[Contralateral local anesthesia in stump, phantom and post-traumatic pain].

Contralateral local anaesthesia was employed in patients with chronic (n = 42) and acute (n = 8) pain syndromes (see Table 1). I. Phantom limb and stump pain: n = 10; II. Pain of face and ear: n = 10; III. Pain of neck and trunk: n = 14; IV. Pain of the hip joint: n = 6; V. Pain of the extremities: n = 10: Sa. = 50 patients. Among these were n acute pain syndromes: I.: n = 0; II.: n = 1; III.: n = 1; IV.: n = 1; V.: n = 5 (Sa.: n = 8). 42 patients with chronic pain syndromes were treated with contralateral local anaesthesia (CLA). In 27 patients CLA displayed a clear effect upon the chronic pain; in 8 patients pain release was more than 50%, in 15 patients pain release was less than 50%. 3 patients relapsed into their former condition of pain. CLA was without any positive influence in 12 cases. The medium frequency of treatments was between 5 and 6 in both groups. The average time of treatment amounted to 6 and 7 months respectively. In 8 patients with acute pain syndromes contralateral local anaesthesia produced the following results: 6 patients were permanently released from their pain; in 2 patients CLA remained without any success. The average frequency of treatment was 1.25; the average time of observation was 2.3 months. Hence we suggest that CLA should be employed as early as possible in acute or chronic posttraumatic or postoperative pain syndromes. The influence of contralateral pain therapy on acute and chronic pain conditions of the opposite side can be affirmed; its mechanism remains to be clarified. Obviously it is possible to exert an inhibitory influence from the contralateral side upon peripheral, spinal, reticular and thalamic regions, which can lead to the extinction of acute and chronic pain conditions on the opposite side. According to our experiences it is necessary that the cerebro-spinal nerve system - apart from the traumatic lesion - is intact and that the pain syndrome is not maintained by a psychic disturbance.