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British Journal of Anaesthesia, Vol 75, Issue 5 634-635, Copyright © 1995 by The Board of Management and Trustees of the British Journal of Anaesthesia

SHORT COMMUNICATIONS

Temporal summation during extradural anaesthesia

M. Curatolo, S. Petersen-Felix, L. Arendt-Nielsen, M. Fischer and A. M. Zbinden
Institute of Anaesthesiology and Intensive Care, University of Bern, Inselspital, 3010 Bern, Switzerland; Center for Sensory-Motor Interaction, Laboratory for Experimental Pain Research, University of Aalborg, Denmark

We have investigated in 10 patients the effect of extradural anaesthesia on temporal summation by comparing pain thresholds to single and repeated (five impulses at 2 Hz) electrical stimuli and compared these tests with pinprick and cold stimulation. Bupivacaine 0.5% (20 ml) was injected at L2-3. After extradural anaesthesia the threshold to repeated stimuli was significantly lower than the threshold to single stimuli (P = 0.0007). Nine patients lost cold sensation and 10 patients pinprick sensation. Pain to single electrical stimulation disappeared in six patients and pain to repeated electrical stimulation in one. Pain may be evoked by temporal summation of repeated electrical stimuli even when pinprick sensation, cold sensation and pain to single electrical stimuli are inhibited. Thus temporal summation should be taken into consideration when extradural analgesia is assessed.
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