Effect of local and intravenous lidocaine on ongoing activity in injured afferent nerve fibers
- 1 July 2011
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Pain
- Vol. 152 (7), 1562-1571
- https://doi.org/10.1016/j.pain.2011.02.046
Abstract
Lidocaine applied systemically or locally attenuates neuropathic pain in patients. Here we tested the hypothesis that ectopic activity in injured afferent A- or C-fibers is suppressed by lidocaine. In rats the sural nerve (skin nerve) or lateral gastrocnemius-soleus nerve (muscle nerve) was crushed. Four to 11 days after crush lesion afferent fibers were isolated from the lesioned nerves in bundles rostral to the injury site. Ongoing ectopic activity was recorded from 75 A-fibers (muscle N = 43, skin N = 32) and 69 C-fibers (muscle N = 30, skin N = 39). Most afferent fibers were functionally characterized by their responses to mechanical and thermal (mostly heat) stimuli applied at or distal to the nerve injury site. Low-threshold cold-sensitive cutaneous C-fibers were excluded from the analysis [34,35]. Lidocaine was either applied to the nerve at or distal to the injury site in concentrations of 1 to 1000 μg/mL or injected i.v. in doses of 0.09 to 9 mg/kg (skin) or 0.047 to 4.7 mg/kg (muscle). Local application of lidocaine depressed ectopic activity in A- and C-fibers dose-dependently. Depression was weaker in C- than in A-fibers. Intravenous application of lidocaine depressed ongoing ectopic activity in A- and C-fibers dose-dependently. Responses to heat or mechanical stimulation of the injured nerve were not suppressed at the highest concentrations of lidocaine. The results support the hypothesis that decrease of neuropathic pain following local or systemic application of a local anesthetic is related to decrease of ectopic ongoing activity in injured afferent nerve fibers. Lidocaine may attenuate neuropathic pain in patients. Intravenous or local lidocaine suppressed the ectopic activity in injured afferent A- or C-fibers in a rat model of pain.Keywords
Funding Information
- German Research Foundation
- Grünenthal GmbH, Aachen, Germany
This publication has 69 references indexed in Scilit:
- The roles of sodium channels in nociception: Implications for mechanisms of painPain, 2007
- Systemic Administration of Local Anesthetics to Relieve Neuropathic Pain: A Systematic Review and Meta-AnalysisAnesthesia & Analgesia, 2005
- An Open-Label Study of the Lidocaine Patch 5% in Painful Idiopathic Sensory PolyneuropathyPain Medicine, 2005
- Effectiveness of the lidocaine patch 5% on pain qualities in three chronic pain states: assessment with the Neuropathic Pain ScaleCurrent Medical Research and Opinion, 2004
- Lidocaine patch 5% and its positive impact on pain qualities in osteoarthritis: results of a pilot 2-week, open-label study using the Neuropathic Pain ScaleCurrent Medical Research and Opinion, 2004
- Review of Lidocaine Patch 5% Studies in the Treatment of Postherpetic NeuralgiaDrugs, 2004
- Lidocaine Patch 5% Reduces Pain Intensity and Interference with Quality of Life in Patients With Postherpetic Neuralgia: An Effectiveness TrialPain Medicine, 2002
- Lidocaine test in neuralgiaPain, 1992
- Sympathetic and afferent somata projecting in hindlimb nerves and the anatomical organization of the lumbar sympathetic nervous system of the ratJournal of Comparative Neurology, 1988
- Clinical Pharmacokinetics of LignocaineClinical Pharmacokinetics, 1978