Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Jul-Sep;31(3):384-93.
doi: 10.4103/0970-9185.161679.

Physiological and pharmacologic aspects of peripheral nerve blocks

Prasanna Vadhanan  1 , Debendra Kumar Tripaty  2 , S Adinarayanan  3
Affiliations

Physiological and pharmacologic aspects of peripheral nerve blocks

Prasanna Vadhanan et al. J Anaesthesiol Clin Pharmacol. 2015 Jul-Sep.

Abstract

A successful peripheral nerve block not only involves a proper technique, but also a thorough knowledge and understanding of the physiology of nerve conduction and pharmacology of local anesthetics (LAs). This article focuses on what happens after the block. Pharmacodynamics of LAs, underlying mechanisms of clinically observable phenomena such as differential blockade, tachyphylaxis, C fiber resistance, tonic and phasic blockade and effect of volume and concentration of LAs. Judicious use of additives along with LAs in peripheral nerve blocks can prolong analgesia. An entirely new group of drugs-neurotoxins has shown potential as local anesthetics. Various methods are available now to prolong the duration of peripheral nerve blocks.

Keywords: Local anesthesia; nerve blockade; regional anesthesia.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Intraneural arrangement
Figure 2
Figure 2
Ion distribution across neuronal membranes
Figure 3
Figure 3
NaV channel cross-section
See this image and copyright information in PMC

References

    1. Bonnel F. Microscopic anatomy of the adult human brachial plexus: an anatomical and histological basis for microsurgery. Microsurgery. 1984;5:107–18. - PubMed
    1. Moayeri N, Bigeleisen PE, Groen GJ. Quantitative architecture of the brachial plexus and surrounding compartments, and their possible significance for plexus blocks. Anesthesiology. 2008;108:299–304. - PubMed
    1. Neal JM, Gerancher JC, Hebl JR, Ilfeld BM, McCartney CJ, Franco CD, et al. Upper extremity regional anesthesia: Essentials of our current understanding, 2008. Reg Anesth Pain Med. 2009;34:134–70. - PMC - PubMed
    1. Myers RR, Heckman HM. Effects of local anesthesia on nerve blood flow: Studies using lidocaine with and without epinephrine. Anesthesiology. 1989;71:757–62. - PubMed
    1. Bell MA, Weddell AG. A descriptive study of the blood vessels of the sciatic nerve in the rat, man and other mammals. Brain. 1984;107(Pt 3):871–98. - PubMed