Hiedl P, Struppler A, Gessler M
Department of Neurology, Technical University of Munich, Möhlstrasse 28, 8000 Munich 80,G.F.R.
Pain. 1979 Oct;7(2):129-134. doi: 10.1016/0304-3959(79)90004-6.
Experimental C-fiber pain caused by radiant heat was applied to the skin area supplied by the left sural nerve of 20 subjects. Percutaneous electrical stimulation (PNS) was performed on the left sural nerve, the left superficial peroneal nerve and the right superficial radial nerve. Stimulation frequencies were: 3, 50, 100, 300, 500 and 1000 Hz. The analgesia resulting at the different stimulation sites was recorded according to a preset scale of estimation. Without considering the influence of the different frequencies, the best analgesic effects were reached if noxious heating and PNS were both performed on the left sural nerve; the anatomical conditions prevented us from distinguishing between the effects of possible peripheral blockade or spinal modification of pain. PNS of the superficial peroneal nerve seems to indicate spinal, possibly polysegmental, interactions between C-fiber pain and electrical stimulation of thick myelinated fibers. However, long loop effects may also play a part in local analgesia as demonstrated by PNS of the right radial nerve.
对20名受试者左侧腓肠神经所支配的皮肤区域施加由辐射热引起的实验性C纤维疼痛。对左侧腓肠神经、左侧腓浅神经和右侧桡浅神经进行经皮电刺激(PNS)。刺激频率为:3、50、100、300、500和1000Hz。根据预设的评估量表记录不同刺激部位产生的镇痛效果。不考虑不同频率的影响,如果在左侧腓肠神经上同时进行有害加热和PNS,则可达到最佳镇痛效果;解剖学条件使我们无法区分可能的外周阻滞或疼痛的脊髓调节的效果。腓浅神经的PNS似乎表明C纤维疼痛与粗有髓纤维的电刺激之间存在脊髓性、可能是多节段性的相互作用。然而,如右侧桡神经的PNS所示,长环效应也可能在局部镇痛中起作用。