Biomedical subjects

Marco Lacerenza

Publications and source records attributed to Marco Lacerenza.

3 recordsLinked to original sources

PubMed2003

The Lindblom roller.

Neuropathic pain is caused by injury of the peripheral or central nervous system. The neurological examination of the sensory system in neuropathic pain patients guides the anatomical localization of the injury. Among the sensory modalities to be tested, priority should be given to those subserved by small peripheral sensory fibers or by the spinothalamic tract that most commonly are abnormal in neuropathic pain patients. Testing of cold and warm perception was traditionally carried out in the clinic using tubes filled with water at different temperatures, a cumbersome method that has limited the routine examination of these sensory modalities. The Lindblom roller offers a practical and effective method of readily testing temperature perception and is among the best available clinical tools for delineating the anatomical boundaries of a sensory abnormality. Routinely use of the Lindblom roller shall be standard bedside clinical assessment of neuropathic pain patients. To exemplify this statement we describe two patients affected by complex and fluctuating painful sensory abnormalities caused by an extradural mass compressing the spinal cord. The level of the injury was readily localized with a roller kept at room temperature.

Aged↗

PubMed1995

Pre-injury lidocaine treatment prevents thermal hyperalgesia and cutaneous thermal abnormalities in a rat model of peripheral neuropathy.

The effect of lidocaine pretreatment on thermal hyperalgesia and thermal skin asymmetries provoked by experimental mononeuropathy was investigated in rats. Forty anesthetized rats were given sciatic nerve ligatures according to the technique of Bennett and Xie. Rats were divided into 3 groups: 16 were ligated without lidocaine, 16 were ligated after lidocaine bathing of the nerve, and 8 were ligated after systemic lidocaine (6-8 mg/kg). Six sham-operated rats for each group were also prepared. From the first postoperative day the responses to the hot-plate test were assessed daily for 4 weeks by tracking the paw-licking latency (PLL) for both hindpaws. Shorter or longer latencies on the operated side were respectively considered sign of hyperalgesia and hypoalgesia. Infrared thermographic images of plantar hindpaws were taken in 22 operated rats in the 2nd postoperative week. Thermographic images of 8 non-operated rats were used as control. Animals operated without lidocaine exhibited shorter PLL (P < 0.001) and a decreased skin temperature on the operated side (P < 0.001). In the lidocaine-pretreated rats, no paw-licking reflex was present for a variable postoperative period (1 week or more) and afterwards there was a trend toward recovery of normal PLL values at the 4th week; the hindpaw skin temperature was symmetrical and normal. Sham-operated rats had normal tests. It is postulated here that lidocaine prevents behavioral and thermal manifestation of mononeuropathy by blocking early afferent injury barrage.

Animals↗

PubMed1992

Lidocaine test in neuralgia.

Ten patients with organic nerve injury causing chronic neuropathic pain were tested for the effects of intravenous lidocaine versus saline upon psychophysical somatosensory variables. The variables assessed were the subjective magnitude of pain, area of mechanical hyperalgesia and presence and magnitude of thermal heat/cold hyperalgesia. The study methods applied to evaluate these conditions were the conventional testing of somatosensory submodalities with area mapping and the subjective magnitude estimation of spontaneous pain. It was found that spontaneous pain and mechanical hyperalgesia were consistently improved, transiently, by intravenous administration of lidocaine in all 10 patients; areas of hyperalgesia which extended beyond the territory of the nerve also improved transiently. Spontaneous pain and mechanical hyperalgesia, but not hypoesthesia, were transiently improved by injection of saline in only 1 of the 10 patients. This outcome is probably due to a placebo effect. This improvement is in keeping with the inhibition of anomalous neural impulses which can be generated anywhere along the sensory channels responsible for generating spontaneous pain and hyperalgesia. Thus, intravenous lidocaine is proposed as a diagnostic aid in the examination of patients complaining of complex sensory disorders associated with nerve injury. The transient pain relief may allow a fuller identification of the area of sensory loss.

Adolescent↗