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Local application of volatile anesthetics attenuates the response to a mechanical stimulus in humans

[L’application locale d’anesthésiques volatils diminue la réaction au stimulus mécanique chez les humains]

Argyro Fassoulaki, MD PhD DEAA^*, Ioanna Skouteri, MD^*, Ioanna Siafaka, MD^* and Constantine Sarantopoulos, MD MSc PhD DEAA

^* From the Department of Anesthesiology, Aretaieio Hospital, Medical School, University of Athens, Athens; and
the Department of Anesthesia, Medical College of Wisconsin, Milwaukee, USA.

Address correspondence to: Dr. Argyro Fassoulaki, 57-59 Raftopoulou street, 11744 Athens, Greece. Phone: +30210-9024530; +30210-7286334; +30210-7286323; Fax: +30210-9024530; E-mail: fassoula{at}aretaieio.uoa.gr; afassou1{at}otenet.gr

Purpose: Volatile anesthetics may cause local hyperalgesia and/or analgesia. This double-blind randomized study investigated the effect of these medications when applied locally on the response to a mechanical stimulus.

Methods: In experiment 1, standard commercial preparations of halothane 1 mL, isoflurane 1.5 mL and sevoflurane 2.7 mL were randomly applied on the forearm of 30 volunteers for 30 min, after which the response to a mechanical stimulus was recorded. The other forearm received water as control. The next day, the experiment for each anesthetic was repeated in a reverse fashion. Thirty minutes after the application, the response to a standardized mechanical stimulus was recorded. In experiments 2 and 3, the response to the same mechanical stimulus was tested after local applications of 2, 4, and 6 mL of halothane or after a local application of 5 mL sevoflurane respectively.

Results: Low doses of the three anesthetics did not alter the response to the mechanical stimulus (F = 3.055, df = 1,174, P = 0.082). Two, 4, and 6 mL of halothane attenuated the response to the mechanical stimulus by 36%, 27% and 29% respectively (F = 9.586, df = 1,114, P = 0.002). Five millilitres of sevoflurane attenuated the response to the mechanical stimulus by 36% (F = 5.111, df = 19, P < 0.001).

Conclusion: Low liquid volumes of volatile anesthetics, when applied locally to the skin, did not influence the response to a mechanical stimulus, but higher volumes attenuated this response.