Pethidine has a local anaesthetic action on peripheral nerves in vivo. Addition to prilocaine 0.25% for intravenous regional anaesthesia in volunteers.

In a double-blind, randomised study, we have examined the effects of the addition of pethidine 100 mg to 40 ml prilocaine 0.25% for intravenous regional anaesthesia in healthy volunteers. During intravenous regional anaesthesia the hand and forearm are isolated from the rest of the circulation and pethidine interaction with central opiate receptors does not occur. Pethidine increased the speed of onset and extent of sensory and motor block, reduced tourniquet and forearm pain, and subjectively improved the quality of the block. Pethidine has local anaesthetic action on peripheral nerves in vivo.