Sympathetic Blockade Increases Tactile Sensitivity

To determine whether tactile sensitivity of the normal skin is altered by suppression of sympathetic efferent activity, the effect of stellate ganglion block and epidural sympathetic block on touch threshold was studied. The study was performed on ten individuals with various chronic pain syndromes. Tactile sensitivity was measured in the normal skin area with the use of von Frey filaments and a two-alternative forced-choice procedure with a staircase presentation of touch stimuli. With stellate ganglion block, touch threshold decreased on the side of the block by 48.8 ± 8.% (P = 0.002) without any significant change in the threshold on the healthy, nonblocked side (P = 0.003 for the difference between the sides). With epidural sympathetic block, touch threshold decreased to the same extent on the diseased and healthy sides, which were both affected by the block (46.2 ± 11.4%, P = 0.027 and 47.7 ± 12.5%, P = 0.032, respectively). The results show that sympathetic blockade increases tactile sensitivity. They also suggest that sympathetic efferent activity modulates the function of tactile receptors. It is hypothesized that the sympathetic modulation makes tactile receptors less sensitive to touch, less specific, and probably more prone to code tactile stimuli in such a way that the brain recognizes this code as pain.