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British Medical Bulletin 2005 71(1):61-76; doi:10.1093/bmb/ldh035
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Published online 31 January 2005

British Medical Bulletin, Vol. 71 © The British Council 2005; all rights reserved

Assessment of regional analgesia in clinical practice and research

Michele Curatolo*, Steen Petersen-Felix* and Lars Arendt-Nielsen{dagger}

* Department of Anaesthesiology, University Hospital of Berne, Inselspital, Switzerland and {dagger} Laboratory for Experimental Pain Research, Centre for Sensory–Motor Interaction, University of Aalborg, Denmark

Correspondence to: Dr Michele Curatolo, Department of Anaesthesiology, Division of Pain Therapy Inselspital, 3010 Berne, Switzerland. E-mail: michele.curatolo{at}insel.ch

Assessment of pain and sensory function during regional analgesia contributes to a better understanding of the mechanisms underlying the action of drugs and techniques, and provides information on the effectiveness of regional analgesia in daily practice. Sensory tests only partially mimic clinical pain, mainly because they are artificial and reproduce only a part of the complex experience of pain. Therefore information gained by sensory tests should not be uncritically generalized to clinical pain conditions. Studies using experimental pain models are not in competition with studies performed under clinical conditions, but complement them. In order to mirror clinical pain, experimental models ideally stimulate muscles and viscera, induce peripheral and central sensitization, and evoke temporal and spatial summation. These methods are available, but are underused. Test modalities used in clinical practice have limited validity. In recent years almost no research has been performed to develop better test modalities that are suitable for daily practice.


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