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British Journal of Anaesthesia, 1985, Vol. 57, No. 6 612-620
© 1985 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

DIFFERENTIAL NERVE BLOCKING ACTIVITY OF AMINO-ESTER LOCAL ANAESTHETICS

J. A. W. WILDSMITH, M.D., F.F.A.R.C.S., A. J. GISSEN, M.D., J. GREGUS, and B. J. COVINO, PH.D., M.D.

Department of Anaesthesia, Harvard Medical School, Brigham and Women's Hospital Boston, MA, U.S.A.

Correspondence to: J.A.W.W., Department of Anaesthetics, Lauriston Place, Edinburgh EH3 9YW.

The in vitro sensitivities to local anaesthetic blockade of A, B and C nerve fibres in rabbit vagus nerves were examined using a series of structurally similar amino-ester agents which varied in lipid solubility and anaesthetic potency. A fibres were found to be the most sensitive and C fibres the least sensitive to conduction blockade with all the agents, provided that equilibrium blockade was allowed to develop. A correlation existed between the intrinsic anaesthetic potency of the various agents and their lipid solubilities. Equipotent concentrations of the drugs blocked C fibres at approximately the same rate, but there were marked variations in the rate at which A fibres were blocked. Amethocaine, an agent of high lipid solubility, blocked A fibres more quickly than C. As lipid solubility decreased through the series studied, so the onset of conduction blockade of A fibres was prolonged. It is suggested that this related to decreasing ability to penetrate the lipid diffusion barriers around A fibres. The traditional view that C fibres were more sensitive to block may have arisen because of confusion between absolute sensitivity and rate of development of conduction blockade.


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