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Diffusional delay in local anesthetic block in vitro.

B R Fink, A M Cairns

    Anesthesiology
    |November 1, 1984
    PubMed
    Summary
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    Lidocaine diffusion to myelinated and unmyelinated nerve fibers was compared. Results indicate lidocaine diffuses equally to both, suggesting diffusion differences do not cause clinical differential nerve block.

    Area of Science:

    • Neuroscience
    • Pharmacology
    • Physiology

    Background:

    • Lidocaine is a local anesthetic that blocks nerve conduction.
    • Understanding lidocaine's diffusion is crucial for its clinical application, particularly regarding differential nerve block.

    Purpose of the Study:

    • To compare the diffusion rates of lidocaine to myelinated and unmyelinated axons in the rabbit vagus nerve.
    • To investigate if differential diffusion contributes to the clinical phenomenon of differential nerve block.

    Main Methods:

    • Individual afferent fibers of the rabbit vagus nerve were used.
    • The time for 95% completion of impulse conduction time increase by lidocaine was measured.
    • Diffusion was assessed in both sheathed and desheathed nerve preparations.

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    Main Results:

    • A small, statistically insignificant diffusion lag of approximately four minutes was observed at the perineurial sheath.
    • No significant difference was found in the time for lidocaine to reach its asymptotic effect in myelinated versus unmyelinated axons (average additional 13 minutes).

    Conclusions:

    • Lidocaine diffuses readily to the excitable membranes of both myelinated and unmyelinated axons.
    • Differential diffusion within the nerve is unlikely to be a factor in clinical differential nerve block.