Improved sensory relearning after nerve repair induced by selective temporary anaesthesia - a new concept in hand rehabilitation.

Author(s): Rosen B, Bjorkman A, Lundborg G

Affiliation(s): Department of Hand Surgery, Lund University, University Hospital Malmo, Sweden. birgitta.rosen@med.lu.se

Publication date & source: 2006-04, J Hand Surg [Br]., 31(2):126-32. Epub 2005 Dec 13.

Publication type: Randomized Controlled Trial; Research Support, Non-U.S. Gov't

The outcome after nerve repair in adults is generally poor. We hypothesized that forearm deafferentation would enhance the sensory outcome by increasing the cortical hand representation. A prospective, randomized, double-blind study was designed to investigate the effects of cutaneous forearm anaesthesia combined with sensory re-education on the outcome after ulnar or median nerve repair. During a 2 week period, a local anaesthetic cream (EMLA (n = 7) or placebo (n=6) was applied repeatedly onto the flexor aspect of the forearm of the injured arm and combined with sensory re-education. Evaluation of sensory function was carried out at regular intervals and at 4 weeks after the last EMLA/placebo session. The EMLA group showed significant improvement compared to placebo in perception of touch/pressure, tactile gnosis and in the summarized outcome after 6 weeks. These results suggest that cutaneous forearm anaesthesia of the injured limb, in combination with sensory re-education, can enhance sensory recovery after nerve repair.