Pain responses to perineuromal injection of normal saline, gallamine, and lidocaine in humans

Charles Chabal, Louis Jacobson, Lisa C. Russell, Kim J. Burchiel

Research output: Contribution to journalArticle

65 Scopus citations

Abstract

Rat neuromas have shown an increase of spontaneously active fibers to systemically administered potassium channel blocking agents such as tetraethylammonium chloride (TEA) and gallamine. Neuroma formation and spontaneous activity have been associated with autotomy in rats and pain in humans. To evaluate the chemosensitivity of human neurons to potassium channel blocking agents, 9 subjects with neuroma pain underwent perineuromal injection in a single-blinded fashion of normal saline, gallamine, and lidocaine. Sodium chloride had no effect on control pain levels, while gallamine significantly increased and lidocaine significantly decreased pain from control levels. Three of 4 patients with accompanying phantom limb pain noted an increase in pain after the injection of gallamine. The data suggest that peripheral input plays a modulating but not solitary role in both neuroma and phantom limb pain. Agents which increase potassium channel permeability or decrease sodium influx would be predicted to decreased perceived pain.

Original languageEnglish (US)
Pages (from-to)321-325
Number of pages5
JournalPain
Volume36
Issue number3
DOIs
StatePublished - Mar 1989

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Keywords

  • Gallamine
  • Lidocaine
  • Neuroma pain
  • Perineuromal injection
  • Phantom limb pain
  • Saline

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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