Klinikum Nürnberg, Dept. Anesthesiology, Nuremberg, Germany University Erlangen Nuremberg, Dept. Physiology 1, Erlangen, Germany Bavarian Health and Food Safety Authority, Erlangen, Germany.
Pain. 2010 Apr;149(1):71-75. doi: 10.1016/j.pain.2010.01.012. Epub 2010 Feb 6.
The effect of regional anesthesia of the brachial plexus on the size and intensity of the histamine-induced axon reflex flare (neurogenic inflammation) of the forearm and the upper arm was compared to that of the contralateral arm as control in humans. No changes in the axon reflex could be assessed. Thus the lateral spread of the axon reflex flare must be transmitted by peripheral nerve branches not affected by the anesthesia in the axilla. This excludes the existence of physiologically relevant amounts of proximal branchpoints, DRG neurons with multiple peripheral axons or spinal interneurons transmitting action potentials between peripheral C-afferents involved in the axon reflex flare. Mechanoinsensitive C-fibres are known to be activated by histamine and to be responsible for the neuropeptide release in the skin inducing the axon reflex flare. Reports on those proximal connections can therefore obviously not extend to mechanoinsensitive C-fibres and do not explain the origin of neurogenic inflammation in humans without prior sensitization.
在人体中，比较了臂丛神经区域麻醉对前臂和上臂组胺诱导的轴突反射（神经源性炎症）的大小和强度的影响，并与对侧手臂作为对照进行了比较。未评估轴突反射的变化。因此，轴突反射的侧向扩散必须通过未受腋窝麻醉影响的外周神经分支来传递。这排除了生理上相关数量的近端分支点、具有多个外周轴突的 DRG 神经元或在参与轴突反射的外周 C 传入纤维之间传递动作电位的脊髓中间神经元的存在。已知机械敏感 C 纤维可被组胺激活，并负责在皮肤中释放神经肽，从而引发轴突反射。因此，关于那些近端连接的报告显然不能扩展到机械敏感 C 纤维，并且不能解释未经预先敏化的人类神经源性炎症的起源。
