 39 (02) : 261 - 269
  • [7] SOMATOSENSORY CORTICAL MAP CHANGES FOLLOWING DIGIT AMPUTATION IN ADULT MONKEYS
    MERZENICH, MM
    NELSON, RJ
    STRYKER, MP
    CYNADER, MS
    SCHOPPMANN, A
    ZOOK, JM
    [J]. JOURNAL OF COMPARATIVE NEUROLOGY, 1984, 224 (04) : 591 - 605
  • [8] MIHIC DN, 1983, ANAESTHESIST, V32, P30
  • [9] PHANTOM LIMB SYNDROME OCCURRING DURING SPINAL-ANESTHESIA
    MILES, JE
    [J]. JOURNAL OF NERVOUS AND MENTAL DISEASE, 1956, 123 (04) : 365 - 368
  • [10] INDUCTION OF IMMEDIATE SPATIOTEMPORAL CHANGES IN THALAMIC NETWORKS BY PERIPHERAL BLOCK OF ASCENDING CUTANEOUS INFORMATION
    NICOLELIS, MAL
    LIN, RCS
    WOODWARD, DJ
    CHAPIN, JK
    [J]. NATURE, 1993, 361 (6412) : 533 - 536