Local anaesthesia efficacy: discrepancies between in vitro and in vivo studies

Acta Anaesthesiologica Scandinavica
S Pateromichelakis, A A Prokopiou

Abstract

Electrophysiological studies on isolated nerves have been used extensively in the past to assess the comparative efficiency of local anaesthetics as agents of peripheral nerve blockade. It is shown here that three closely related amide local anaesthetics behave differently in vitro and in vivo. In terms of onset of action and of maximum suppression of the evoked action potential, mepivacaine proved a less efficient anaesthetic than lidocaine or prilocaine on isolated nerves, but in parallel studies on the sciatic nerve of live animals and in the absence of vasoconstrictors: (a) mepivacaine's potency was superior to that of the other two agents, (b) its speed of onset of anaesthetic action was at least as good and (c) its duration of action was found to be considerably longer. These results, in combination with the physical properties of the anaesthetics examined, favour differential ionization as the cause of the reduced performance of mepivacaine in the nerve bath. Thus, studies on isolated nerves, which are often quoted in the pharmacological literature, can be poor guides to the in vivo comparative efficacy of local anaesthetics.

References

Jan 1, 1977·Annual Review of Pharmacology and Toxicology·J Adriani, M Naraghi
Jan 1, 1976·Clinical Endocrinology·R Neher, A Milani
Jul 1, 1986·British Journal of Anaesthesia·B G Covino
Dec 1, 1987·Postgraduate Medical Journal·P H Smith, T G Armitage
Nov 1, 1986·Acta Anaesthesiologica Scandinavica·A A ProkopiouJ P Rood
Dec 1, 1969·Australian Dental Journal·D J Bradley, N D Martin
Jun 1, 1982·Journal of Dentistry·P CaruanaJ P Rood
Feb 1, 1961·British Journal of Pharmacology and Chemotherapy·A ASTROM, N H PERSSON
Jul 1, 1961·The Journal of the American Dental Association·C WEILR F YACKEL
May 1, 1960·Toxicology and Applied Pharmacology·F P LUDUENAH P DROBECK
Feb 1, 1963·The Journal of Pharmacy and Pharmacology·G C JEFFERSON
Nov 1, 1961·Anesthesiology·P R KNOXC R STEPHEN

❮ Previous
Next ❯

Citations

Feb 5, 2000·Regional Anesthesia and Pain Medicine·D S KohaneC B Berde
Feb 25, 2020·Equine Veterinary Journal·Alycia CrandallDavid Levine

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

© 2021 Meta ULC. All rights reserved