Articles: nerve-block.
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Anesthesia and analgesia · Aug 1983
Comparative StudyLidocaine and bupivacaine differential blockade of isolated canine nerves.
In vitro studies of pharmacologic actions of local anesthetics are usually performed at room temperature using amphibian nerves exposed to local anesthetics for substantial periods of time. We performed in vitro studies of pharmacologic responses of motor A fibers and sensory C fibers to lidocaine and bupivacaine in clinically effective concentrations using a canine nerve preparation at body temperature with short exposure times to evaluate responses under clinically relevant conditions. Differential blockade of isolated, desheathed phrenic and vagus nerves was achieved with bupivacaine (0.58 mM), C fibers being blocked before A fibers (P less than 0.05). Lidocaine (2.8 mM) did not block A and C fibers differentially.
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Differential block of peripheral nerve fibers was attempted in vitro by a new approach based on inhibiting the membrane pump with ouabain. Sequential concentration dependent extinction of the components of the compound action potential was obtained: C extinguished first, A delta next, A beta last. The sequence conforms to expectations based on axonal size. Because pain is mediated by C and A delta fibers, and block of these groups by ouabain was not reversed readily, further investigation of the practicability of the new approach seems warranted.