Does a regional nerve block change cutaneous perception thresholds outside the anaesthetic area? Implications for the interpretation of diagnostic blocks.

Abstract

The present study was performed on pain-free subjects and patients to analyse if local anaesthetics (LA) normally used for nerve blocks in the orofacial region resulted in generalised changes in cutaneous somatosensory perception thresholds outside the territory of the primarily blocked nerve. Five subjects received an intra-oral nerve block and 5 patients received epidural anaesthesia, serving as a reference group considering the larger amounts of LA used in this latter type of anaesthesia. No differences (after vs. prior to LA) were detected regarding thresholds to tactile, cold, warmth or heat pain stimuli in skin areas outside the regions directly blocked. This was also true for the difference limens between warm-cold thresholds. Our data do not indicate any generalised influence on tactile, thermal and pain perception thresholds in pain-free subjects.