Overview of local anesthetics

Helgeson, Lars E.; Sinatra, Raymond S.

doi:10.1017/cbo9780511841378.064

Cited by 2 publications

(2 citation statements)

References 7 publications

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“…In a peripheral nerve, the nerve fibers are arranged as outer mantle fibers innervating the proximal structures and inner core fibers innervating the distal structures. Mantle fibers from outside to inside include C-fibers (unmyelinated) and Aδ (noxious) and Aβ fibers (sensory), whereas core fibers mainly include Aα fibers (motor) [6]. Local anesthetic agent diffuses from the mantle to the core along a concentration gradient, with anesthesia progressing in a proximal-to-distal direction.…”

Section: Discussionmentioning

confidence: 99%

Unraveling the mysteries of a costoclavicular block: A case report

Sonawane¹,

Dixit²,

Balavenkatasubramanian³

2020

IJCR

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The outcome of regional anesthesia with respect to the sensory and motor effects of local anesthetics has been a mystery to anesthesiologists. However, testing these effects is subjective with the currently available scoring/grading systems. We report an unusual case where the author himself is a patient, a 37-year-old male with no comorbidities, who underwent plating of distal radius fracture under costoclavicular block (CCB). He took this opportunity to record changes in the sensory and motor functions that he experienced until he regained them completely. This case report is a narration of his own experiences related to CCB during the perioperative period.

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Section: Discussionmentioning

confidence: 99%

Unraveling the mysteries of a costoclavicular block: A case report

Sonawane¹,

Dixit²,

Balavenkatasubramanian³

2020

IJCR

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“…Mantle fibers mainly include (from outside to inside) B-fibers (autonomic), Cfibres (unmyelinated), Aδ (noxious), and Aβ fibers (sensory). The core fibers mainly include Aα fibers (motor) [70]. Depending on the fiber type and size, the sequence of block onset is B fibers> C fibers = Aδ fibers> Aγ fibers> Aβ fibers> Aα fibers.…”

Section: Nerve Fibers Arrangementmentioning

confidence: 99%

“Knowing It Before Blocking It,” the ABCD of the Peripheral Nerves: Part A (Nerve Anatomy and Physiology)

Sonawane,

Dixit,

Jayaraj

et al. 2023

Cureus

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Regional anesthesia (RA) is an interplay between the local anesthetic (LA) solution and the neural structures, resulting in nerve conduction blockade. For that, it is necessary to understand which hurdles the LA has to overcome and which components of the nerves are involved. Background knowledge of the neural and non-neural components of the nerve helps locate the safest area for LA deposition. In addition, knowledge of nerve physiology and the conduction process helps to understand the patterns of block onset, involved fibers, and block regression. Neural connective tissue protects the nerve on the one hand and influences the overall effect of the blockade and the occurrence of nerve injuries on the other. The arrangement of the nerve fibers explains the science behind the differential blockage after LA deposition. This article describes the important aspects of nerve anatomy (nerve formation and composition) and nerve physiology (impulse generation and propagation). It also provides insight into the physiological processes involved when a damaged neural structure leads to potential clinical symptoms. It will help readers sharpen their skills and knowledge to execute safe RA without damaging any vital structures in the nerve.

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Overview of local anesthetics

Cited by 2 publications

References 7 publications

Unraveling the mysteries of a costoclavicular block: A case report

Unraveling the mysteries of a costoclavicular block: A case report

“Knowing It Before Blocking It,” the ABCD of the Peripheral Nerves: Part A (Nerve Anatomy and Physiology)

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