Leveille Cameron F, Willand Michael P, So Katelyn J W, Barlow Leah N, Patchett Emma, Li Jie, Sask Kyla N, Bain James R
McMaster University, Hamilton, ON, Canada.
Epineuron Technologies Inc., Mississauga, ON, Canada.
Hand (N Y). 2025 Sep 21:15589447251369034. doi: 10.1177/15589447251369034.
Brief electrical stimulation (ES) of injured peripheral nerves for 1 hour has been shown to accelerate nerve regeneration with proximal action potential conduction to the neuron cell body, a requirement to elicit therapeutic benefit. Local anesthetic is often used to manage pain in patients. However, using lidocaine after ES therapy has been controversial. We assessed the effects of extraneural usage of lidocaine after ES therapy on nerve regeneration in a rodent nerve injury model.
Lewis rats underwent tibial nerve transection and immediate repair and randomized to 4 groups: control (REP), extraneural lidocaine alone (REP + LIDO), 60-minute ES (60 ES), and 60-minute ES with extraneural lidocaine (60 ES + LIDO). The tibial nerve was retrograde labeled distally from the neurorrhaphy 28 days post repair. Spinal cords and dorsal root ganglia were harvested to assess motor and sensory neuron counts. Data were analyzed using 1-way analysis of variance (ANOVA) with a post-hoc Tukey correction.
Using lidocaine after nerve repair did not affect nerve regeneration in the control group (REP vs REP + LIDO) or ES group (60 ES vs 60 ES + LIDO), with motor and sensory neuron counts not statistically different between groups. Electrical stimulation therapy showed at least a 60% increase in motor and sensory neuron counts than controls, a statistically significant effect ( < .001).
Extraneural usage of lidocaine after ES does not abolish the improved effect of ES on nerve regeneration. Future clinical studies should evaluate the usage of subcutaneous injection of lidocaine post ES for analgesia control.
已证明对损伤的周围神经进行1小时的短暂电刺激（ES）可加速神经再生，并使动作电位向神经元细胞体进行近端传导，这是产生治疗效果的必要条件。局部麻醉剂常用于控制患者的疼痛。然而，在ES治疗后使用利多卡因一直存在争议。我们在啮齿动物神经损伤模型中评估了ES治疗后在神经外使用利多卡因对神经再生的影响。
将Lewis大鼠的胫神经切断并立即修复，随机分为4组：对照组（REP）、单纯神经外利多卡因组（REP + LIDO）、60分钟ES组（60 ES）和60分钟ES加神经外利多卡因组（60 ES + LIDO）。在修复后28天从神经缝合处向远端对胫神经进行逆行标记。采集脊髓和背根神经节以评估运动和感觉神经元计数。数据采用单因素方差分析（ANOVA）并进行事后Tukey校正分析。
神经修复后使用利多卡因对对照组（REP与REP + LIDO）或ES组（60 ES与60 ES + LIDO）的神经再生没有影响，各组之间的运动和感觉神经元计数无统计学差异。电刺激疗法显示运动和感觉神经元计数比对照组至少增加60%，具有统计学显著效应（P <.001）。
ES后在神经外使用利多卡因不会消除ES对神经再生的改善作用。未来的临床研究应评估ES后皮下注射利多卡因用于控制镇痛的用法。
