Pain practice : the official journal of World Institute of Pain
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The neuroselective effects of tourniquet ischemia/compression in healthy volunteers were evaluated using the automated electrodiagnostic sensory Nerve Conduction Threshold (sNCT) test. The sNCT evaluation generates reliable, painless Current Perception Threshold (CPT) measures. Standardized CPT measures using constant alternating current sinusoid waveform stimulus at 3 different frequencies 5 Hz, 250 Hz, and 2 kHz (NeurometerEG CPT/C Neurotron, Inc. ⋯ There were no significant changes in 5 Hz CPT measures. The results of this study demonstrate the ability of the sNCT test to quantify previously described differential neuroselective effects of tourniquet ischemia on sensory nerve function. Demonstration of statistically significant increases in CPT values at 2000 Hz and 250 Hz secondary to tourniquet ischemia, with no change in 5 Hz CPT values, is consistent with the understanding that 2000 Hz sine wave stimuli activate the large myelinated sensory fibers, 250 Hz sine wave stimuli activate small myelinated sensory fibers, and 5 Hz sine wave stimuli activate small unmyelinated sensory fibers.
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Complex Regional Pain Syndrome Type-I (CRPS-I) is a neuropathic pain syndrome resulting from complex pain mechanisms that involve several levels and components of the nervous system. CRPS-I consists of multiple signs, including autonomic dysfunction, in the form of edema, vasomotor changes, motor dysfunctions, muscle spasms, tremors and dystonia, as well as burning pain, hypersensitivity and allodynia that could present in any combination. ⋯ Multiple analgesic modalities have been used to facilitate the rehabilitation program with varying rates of success. The most successful treatment is a multi-disciplinary comprehensive approach, where initial pain control allows for physical and psychological interventions that are believed to be the basis for successful treatment.(1) The pain in CRPS-I may be mediated through the sympathetic nervous system, sympathetic maintained pain (SMP) or sympathetic independent pain (SIP)(2).