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Nociceptive flexion reflex. Principles and applications of the threshold determination

by S Dalmas, P Scherpereel
Annales francaises danesthesie et de reanimation (1989)

Abstract

The threshold for the pain flexion reflex in the lower limb can be used to determine the potency in man of analgesic drugs acting centrally. A new apparatus is, the "algometre", described. Bipolar electrical stimulation (5 stimuli of 1 ms over a period of 10 ms) is applied to the saphenous nerve just behind the external malleolus. An amplifier detects the muscle response (electromyogramme; EMG) at the muscle-tendon junction in the popliteal space; this occurs about 70-130 ms after the painful stimulus. The whole system is linked to a microcomputer. The EMG and EMG/intensity curves are displayed on a colour screen, and can be copied by a colour tracing table. The whole machine is mobile and can be moved from bed to bed. An increase in the threshold during inhalation of 50% nitrous oxide in oxygen was shown. However, the usefulness of the "algometre" in clinical practice remains to be assessed by further studies.

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