scholarly journals Dramatic Response to Lidocaine Infusion for Pain from Brachial Plexus Avulsion Injury

2021 ◽  
pp. 219-222
Keyword(s):  
Brachial Plexus ◽  
Pain Syndrome ◽  
Cancer Center ◽  
Intravenous Lidocaine ◽  
Avulsion Injury ◽  
Brachial Plexus Avulsion ◽  
Pain Syndromes ◽  
Analgesic Agents ◽  
Severe Chronic Pain ◽  
Higher Doses

BACKGROUND: Traumatic brachial plexus avulsion injury (tBPI) can cause a severe chronic pain syndrome that is very difficult to treat. Though lidocaine has been shown to be effective for other pain syndromes, effectiveness in tBPI has not previously been reported. CASE REPORT: A 55-year-old man with tBPI had severe pain and minimal relief with numerous analgesic agents. He was able to access intravenous lidocaine as he was being treated at a cancer center, and had a sustained response to 7 mg/kg given over an hour. CONCLUSION: There is potential for a single bolus intravenous lidocaine infusion to provide good pain control sustained over many months in patients with traumatic brachial plexus injury. An adequate serum concentration of lidocaine is required for analgesic effect. If initial doses of lidocaine are tolerated but ineffective, higher doses may still be beneficial. KEY WORDS: Brachial plexus avulsion, lidocaine, lignocaine, pain management, palliative care, therapeutics, trauma

Late Cervical Spinal Cord Herniation Resulting from Post-Traumatic Brachial Plexus Avulsion Injury

2020 ◽  
Vol 137 ◽  
pp. 1-7 ◽  
Author(s):  
Andrew S. Jack ◽  
Jens R. Chapman ◽  
Praveen V. Mummaneni ◽  
Line G. Jacques ◽  
Carter S. Gerard
Keyword(s):  
Spinal Cord ◽  
Brachial Plexus ◽  
Cervical Spinal Cord ◽  
Avulsion Injury ◽  
Brachial Plexus Avulsion ◽  
Spinal Cord Herniation ◽  
Post Traumatic

Pain Phenomena and Sensory Recovery following Brachial Plexus Avulsion Injury and Surgical Repairs

2006 ◽  
Vol 31 (6) ◽  
pp. 596-605 ◽  
Author(s):  
M. HTUT ◽  
P. MISRA ◽  
P. ANAND ◽  
R. BIRCH ◽  
T. CARLSTEDT
Keyword(s):  
Brachial Plexus ◽  
Quantitative Sensory Testing ◽  
Border Zone ◽  
Sensory Testing ◽  
Original Source ◽  
Avulsion Injury ◽  
Brachial Plexus Avulsion ◽  
Sensory Recovery ◽  
New Treatments ◽  
Thermal Stimuli

Seventy-six patients with severe brachial plexus avulsion injuries were studied using pain questionnaires and quantitative sensory testing. There was significant correlation between pain intensity and the number of roots avulsed prior to surgery ( P = 0.0004) and surgical repairs were associated with pain relief. Sensory recovery to thermal stimuli was observed, mainly in the C5 dermatome. Allodynia to mechanical and thermal stimuli was observed in the border zone of affected and unaffected dermatomes in 18% of patients assessed early (<6 months) and 37% patients at later stages. Pain and sensations referred to the original source of afferents occurred at a later stage (>6 months) in 12% of patients and were related to nerve regeneration. By contrast, “wrong-way” referred sensations (e.g. down the affected arm while shaving or drinking cold fluids) were reported by 44% of patients and often occurred early, suggesting CNS plasticity. Understanding sensory mechanisms will help develop new treatments for severe brachial plexus injuries.

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