Search

Controversy still surrounds the differential susceptibility of nerve fibers to local anesthetic conduction block. In order to help resolve this controversy, we developed an in vivo model of peripheral nerve blockade in the cat that closely reproduced the clinical state. Using this model, differential rate of nerve blockade of A-alpha, A-delta, and C fibers by 2-chloroprocaine, lidocaine, bupivacaine, and etidocaine was observed and quantitated. C fibers were blocked first by 2-chloroprocaine, lidocaine and bupivacaine. Etidocaine blocked A-delta fibers first. A-alpha fibers always were blocked last. Of the four local anesthetics tested, 2-chloroprocaine produced the greatest differential rate of block of the nerve fibers, and etidocaine produced the least.

The responses of peripheral nerves less than 6 hr after and 2 weeks after exposure to 2-chloroprocaine (2-CP) and bisulfite (BS) were studied in cats using electrophysiologic techniques and by light and electron microscopy. Three percent 2-CP with 0.07% or 0.2% BS was not toxic to peripheral nerves. Three percent 2-CP with 1.2% BS and 1.2% BS (pH 2.8) alone had an acute effect on the peripheral nerves but no chronic effect. Ten percent BS (pH 2.8) caused Wallerian degeneration. However, at pH 4.8, no chronic toxicity was observed. Using conductivity measurements, it was shown that 2-CP and BS, when mixed, form an ion pair in solution that lowers the effective concentration of BS.