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Journal of Hand Surgery (British and European Volume)
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Improved Sensory Relearning after nerve Repair Induced by Selective Temporary Anaesthesia – A New Concept in Hand Rehabilitation

B. ROSÉN
A. BJÖRKMAN
G. LUNDBORG

From the Department of Hand Surgery, Lund University, University Hospital Malmö, Malmö, Sweden

Correspondence: Mrs Birgitta Rosén, Department of Hand Surgery, Malmö University Hospital, SE-205 02 Malmö, Sweden. Tel.: +40 40 33 67 69; fax: +40 40 92 88 55. E-mail: birgitta.rosen{at}med.lu.se

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.

Key Words: nerve injury • anaesthesia • sensory relearning • hand function

Journal of Hand Surgery (British and European Volume), Vol. 31, No. 2, 126-132 (2006)
DOI: 10.1016/J.JHSB.2005.10.017
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