Fink B R, Cairns A M
Anesthesiology. 1984 Feb;60(2):111-20. doi: 10.1097/00000542-198402000-00006.
The study of compound action potentials has not succeeded in determining exact limits to differential block of nerve fibers by local anesthetics. Further observations on individual neurons therefore were undertaken. Rabbit vagus nerve and ganglion were superfused in vitro at 37 degrees C, pH 7.4. Activity evoked by stimulating the distal end of the nerve was monitored extracellularly from individual somata by a microelectrode in the ganglion. Lidocaine HCl in steps of 0.2-0.1 mmol/l (0.0005-0.0025 g/dl) was applied to the intervening nerve to identify two concentrations, respectively, just sparing and extinguishing conduction in the axon belonging to the soma, the average being regarded as the blocking concentration. The mean blocking concentrations (mM, +/- SD) for axons conducting at control velocities between 3 and 26 m/s (myelinated axons) was 0.43 +/- 0.15, N = 18, for axons slower than 1.4 m/s (unmyelinated axons) 0.63 +/- 0.14, N = 11, for intermediate velocity axons 0.19 +/- 0.18, N = 7. The differences were significant by Scheffé's multiple comparisons test (P less than 0.01). Although the myelinated axons were blocked by a lower average concentration of lidocaine than unmyelinated axons, they manifested significantly more slowing of conduction before block (P less than 0.001). No relation between blocking concentration or latency increase and conduction velocity (fiber size) was evident within any fiber group.
复合动作电位的研究未能成功确定局部麻醉药对神经纤维差异阻滞的确切界限。因此,对单个神经元进行了进一步观察。兔迷走神经和神经节在37℃、pH 7.4的条件下进行体外灌流。通过刺激神经远端诱发的活动,在神经节中用微电极从单个胞体进行细胞外监测。将盐酸利多卡因以0.2 - 0.1 mmol/l(0.0005 - 0.0025 g/dl)的梯度施加于中间神经,以分别确定刚好能保留和消除属于该胞体的轴突传导的两种浓度,其平均值被视为阻滞浓度。对于在对照速度3至26 m/s之间传导的轴突(有髓轴突),平均阻滞浓度(mM,±SD)为0.43 ± 0.15,N = 18;对于速度低于1.4 m/s的轴突(无髓轴突),为0.63 ± 0.14,N = 11;对于中等速度轴突,为0.19 ± 0.18,N = 7。通过谢费多重比较检验,差异具有显著性(P < 0.01)。尽管有髓轴突被利多卡因阻滞的平均浓度低于无髓轴突,但它们在阻滞前传导速度的减慢更为显著(P < 0.001)。在任何纤维组内,阻滞浓度或潜伏期增加与传导速度(纤维大小)之间均无明显关系。