Temporal analysis of regional anaesthesia-induced sensorimotor dysfunction: a model for understanding phantom limb.

Détails

ID Serval
serval:BIB_143D44F9C28C
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Temporal analysis of regional anaesthesia-induced sensorimotor dysfunction: a model for understanding phantom limb.
Périodique
British Journal of Anaesthesia
Auteur(s)
Silva S., Bataille B., Jucla M., Minville V., Samii K., Fourcade O., Démonet J.F., Loubinoux I.
ISSN
1471-6771 (Electronic)
ISSN-L
0007-0912
Statut éditorial
Publié
Date de publication
2010
Peer-reviewed
Oui
Volume
105
Numéro
2
Pages
208-213
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Résumé
BACKGROUND: The peripheral deafferentation induced by regional anaesthesia (RA) results in misperception of size-shape (S) and posture (P) of the anesthetized limb. During RA, most patients seem to describe motionless 'phantom limbs' fixed in stereotyped illusory positions, suggesting that RA could unmask stable postural patterns. The question of whether movement illusions exist or not after anaesthesia needs a prospective study. This study aimed to describe the phenomenology of RA-induced kinesthetic illusions (K illusions).
METHODS: We examined prospectively the body image alteration during infraclavicular blocks in 20 patients. Multimodal sensory testing (pinprick, heat-cold, pallesthesia, and arthrokinesia) and assessment of motor function were performed every 5 min for 60 min after administration of the local anaesthetics. Meanwhile, patients described phantom limb sensations (S, P, and K illusions).
RESULTS: We individualized the occurrence of K illusions [44 (8) min] with respect to S illusions [7 (3) min; P<0.005] and P illusions [22 (4) min; P<0.001]. A close relationship between the onset of K illusions and proprioceptive impairment (arthrokinesia: r=0.92, P<0.001; pallesthesia: r=0.89, P<0001) and abolishment of motor activity (r=0.83, P<0.001) was identified. Finally, a principal component analysis showed that S and P illusions were essentially related to the proprioceptive impairment.
CONCLUSIONS: This study analyses for the first time the temporal evolution of sensorimotor dysfunction and the onset of K illusions during RA. Our results suggest the involvement of an alteration of proprioception and motor functions in the origin of this phenomenon. These data agree with the motor awareness theory.
Mots-clé
Adult, Body Image, Brachial Plexus, Female, Humans, Illusions/physiology, Male, Middle Aged, Models, Biological, Nerve Block/adverse effects, Nerve Block/methods, Phantom Limb/physiopathology, Principal Component Analysis, Psychomotor Performance, Somatosensory Disorders/etiology, Upper Extremity/surgery, Young Adult
Pubmed
Web of science
Création de la notice
24/03/2013 20:27
Dernière modification de la notice
03/03/2018 14:04
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