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Related Concept Videos

Local Anesthetics: Differential Sensitivity of Nerve Fibers01:24

Local Anesthetics: Differential Sensitivity of Nerve Fibers

Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
Depolarizing Blockers: Mechanism of Action01:28

Depolarizing Blockers: Mechanism of Action

Depolarizing blockers act on skeletal muscle fibers' membranes and induce their depolarization. Most depolarizing blockers have two quaternary N+ atoms that bind the nicotinic acetylcholine receptors and cause neuromuscular blockade within minutes.
Succinylcholine is the most commonly used depolarizing blocker. Chemically, it constitutes two molecules of acetylcholine joined together by an acetate methyl group. They act on the receptors in the same way as acetylcholine. Because succinylcholine...
Local Anesthetics: Mechanism of Action01:23

Local Anesthetics: Mechanism of Action

Local anesthetics (LAs) block sensory and motor impulses by inhibiting the sodium channels on the nerve cell membranes. This induces temporary loss of sensation, relieving pain in a specific body area.
Local anesthetics are amphiphilic molecules consisting of a hydrophobic aromatic part linked to a hydrophilic group by an ester or amide linkage. They are weak bases and are usually available as salts, which increases their solubility and stability. Once administered, LAs exist in the body either...
Depolarizing Blockers: Pharmocokinetics01:19

Depolarizing Blockers: Pharmocokinetics

Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia

Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...

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Updated: Jun 16, 2026

Electrophysiological Methods to Assess Peripheral Pain Block in an Anesthetized Rat
08:05

Electrophysiological Methods to Assess Peripheral Pain Block in an Anesthetized Rat

Published on: November 21, 2025

Prolonged sensory-selective nerve blockade.

Itay Sagie1, Daniel S Kohane

  • 1Department of Anesthesiology, Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.

Proceedings of the National Academy of Sciences of the United States of America
|February 6, 2010
PubMed
Summary
This summary is machine-generated.

Researchers developed prolonged sensory-selective nerve blocks using surfactants and QX-314, a lidocaine derivative. This breakthrough offers targeted pain relief without motor function loss, enhancing local anesthesia applications.

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Partial Sciatic Nerve Ligation: A Mouse Model of Chronic Neuropathic Pain to Study the Antinociceptive Effect of Novel Therapies
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Area of Science:

  • Anesthesiology
  • Pharmacology
  • Neuroscience

Background:

  • Sensory-selective local anesthesia is crucial for pain management without motor impairment.
  • Existing local anesthetics often lack selectivity, affecting both sensory and motor nerves.

Purpose of the Study:

  • To develop a method for achieving prolonged sensory-selective nerve blocks.
  • To investigate the combination of surfactants and lidocaine derivatives for enhanced local anesthesia.

Main Methods:

  • Utilized specific concentrations of surfactants (e.g., octyltrimethylammonium bromide - OTAB) combined with QX-314, a lidocaine derivative.
  • Administered injections and assessed the duration and selectivity of nerve blockade.
  • Tested various surfactant types (cationic, neutral, anionic) and another lidocaine derivative (QX-222).

Main Results:

  • Achieved prolonged sensory-selective nerve blocks lasting up to 7 hours with 25 mM QX-314 and 30 mM OTAB.
  • Demonstrated that surfactants impart varying degrees of sensory selectivity.
  • Confirmed the effect is local, resulting from the interaction between the surfactant and lidocaine derivative.

Conclusions:

  • Specific surfactant-lidocaine derivative combinations can create long-lasting, sensory-selective nerve blocks.
  • This approach offers a promising strategy for developing advanced local anesthetics with improved safety and efficacy.
  • Potential applications include labor pain management without compromising pushing ability.