Methylprednisolone shortens the effects of bupivacaine on sensory nerve fibers in vivo

被引:5
作者
Johansson, A
机构
[1] Department of Anaesthesiology, Lund University, Malmö General Hospital, Malmö
[2] Department of Anaesthesiology, Lund University, Malmö General Hospital
关键词
corticosteroid; local anesthetics; nerve conduction; nerve fiber;
D O I
10.1111/j.1399-6576.1996.tb04494.x
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Perineural administration of corticosteroids is frequently applied in the treatment of a variety of chronic pain conditions. Methylprednisolone selectively inhibits the transmission of nerve impulses in C-fibers whereas A-fiber activity is unaffected. In the present study the effect of a mixture of 0.05 ml of methyprednisolone (40 mg/ml) and 0.05 ml of bupivacaine (5 mg/ml) was compared to that of 0.05 ml bupivacaine (5 mg/ml) using a plantar nerve block model in the rat. The conduction of impulses in electrically stimulated A-fibers of the plantar nerve was monitored by a bipolar volley recording from the sciatic nerve. Impulse conduction in electrically stimulated C-fibers was studied through a C-fiber evoked segmental flexion reflex. The function of both the A-fibers and the C-fibers exposed to the methylprednisolone-bupivacaine mixture showed a less profound block with signs of earlier recovery than those exposed to plain bupivacaine. The A-fibers recovered somewhat faster than the C-fibers. It is postulated that methylprednisolone adjuvant to bupivacaine affects the intra-axonal uptake of bupivacaine in C-fibers but not in A-fibers by some unknown mechanism. The effect seems to be longer lasting in C-fibers than in A-fibers.
引用
收藏
页码:595 / 599
页数:5
相关论文
共 34 条
[1]  
[Anonymous], 1986, REGION ANESTH
[2]   A PERIPHERAL MONONEUROPATHY IN RAT THAT PRODUCES DISORDERS OF PAIN SENSATION LIKE THOSE SEEN IN MAN [J].
BENNETT, GJ ;
XIE, YK .
PAIN, 1988, 33 (01) :87-107
[3]   EPIDURAL STEROID INJECTIONS FOR LOW-BACK-PAIN AND LUMBOSACRAL RADICULOPATHY [J].
BENZON, HT .
PAIN, 1986, 24 (03) :277-295
[4]  
BOGDUK N, 1988, NEURAL BLOCKADE CLIN, P946
[5]  
Busch E H, 1989, J Clin Anesth, V1, P431, DOI 10.1016/0952-8180(89)90006-8
[6]  
Cronen M C, 1990, J Pain Symptom Manage, V5, P379, DOI 10.1016/0885-3924(90)90034-H
[7]   CORTICOSTEROIDS SUPPRESS ECTOPIC NEURAL DISCHARGE ORIGINATING IN EXPERIMENTAL NEUROMAS [J].
DEVOR, M ;
GOVRINLIPPMANN, R ;
RABER, P .
PAIN, 1985, 22 (02) :127-137
[8]  
DOUSS T, 1975, NZ MED J, V81, P473
[9]   OCCIPITAL NERVE BLOCK IN THE MANAGEMENT OF HEADACHE AND CERVICAL PAIN [J].
GAWEL, MJ ;
ROTHBART, PJ .
CEPHALALGIA, 1992, 12 (01) :9-13