Is the R3 component of the human blink reflex nociceptive in origin?

被引:40
作者
Ellrich, J
Katsarava, Z
Przywara, S
Kaube, H
机构
[1] Univ Erlangen Nurnberg, Emil Fischer Ctr, Dept Expt & Clin Pharmacol & Toxicol, D-91054 Erlangen, Germany
[2] Univ Essen Gesamthsch, Dept Neurol, D-45122 Essen, Germany
[3] UCL Natl Hosp Neurol & Neurosurg, Inst Neurol, London WC1 3BG, England
关键词
anesthesia; brainstem; electric; laser; trigeminal;
D O I
10.1016/S0304-3959(00)00465-6
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
The R3 component of the blink reflex can reproducibly be evoked by noxious stimulation but can probably also be elicited by innocuous stimuli. This study was conducted to investigate the contribution of nociceptive A delta and C fibers to the generation of the electrically evoked R3 blink reflex. Electrical thresholds for detection. pain and all blink reflex components were determined and the modulatory effects of local anesthesia were investigated. The electrical R3 threshold of 4.6 +/- 0.5 mA (mean +/- SE) corresponded to 2.9 times the detection threshold and to 0.35 times the pain threshold. The R3 threshold was significantly below the pain threshold. Under local anesthesia of the supraorbital skin with a complete loss of warm and cold sensation, a loss of pinprick sensation. but a normal detection of tactile stimuli, the electrical pain threshold increased, all other thresholds remained unchanged. Under local anesthesia none of the reflex components were significantly reduced. Cutaneous A beta fibers and nociceptive A delta fibers, but not unmyelinated C fibers, contribute to the generation of the electrically evoked R3 component. According to the recruitment order in peripheral sensory nerves the electrical threshold of the R3 is mainly determined by activation of A beta fibers. Thus, it can nor be assumed that the electrically evoked R3 is an adequate model to investigate nociceptive processing. (C) 2001 International Association for the Study of Pain. Published by Elsevier Science B.V. All rights reserved.
引用
收藏
页码:389 / 395
页数:7
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