Mechanisms of Differential Nerve Block

  • S. A. Raymond
  • A. J. Gissen
Part of the Handbook of Experimental Pharmacology book series (HEP, volume 81)


Local anesthesia has been in active clinical use for 100 years. During the past 50 years surprisingly little change has occurred in drugs or techniques. Recently there has been a rapid increase in the demands placed on the anesthesiologist: The parturient needs pain relief but does not wish to prolong her labor by decrease in motor function. The patient with chronic pain needs relief but a clear sensor-ium so he may continue as an active member of society. Patients suffering from various neurological disorders with uncontrollable muscle spasms need relief without loss of sensation. These demands can be satisfied only partially with available methods of local anesthesia.


Peripheral Nerve Conduction Velocity Myelinated Fiber Conduction Block Compound Action Potential 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Adrian ED (1921) The recovery process of excitable tissues. Part II. J Physiol (Lond) 55:193–225Google Scholar
  2. Adrian ED (1932) The mechanism of nervous action. University of Pennsylvania Press, PhiladelphiaGoogle Scholar
  3. Ahlgren EW, Stephen CR, Lloyd EAC, McCollum DE (1966) Diagnosis of pain with a graduated spinal block technique. JAMA 195:125–128Google Scholar
  4. Amagasa S, Ando K, Sakai M, Kato Y, Ichiyanagi K (1984) Phenol exerts greater effects on larger nerve fibers. Pain (Suppl. 2):S 10Google Scholar
  5. Arbuthnott R, Boyd I A, Kalu KU (1980) Ultrastructural dimensions of myelinated peripheral nerve fibers in the cat and their relation to conduction velocity. J Physiol (Lond) 308:125–157Google Scholar
  6. Arrowood JG (1950) Differential spinal block with particular reference to hypertensive patients. Proc R Soc Med 43:919–928PubMedGoogle Scholar
  7. Arrowood JG, Sarnoff SJ (1948) Differential spinal block: use in the investigation of pain following amputation. Anesthesiology 9:614–622PubMedGoogle Scholar
  8. Bakland LK (1973) Electroanalgesia by transalveolar and transdental stimulation. Thesis, Harvard School of Dental Medicine, Boston, MAGoogle Scholar
  9. Bennett AL, Wagner JC, McIntyre AK (1942) The determination of local anesthetic potency by observation of the nerve action potential. J Pharmacol Exp Ther 75:125–136Google Scholar
  10. Berthold CH (1978) Morphology of normal peripheral axons. In: Waxman SG (ed) Physiology and pathobiology of axons. Raven, New York, pp 3–63Google Scholar
  11. Bischoff A (1979) Congenital insensitivity to pain with anhidrosis: a morphometric study of sural nerve and cutaneous receptors in the human prepuce. In: Bonica JJ (ed) Advances in pain research and therapy, vol 3. Raven, New York, pp 53–65Google Scholar
  12. Bishop GH, O’Leary J (1939) B and C nerve fibers. Am J Physiol 126:434Google Scholar
  13. Bishop GH, Heinbecker P, O’Leary J (1933) The function of the non-myelinated fibers of the dorsal roots. Am J Physiol 106:647–669Google Scholar
  14. Boyd IA, Kalu KU (1979) Scaling factor relating conduction velocity and diameter for myelinated afferent nerve fibres in cat hind limb. J Physiol (Lond) 289:277–297Google Scholar
  15. Bromage PR (1978) Epidural analgesia. Saunders, Philadelphia, PAGoogle Scholar
  16. Brown DT, Morison DH, Covino BG, Scott DB (1980) Comparison of carbonated bupiva-caine and bupivacaine hydrochloride for extradural anaesthesia. Br J Anaesth 52:419–422PubMedGoogle Scholar
  17. Burgess PR, Yu WJ, Clark FJ, Simon J (1982) Signaling of kinesthetic information by peripheral sensory receptors. Annu Rev Neurosci 5:171–187PubMedGoogle Scholar
  18. Burke D, Mackenzie RA, Skuse NF, Lethlean AK (1975) Cutaneous afferent activity in median and radial nerve fascicles: a microelectrode study. J Neurol Neurosurg Psy-chiatr 38:855–864Google Scholar
  19. Caldwell PC (1958) Studies on the internal pH of large muscle and nerve fibres. J Physiol (Lond) 142:22–49Google Scholar
  20. Carley LR (1984) Characterizing and comparing the aftereffects of activity at successive nodes of Ranvier from frog sciatic nerve fibers. Ph D Thesis, Dept Electrical Engineering and Computer Science, MIT, Cambridge, MassGoogle Scholar
  21. Carley LR, Raymond SA (1983) Comparison of the aftereffects of activity between nodes of Ranvier. Soc Neurosci (Abstr) 9:1049. 24Google Scholar
  22. Cassell EJ (1982) The nature of suffering and the goals of medicine. NEngl J Med 306: 639–645Google Scholar
  23. Catchlove RFH (1972) The influence of CO2 and pH on local anesthetic action. J Pharmacol Exp Ther 181:298–309PubMedGoogle Scholar
  24. Catchlove RFH (1973) Potentiation of two different local anaesthetics by carbon dioxide. Br J Anaesth. 45:471–475PubMedGoogle Scholar
  25. Chapman CR (1980) Pain and perception: comparison of sensory decision theory and evoked potential methods. Res Pub Assoc Res Nern Ment Dis 58:111–142Google Scholar
  26. Chiu SY, Ritchie JM (1984) On the physiological role of internodal potassium channels and the security of conduction in myelinated nerve fibers. Proc R Soc Lond (Biol) 220:415–422Google Scholar
  27. Chiu SY, Richie JM, Rogart RB, Stagg D (1979) A quantitative description of membrane currents in rabbit myelinated nerve. J Physiol (Lond) 292:149–166Google Scholar
  28. Clark D, Hughes J, Gasser HS (1935) Afferent function in the group of nerve fibers of slowest conduction velocity. Am J Physiol 114:69–76Google Scholar
  29. Clifton GL, Coggleshell RE, Vance WH, Willis WD (1976) Receptive fields of unmyelinated ventral root afferent fibres in the cat. J Physiol (Lond) 256:573–600Google Scholar
  30. Coggleshell RE, Applebaum ML, Fazen ML, Stubbs TB, Sykes MT (1975) Unmyelinated axons in human ventral roots: a possible explanation for the failure of dorsal rhizotomy to relieve pain. Brain 98:157–166Google Scholar
  31. Cohen LB, DeWeer P (1977) Structural and metabolic processes directly related to action potential propagation. Handbook of Physiology Chap 5, American Physiological Society, Washington, pp 137–159Google Scholar
  32. Cole F (1952) Tourniquet pain. Anaesth. Analg 31:63–64Google Scholar
  33. Colquhoun DJ, Ritchie JM (1972) The interaction at equilibrium between TTX and mammalian non-myelinated nerve fibers. J Physiol (Lond) 221:533–553Google Scholar
  34. Collins WF Jr, Nulsen FE, Randt CT (1960) Relation of peripheral nerve fiber size and sensation in man. Arch Neurol 3:381–385PubMedGoogle Scholar
  35. Condouris G A (1961) A study on the mechanism of action of cocaine on amphibian peripheral nerve. J Pharmacol Exp Ther 131:243–249PubMedGoogle Scholar
  36. Condouris GA, Goebel RH, Brady T (1976) Computer simulation of local anesthetic effects using a mathematical model of myelinated nerve. J Pharmacol Exp Ther 196: 737–745PubMedGoogle Scholar
  37. Connelly CM (1959) Recovery processes and metabolism of nerve. Rev Mod Phys 31: 474–484Google Scholar
  38. Coraboeuf E, Niedergerke R (1953) Kohlensäure- und pH-Wirkung an der markhaltigen Einzelfaser des Froschs. Pflügers Archiv 258:103–107PubMedGoogle Scholar
  39. Courtney KR (1975) Mechanism of frequency-dependent inhibition of sodium currents in frog myelinated nerve by the lidocaine derivative GEA968. J Pharmacol Exp Ther 195:225–236PubMedGoogle Scholar
  40. Courtney KR, Kendig JJ, Cohen EN (1978) Frequency-dependent conduction block: the role of nerve impulse pattern in local anesthetic potency. Anesthesiology 48:111–117PubMedGoogle Scholar
  41. Crescitelli F (1948) Carbamate conduction block in frog nerve fibers. Am J Physiol 155: 82–91PubMedGoogle Scholar
  42. Crescitelli F (1950) A temperature differentiation on the dual action of amyl carbamate on frog nerve. J Cell Comp Physiol 35:261–272Google Scholar
  43. Crescitelli F (1952 a) Some features in responses of different nerve fiber types to a deficiency of sodium. Am J Physiol 169:1–10PubMedGoogle Scholar
  44. Crescitelli F (1952 b) Modification in responses to sodium of nerve fibers treated with drugs. Am J Physiol 169:638–648PubMedGoogle Scholar
  45. Darian-Smith I, Johnson OK, Dykes R (1973) “Cold” fiber population innervating palmar and digital skin of monkey: responses to cooling pulses. J Neurophysiol 36:325–346PubMedGoogle Scholar
  46. Dawson GD (1971) Brain mechanisms. In: Remond A (ed) Handbook of EEG and clinical neurophysiology Vol 9, Elsevier, Amsterdam, pp 44–56Google Scholar
  47. Denny-Brown D, Brenner C (1944) Lesion in peripheral nerve resulting from compression by spring clip. Arch Neurol Psychiatr 52:1–19Google Scholar
  48. Dhopesh VP, Bums RA (1976) Loss of nerve conduction in heat stroke. NEng J Med 294:557–558Google Scholar
  49. Didisheim JC, Postemak JM (1959) Anesthésie différentiale du nerf sciatique de la grenouille. Helv Physiol Acta 17:242–253Google Scholar
  50. Dixon WE (1905) The selective action of cocaine on nerve fibres. J Physiol (Lond) 32: 87–94Google Scholar
  51. Dodd J, Jahr CE, Jessel TM (1984) Neurotransmitters and neuronal markers at sensory synapses in dorsal horn. In Kruger L, Liebeskind JC (eds) Advances in pain research and therapy, vol 6. Raven, New York, pp 105–121Google Scholar
  52. Dodt HU, Strichartz GR, Zimmermann M (1983) Phenol solutions differentially block conduction in cutaneous nerve fibers of the cat. Neurosci Lett 42:323–327PubMedGoogle Scholar
  53. Douglas WW, Malcolm JL (1955) The effect of localized cooling on conduction in cat nerves. J Physiol (Lond) 130:53–71Google Scholar
  54. Douglas WW, Ritchie JM (1957) Non-medullated fibers in the saphenous nerve which signal touch. J Physiol (Lond) 139:385–399Google Scholar
  55. Douglas WW, Ritchie JM (1962) Mammalian non-myelinated nerve fibers. Physiol Rev 42:297–334PubMedGoogle Scholar
  56. Douglas WW, Ritchie JM, Straub RW (1960) The role of non-myelinated fibers in signalling cooling of the skin. J Physiol (Lond) 150:266–283Google Scholar
  57. Dun FT (1955) The delay and blockage of sensory impulses in the dorsal root ganglion. J Physiol (Lond) 127:252–264Google Scholar
  58. Dyck PJ, Lambert EH, Nichols PC (1972) Quantitative measurements of sensation related to compound action potential and number and sizes of myelinated and unmyelinated fibers of sural nerve in health, Friedrich’s ataxia, hereditary sensory neuropathy and tabes dorsalis. In: Cobb WA (ed). Handbook of EEG and clinical neurophysiology, Vol 9, Somatic sensation. Elsevier, Amsterdam pp 83–118Google Scholar
  59. Erlanger J, Blair EA (1940) Facilitation and difficilitation effected by nerve impulses in peripheral fibers. J Neurophysiol 3:107–127Google Scholar
  60. Erlanger J, Gasser HS (1937) Electrical signs of nervous activity. University of Pennsylvania Press, Philadelphia, pp 1–221Google Scholar
  61. Erlanger J, Blair EA, Schoepfle GM (1941) A study of the spontaneous oscillations in the excitability of nerve fibers, with special reference to the action of strychnine. Am J Physiol 134:705–718Google Scholar
  62. Everett GM, Goodsell JS (1952) The greater resistance to procaine of slow fiber groups in some peripheral nerves. J Pharmacol Exp Ther 106:385Google Scholar
  63. Everett GM, Toman JEP (1954) Procaine block of fiber groups in various nerves. Fed Proc 13:352–353Google Scholar
  64. Fields HL (1984) Brainstem mechanisms of pain modulation. In: Kruger L, Liebeskind JC (eds) Advances in pain research and therapy, vol 6. Raven, New York, pp 242–252Google Scholar
  65. Fields HL, Basbaum AI (1978) Brainstem control of spinal pain-transmission neurons. Annu Rev Physiol 40:217–248PubMedGoogle Scholar
  66. Fields HL, Basbaum AI (1979) Anatomy and physiology of a descending pain control system. In: Bonica JJ (ed) Advances in pain. Research and therapy, vol 3, pp 427–440Google Scholar
  67. Fields HL, Vanegas H, Hentall ID, Zorman G (1983) Evidence that disinhibition of brain stem neurons contributes to morphine analgesia. Nature 306:684–686PubMedGoogle Scholar
  68. Fink BR, Cairns AM (1982) A bioenergetic basis for peripheral nerve fiber dissociation. Pain 12:307–317PubMedGoogle Scholar
  69. Fink BR, Cairns AM (1983 a) Test of differential block by lidocaine in individual nerve fibers. Reg Anesth 8:36–37Google Scholar
  70. Fink BR, Cairns AM (1983 b) Differential peripheral axon block with lidocaine: unit studies in the cervical vagus nerve. Anesthesiology 59:182–186PubMedGoogle Scholar
  71. Fink BR, Cairns AM (1983 c) A new approach to differential peripheral nerve fiber block. Na+, K+-ATPase inhibition. Anesthesiology 59:127–131PubMedGoogle Scholar
  72. Fink BR, Cairns AM (1984) Differential slowing and block of conduction by lidocaine in individual afferent myelinated and unmyelinated axons. Anesthesiology 60:111–120; 515PubMedGoogle Scholar
  73. Fink BR, Cairns AM (1984 b) Differential block times of individual axons. Reg Anesth 9:36Google Scholar
  74. Fitzgerald M (1983) Capsaicin: action on peripheral nerves. A review. Pain 15:109–130PubMedGoogle Scholar
  75. Ford DJ, Raj PP, Pritam S, Regan KR, Ohlweiler D (1984) Differential peripheral nerve block by local anesthetics in the cat. Anesthesiology 60:28–33PubMedGoogle Scholar
  76. Frank JI (1980) Functional reorganization of cat somatic sensory motor cortex Sml after selective dorsal root rhizotomies. Brain Res 186:458–462Google Scholar
  77. Franz DN, Iggo A (1968) Conduction failure in myelinated and non-myelinated axons at low temperatures. J Physiol (Lond) 199:319–345Google Scholar
  78. Franz DN, Perry RS (1974) mechanisms for differential block among single myelinated and non-myelinated axons by procaine. J Physiol (Lond) 236:193–210Google Scholar
  79. Fruhstorfer H, Lindblom U (1983) Vascular participation in deep cold pain. Pain 17: 235–241PubMedGoogle Scholar
  80. Fukushima K, Yohara O, Kato M (1975) Differential blocking of motor fibers by direct current. Pfiugers Arch 358:235–242Google Scholar
  81. Ganong WF (1981) Review of medical physiology. Lange, Los Altos, pp 31–45Google Scholar
  82. Gasser HS (1935 a) Changes in nerve-potentials produced by rapidly repeated stimuli and their relation to the responsiveness of nerve to stimulation. Am J Physiol 35–50Google Scholar
  83. Gasser HS (1935 b) Conduction in nerves in relation to fiber types. Res Publ Assoc Res Nerve Ment Dis 23:44–62; 15:35–59Google Scholar
  84. Gasser HS (1943) Pain-producing impulses in peripheral nerves. Res Publ Assoc Res Nerv Ment Dis 23:44–62Google Scholar
  85. Gasser HS (1950) Unmedullated fibers originating in dorsal root ganglia. J Gen Physiol 33:651–690PubMedGoogle Scholar
  86. Gasser HS, Erlanger J (1927) The role played by the sizes of the constituent fibers of a nerve trunk in determining the form of its action potential wave. Am J Physiol 80:522–547Google Scholar
  87. Gasser HS, Erlanger J (1929) Role of fiber size in establishment of nerve block by pressure or cocaine. Am J Physiol 88:581–591Google Scholar
  88. Gasser HS, Grundfest H (1939) Axon diameters in relation to the spike dimensions and the conduction velocity in mammalian A-fibers. Am J Physiol 127:393–414Google Scholar
  89. Gasser HS, Richards CH, Grundfest H (1938) Properties of the nerve fibers of slowest conduction in the frog. Am J Physiol 123:299–306Google Scholar
  90. Georgopoulos AP (1977) Stimulus-response relations in high-threshold mechanothermal fibers innervating primate glabrous skin. Brain Res 128:547–552PubMedGoogle Scholar
  91. Georgopoulos AP, Mountcastle VB (1976) Functional properties of primary afferent units probably related to pain mechanisms in primate glabrous skin. J Neurophysiol 39: 71–83PubMedGoogle Scholar
  92. Gerick JE, Charles MA, Grodsky GM (1976) Regulation of pancreatic insulin and glucagon secretion. Annu Rev Physiol 38:353Google Scholar
  93. Ghia JN, Toomey TC, Mao W, Duncan G, Gregg JM (1979) Towards an understanding of chronic pain mechanisms: the use of psychologic tests and a refined differential spinal block. Anesthesiology 50:20–25PubMedGoogle Scholar
  94. Gilliatt RW (1980) Acute compression block. In: Sumner AJ (ed). The physiology of peripheral nerve disease, Chap 9. Saunders, Philadelphia, pp 287–315Google Scholar
  95. Gissen AJ, Covino BG, Gregus J (1980) Differential sensitivities of mammalian nerve fibers to local anesthetic agents. Anesthesiology 53:467–474PubMedGoogle Scholar
  96. Gissen AJ, Covino BG, Gregus J (1982 a) Differential sensitivity of fast and slow fibers in mammalian nerve: II. Margin of safety for nerve transmission. Anesth Analg 61: 561–569PubMedGoogle Scholar
  97. Gissen AJ, Covino BG, Gregus J (1982) Differential sensitivity of fast and slow fibers in mammalian nerve: III. Effect of etidocaine and bupivacaine on fast/slow fibers. Anesth Analg 61:570–575PubMedGoogle Scholar
  98. Greene NM (1958) Area of differential block in spinal anesthesia with hyperbaric tetracaine. Anesthesiology 19:45–50PubMedGoogle Scholar
  99. Grossman Y, Parnas I, Spira ME (1979) Differential conduction block in branches of a bifurcating axon. J Physiol (Lond) 295:282–305Google Scholar
  100. Grundfest H (1939) Properties of mammalian B-fibers. Am J Physiol 127:252–262Google Scholar
  101. Hallin RG, Torebjork HE (1973) Electrically induced A and C-fibre responses in intact human skin nerves. Exp Brain Res 16:309–320PubMedGoogle Scholar
  102. Hallin RG, Torebjork HE (1976) Studies on cutaneous A and C-fibre afferents. Skin nerve blocks and perception. In: Zotterman Y (ed) Sensory functions of the skin in primates. Pergamon, Oxford, pp 137–149Google Scholar
  103. Heavner J, de Jong RH (1974) Lidocaine blocking concentrations for B- and C-fibers. Anesthesiology 40:228–233PubMedGoogle Scholar
  104. Heinbecker P, Bartley SH (1940) Action of ether and nembutal on the nervous system. J Neurophysiol 3:219–236Google Scholar
  105. Heinbecker P, Bishop GH (1935) The mechanism of painful sensations. Res Publ Assoc Res Nerve Ment Dis 15:226–238Google Scholar
  106. Heinbecker P, O’Leary J (1933) The mammalian vagus nerve - a functional and histological study. Am J Physiol 106:623–646Google Scholar
  107. Heinbecker P, Bishop GH, O’Leary J (1933) Pain and touch fibers in peripheral nerves. Arch Neurol Psychiatr 29:771–789Google Scholar
  108. Heinbecker P, Bishop GH, O’Leary J (1934) Analysis of sensation terms of nerve impulses. Arch Neurol Psychiatr 31:34–53Google Scholar
  109. Hille B (1968) Pharmacological modifications of the sodium channels of frog nerve. J Gen Physiol 51:199–219PubMedGoogle Scholar
  110. Hille B (1977) The pH-dependent rate of action of local anesthetics on the node of Ranvier. J Gen Physiol 69:475–496PubMedGoogle Scholar
  111. Henneman E (1980) Organization of the spinal cord and its reflexes. In: Mountcastle VB (ed) Medical physiology. Mosby, St. Louis, pp 762–786Google Scholar
  112. Hunt CC, McIntyre AK (1960 a) Properties of cutaneous touch receptors in cat. J Physiol (Lond) 153:88–98Google Scholar
  113. Hunt CC, McIntyre AK (1960 b) An analysis of fibre diameter and receptor characteristics of myelinated cutaneous afferent fibres in cat. J Physiol (Lond) 153:99–112Google Scholar
  114. Ichioka M, Uehara Y, Seikichi K (1960) On the local response of a single node of Raniver under various conditions. Jpn J Physiol 10:235–245PubMedGoogle Scholar
  115. Iggo A (1960) Cutaneous mechanoreceptors with afferent C-fibres. J Physiol (Lond) 152:337–353Google Scholar
  116. Iggo A, Andres KH (1982) Morphology of cutaneous receptors. Annu Rev Neurosci 5: 1–33PubMedGoogle Scholar
  117. Ignelzi RJ, Nyquist JK (1979 a) Observations on fast axoplasmic transport in peripheral nerve following repetitive electrical stimulation. Pain 7:313–320PubMedGoogle Scholar
  118. Ignelzi RJ, Nyquist JK (1979 b) Excitability changes in peripheral nerve fibers after repetitive electrical stimulation. J Neurosurg 51:824–833PubMedGoogle Scholar
  119. Ignelzi RJ, Nyquist JK, Tighe WJ (1981) Repetitive electrical stimulation of peripheral nerve and spinal cord activity. Neurol Res 3:195–208PubMedGoogle Scholar
  120. Ito M, Takahashi I (1960) Impulse conduction through spinal ganglion. In: Katsuki Y (ed) Electrical activity of single cells. Ikagu Shoin, Tokyo, pp 159–179Google Scholar
  121. Jack JJB (1975) Physiology of peripheral nerve fibers in relation to their size. Br J Anaesth 47:173–182PubMedGoogle Scholar
  122. Jancso G, Kiraly E, Jancso-Gabor A (1977) Pharmacologically induced selective degeneration of chemosensitive primary sensitive neurons. Nature 270:741–743PubMedGoogle Scholar
  123. Jänig W (1982) The autonomic nervous system. In: Human physiology. Schmidt RF, Thews G (eds) Springer, Berlin, pp 111–149Google Scholar
  124. Jong, de RH (1980 a) Clinical physiology of local anesthetic action. In: Neural blockade in clinical anesthesia and management of pain, Chap 2. Cousins MS, Bridenbaugh PO (eds). JP Lippincott Co., Philadelphia, pp 21–44Google Scholar
  125. Jong, de RH (1980 b) Editorial views: differential nerve block by local anesthetics. Anesthesiology 53:443PubMedGoogle Scholar
  126. Jong, de RH, Cullen SC (1963) Theoretical aspects of pain: bizarre pain phenomena during low spinal anesthesia. Anesthesiology 24:628–635Google Scholar
  127. Katz J, Joseph (JW (1980) Neuropathology of neurolytic and semidestructive agents. In; Cousins MJ, Bridenbaugh PO (eds) Neural Blockade. Lippincott, Philadelphia, pp 122–132Google Scholar
  128. Krnjević K, Miledi R (1959) Presynaptic failure of neuromuscular propagation in rats. J Physiol (Lond) 149:1–22Google Scholar
  129. LaMotte RH (1984) Cutaneous nociceptors and pain sensation in normal and hyperalgesic skin. Adv Pain Res Ther 6:69–82Google Scholar
  130. Landon DN (1982) The structure of the nerve fiber. In Culp WJ, Ochoa J (eds) Abnormal nerves and muscles as impulse generators. Oxford University Press, New York, p 27–53Google Scholar
  131. Landon DN, Langley OK (1971) The local chemical environment of nodes of Ranvier: a study of cation binding. J Anat 108:419–432PubMedGoogle Scholar
  132. Larrabee MG, Posternak JM (1952) Selective action of anesthetics on synapses and axons in mammalian sympathetic ganglia. J Neurophysiol 15:91–114PubMedGoogle Scholar
  133. Leatherdale RAL (1956) Phantom limb pain associated with spinal analgesia. Anaesthesia 11:249–251PubMedGoogle Scholar
  134. Lehmann JF (1937) The effect of changes in pH on the action of mammalian. A nerve fibers. Am J Physiol 118:600–612Google Scholar
  135. Leksell L (1945) The action potential and excitatory effects of small ventral root fibers to skeletal muscle. Acta Physiol Scand (Suppl) 31:1–84Google Scholar
  136. Leone J, Ochs S (1978) Anoxic block and recovery of axoplasmic transport and electrical excitability of nerve. J Neurobiol 9:229–245PubMedGoogle Scholar
  137. Levine JW, Terman GW, Shavit Y, Nelson LR, Liebeskind JF (1984) Neural, neurochemical, and hormonal bases of stress-induced analgesia. In: Kruger L, Liebeskind JC (eds) Advances in pain research and therapy, vol 6. Raven, New York, pp 277–288Google Scholar
  138. Lewis T (1942) Pain. MacMillan, London, pp 1–192Google Scholar
  139. Lewis T, Pickering GW, Rothchild P (1931) Centripetal paralysis arising out of arrested bloodflow to the limbs including notes on a form of tingling. Heart 16:1–32Google Scholar
  140. Lindblom U, Meyerson BA (1975) Influence on touch, vibration and pain of dorsal column stimulation in man. Pain 1:251–270Google Scholar
  141. Lorente de Nó R (1947 a) Carbon dioxide and nerve function. In: Studies from the Rockefeller Institute for Medical Research, New York, vol 131, p 148–194Google Scholar
  142. Lorente de Nó R (1947 b) Effects of sugars and other substances upon nerve. A study of nerve physiology. Studies from the Rockefeller Institute for Medical Research, New York, vol 131, pp 195–243Google Scholar
  143. Lorente de No R, Condouris GA (1959) Decremental conduction in peripheral nerve: integration of stimuli in the neuron. PNAS 45:592–617Google Scholar
  144. Lundborg G (1980) Intraneural microcirculation and peripheral nerve barriers. Techniques for evaluation - clinical implications. In: Omer GE, Spinner M (eds) Managment of peripheral nerve problems. Saunders, Philadelphia, pp 903–916Google Scholar
  145. Lundborg G, Myers R, Powell H (1983) Nerve compression injury and increased endoneurial fluid pressure. A “miniature compartment syndrome”. J Neurol Neurosurg Psy-chiatr 46:1119–1124Google Scholar
  146. Mackenzie RA, Burke D, Skuse NF, Lethlean AK (1975) Fibre function and perception during cutaneous nerve block. J Neurol Neurosurg Psychiatr 38:865–873PubMedGoogle Scholar
  147. Mackenzie RA, Skuse NF, Lethlean AK (1977) A micro-electrode study of peripheral neuropathy in man: 2. Response to conditioning stimuli. J Neurol Sci 34:175–189PubMedGoogle Scholar
  148. Malenka RC, Kocsis JD, Ransom BR, Waxman SG (1981) Modulation of parallel fiber excitability by postsynaptically mediated changes in extracellular potassium. Science 214:339–341PubMedGoogle Scholar
  149. Manfredi M (1970) Differential block of conduction of larger fibers in peripheral nerve by direct current. Arch Ital Biol 108:52–71PubMedGoogle Scholar
  150. Martin JH (1982) Somatic sensory system I: receptor physiology and submodality coding. In: Kandel ER, Schwartz JF (eds) Principles of neural science. Elsevier, New York, pp 157–169Google Scholar
  151. Matthews PBC (1982) Where does Sherrington’s “muscular sense” originate? Muscles, joints, corollary discharges? Annu Rev Neurosci 5:189–218PubMedGoogle Scholar
  152. Matthews PBC, Rushworth G (1957 a) The selective effect of procaine on the stretch reflex and tendon jerk of soleus muscle when applied to its nerve. J Physiol (Lond) 185: 245–262Google Scholar
  153. Matthews PBC, Rushworth G (1957 b) The relative sensitivity of muscle nerve fibres to procaine. J Physiol (Lond) 135:263–269Google Scholar
  154. Mayer DJ, Price DD, Becker DP (1975) Neurophysiological characteristics of the anterolateral spinal cord neurons contributing to pain perception in man. Pain 1:51–58PubMedGoogle Scholar
  155. Melzack R, Wall PD (1965) Pain mechanism: a new theory. Science 150:971–979PubMedGoogle Scholar
  156. Mendell LM, Henneman E (1979) Input to motoneuron pools and its effects. Chapt 27. In: Mountcastle VB (ed) Medical physiology, vol 1. Mosby, St. Louis, pp 742–761Google Scholar
  157. Mendell LM, Wall PD (1965) Responses of single dorsal cord cells to peripheral cutaneous unmyelinated fibers. Nature 206:97–99PubMedGoogle Scholar
  158. Metzler J, Marks PS (1979) Functional changes in cat somatic sensory-motor cortex during short-term reversible epidural blocks. Brain Res 177:379–383PubMedGoogle Scholar
  159. Meyer G A, Fields HL (1972) Causalgia treated by selective large fibre stimulation of peripheral nerve. Brain 95:163 Miller K (1975) The pressure reversal of anesthesia and the critical volume hypothesis. In: Fink BR (ed) Molecular mechanisms of anesthesia, vol 1. Raven, New York, pp 341–351PubMedGoogle Scholar
  160. Miller K (1975) The pressure reversal of anesthesia and the critical volume hypothesis. In: Fink BR (ed) Molecular mechanisms of anesthesia, vol 1. Raven, New York, pp 341–351Google Scholar
  161. Morison DH (1981) A double-blind compression of carbonated lidocaine and lidocaine hydrochloride in epidural anaesthesia. Can Anaesth Soc J 28:387–389PubMedGoogle Scholar
  162. Mountcastle VB (1980 a) Sensory receptors and neural encoding: Introduction to sensory processes. In: Mountcastle VB (ed) Medical physiology, voll. Mosby, St. Louis, pp 327–347Google Scholar
  163. Mountcastle VB (1980 b) Pain and temperature sensibilities. In: Mountcastle VB (ed) Medical physiology, vol 1. Mosby, St. Louis, pp 391–427Google Scholar
  164. Müller J (1826) Zur vergleichenden Physiologie des Gesichtssinnes des Menschen und der Thiere nebst einem Versuch über die Bewegungen der Augen und über den menschlichen Blick. Cnoblock, LeipzigGoogle Scholar
  165. Nagy JI (1982) Capsaicin’s action on the nervous system. Trends in Neuroscience 5: 362–365Google Scholar
  166. Nathan PW, Sears TA (1961) Some factors concerned in differential nerve block by local anaesthetics. J Physiol (Lond) 157:565–580Google Scholar
  167. Nathan PW, Sears TA (1962) Differential nerve block by sodium-free and sodium-deficient solutions. J Physiol (Lond) 164:375–394Google Scholar
  168. Nicholson C, Phillips JM (1981) Ion diffusion modified by tortuosity and volume fraction in the extracellular microenvironment of the rat cerebellum. J Physiol (Lond) 321: 225–257Google Scholar
  169. Nicholson C, Phillips JM (1982) Diffusion in the brain cell microenvironment. Lectures on Mathematics in the Life Sciences 15:103–122Google Scholar
  170. Ochoa J (1984) Peripheral unmyelinated units in man: structure, function, disorder and role in sensation. Kruger L, Liebeskind JC (eds). Advances in Pain Research Therapy, vol 6. Raven, New York, pp 53–68Google Scholar
  171. Ochoa J, Torebjork HE (1983) Sensations evoked by intraneural microstimulation of single mechanoreceptor units innervating the human hand. J Physiol (Lond) 342:633–654Google Scholar
  172. Ochoa J, Torebjork HE, Culp WJ, Schady W (1982) Abnormal spontaneous activity in single sensory nerve fibers in humans. Muscle nerve 5:574–577Google Scholar
  173. Paintal AS (1965 a) Block of conduction in mammalian myelinated fibers by low temperatures. J Physiol (Lond) 180:1–19Google Scholar
  174. Paintal AS (1965 b) Effects of temperature on conduction in single vagal and saphenous myelinated nerve fibres of the cat. J Physiol (Lond) 180:20–49Google Scholar
  175. Perl ER (1980) Afferent basis of nociception and pain: evidence from the characteristics of sensory receptors and their projections to the spinal dorsal horn. Res Publ Assoc Nerv Ment Dis 58:19–45Google Scholar
  176. Perl ER (1984) Characterization of nociceptors and their activation of neurons in the superficial dorsal horn: first steps for the sensation of pain. In: Kruger L, Liebeskind JC (eds) Advances in pain research and therapy, vol 6. Raven, New York, pp 23–51Google Scholar
  177. Price DD (1984) Roles of psychophysics, neuroscience and experimental analysis in the study of pain. In: Kruger L, Liebeskind JC (eds), Advances in pain research and therapy, vol 6. Raven, New York, pp 341–355Google Scholar
  178. Rang HP, Ritchie JM (1968) On the electrogenic sodium pump in mammalian non-mye-linated nerve fibers and its activation by various external cations. J Physiol (Lond) 196:183–221Google Scholar
  179. Ranson SW (1931) Cutaneous sensory fibers and sensory conduction. Arch Neurol Psychiatr 26:1122–1144Google Scholar
  180. Ranson SW, Droegenmueller WH, Davenport HK, Fisher C (1935) Number, size and mye-lination of the sensory fibers in the cerebrospinal nerves. Res Publ Assoc Nerv Ment Dis 15:3–34Google Scholar
  181. Raymond SA (1979) Effects of nerve impulses on threshold of frog sciatic nerve fibres. J Physiol (Lond) 290:273–303Google Scholar
  182. Raymond SA, Bokesch PM (1983) Effects of CO2/bicarbonate vs an organic buffer on nerve threshold and local anesthetic block at varying pH. Anesthesiology 59:A295Google Scholar
  183. Raymond SA, Lief PA (1984) Psychological assessment of adaptation to transcutaneous electrical nerve stimulation. Pain, Suppl 2:569Google Scholar
  184. Raymond SA, Lettvin JY (1978) Aftereffects of activity in peripheral axons as a clue to nervous coding. In: Waxman SG (ed) Physiology and pathobiology of axons. Raven, New York, pp 203–225Google Scholar
  185. Raymond SA, Roscoe RF (1984) Effects of lidocaine on threshold of nerve axons. Reg Anesth 9:51Google Scholar
  186. Raymond SA, Roscoe RF (1983) Aftereffects of nerve impulses on threshold of frog sciatic fibers depends on pH (pCO2). Soc Neurosci Abstracts 9:513Google Scholar
  187. Reynolds DV (1969) Surgery in the rat during electrical analgesia induced by focal brain stimulation. Science 164:444–445PubMedGoogle Scholar
  188. Ritchie JM (1982) Sodium channel density in excitable membranes. In: Culp WJ, Ochoa J (eds) Abnormal nerves and muscles as impulse generators. Oxford University Press, New York, pp 168–190Google Scholar
  189. Ritchie JM, Ritchie B, Greengard P (1965) The effect of the nerve sheath on the action of local anesthetics. J Pharmacol Exp Ther 150:160–164PubMedGoogle Scholar
  190. Rosenberg PH, Heavner JE (1980) Temperature-dependent nerve blocking action of lidocaine and halothane. Acta Anesth Scand 24:314–320Google Scholar
  191. Ruch TC (1979) Pathophysiology of Pain. In: Ruch TC, Patton HD (eds) Physiology and biophysics. Saunders, Philadelphia, pp 272–324Google Scholar
  192. Rud J (1961) Local anesthetics: an electrophysiological investigation of local anesthesia of peripheral nerves with special reference to xylocaine. Acta Physiol Scand 51 (Suppl) 178:1–171Google Scholar
  193. Rydevik B (1979) Compression injury of peripheral nerve. PhD thesis, Department of Anatomy, University of GothenburgGoogle Scholar
  194. Sarnoff SJ, Arrowood JG (1946) Differential spinal block - a preliminary report. Surgery 20:150–159PubMedGoogle Scholar
  195. Samoff SJ, Arrowood JG (1947 a) Differential spinal block: II. The reaction of sudomotor and vasomotor fibers. J Clin Invest 26:203–216Google Scholar
  196. Samoff SJ, Arrowood JG (1947 b) Differential spinal block: III. The block of cutaneous and stretch reflexes in the presence of unimpaired position sense. J Neurophysiol 10:205:210Google Scholar
  197. Samoff SJ, Arrowood JG, Chapman WP (1948) Differential spinal block. IV. The investigation of intestinal dyskinesia, colonic artery and visceral afferent fibers. Surg Gynecol Obstet 86:571Google Scholar
  198. Schimek F, Sumi SM, Fink BR (1984) Differential effects of hyposomatic hyponatric swelling on A- and C-fibers. Anesthesiology 60:198–204PubMedGoogle Scholar
  199. Schwartz HG (1950) Neurosurgical relief of intractable pain. Surg Clin North Am 30: 1379–1389Google Scholar
  200. Schwarz W, Palade PT, Mille B (1977) Local anesthetics: effect of pH on use-dependent block of sodium channels in frog muscle. Biophys J 20:343–368PubMedGoogle Scholar
  201. Scurlock JE, Heavner JE, de Jong RG (1975) Differential B- and C-fibre block by an amide- and an ester-linked local anesthetic. Br J Anaesth 47:1135–1139PubMedGoogle Scholar
  202. Sessle BJ (1979) Is the tooth pulp a “pure” source of noxious input? In: Bonica JJ (ed) Advances in pain research and therapy, vol 3. Raven, New York, pp 245–260Google Scholar
  203. Sinclair DC (1955) Cutaneous sensation and the doctrine of specific energy. Brain 78: 584–614PubMedGoogle Scholar
  204. Sinclair DC, Hinshaw JR (1950 a) Sensory changes in procaine nerve block. Brain 73: 224–243PubMedGoogle Scholar
  205. Sinclair DC, Hinshaw JR (1950 b) A comparison of the sensory dissociation produced by procaine and by limb compression. Brain 73:480–498PubMedGoogle Scholar
  206. Sinclair DC, Hinshaw JR (1951) Sensory changes in nerve blocks induced by cooling. Brain 74:318–355PubMedGoogle Scholar
  207. Smith DO (1980) Mechanisms of action potential propagation failure at sites of axonal branching in the crayfish. J Physiol (Lond) 301:243–259Google Scholar
  208. Staiman A, Seeman P (1974) Impulse-blocking concentration of anesthetics, alcohols, anticonvulsants, barbiturates, and narcotics on phrenic and sciatic nerves. Can J Physiol Pharmacol 52:535–550PubMedGoogle Scholar
  209. Staiman A, Seeman P (1977) Conduction-blocking concentration of anesthetics increase with nerve axon diameter: studies with alcohol, lidocaine and tetrodotoxin on single myelinated fibers. J Pharmacol Exp Therap 201:340–349Google Scholar
  210. Stansfeld CE, Wallis DI (1983) Differences in tetrodotoxin (TTX) sensitivity in group A-and C–cells of the rabbit nodose ganglion. J Physiol 341:14P-15PGoogle Scholar
  211. Strichartz GR (1973) The inhibition of sodium currents in myelinated nerve by quaternary derivatives of lidocaine. J gen Physiol 62:37–57PubMedGoogle Scholar
  212. Strichartz GR, Wang GK (1986) The kinetic basis for phasic local anesthetic blockade of neuronal sodium channels. In: Roths, Miller K (eds) Molecular and cellular mechanics of anesthetics. Plenum, New York, pp 217–226Google Scholar
  213. Strichartz GR, Zimmermann (1983) Selective conduction blockade among different fiber types in mammalian nerves by lidocaine combined with low temperature. Soc Neurosci (Abstr) 9:675Google Scholar
  214. Swadlow HA, Kocsis JD, Waxman SG (1980) Modulation of impulse conduction along the axon tree. Annu Rev Biophys Bioeng 9:143–179PubMedGoogle Scholar
  215. Tanner JA (1962) Reversible blocking of nerve conduction by alternating current excitation. Nature 195:712–713PubMedGoogle Scholar
  216. Tasaki I (1953) Nervous transmission. Thomas, Springfield, Ill, pp 164Google Scholar
  217. Tasaki I (1982) Physiology and electrochemistry of nerve fibers. Academic, New York, pp 1–348Google Scholar
  218. Tasker RR, Organ LW, Hawrylyshyn P (1980) Deafferentation and Causalgia. Res Publ Assoc Res Nerv Ment Dis 58:305–334PubMedGoogle Scholar
  219. Toman JEP (1952) Neuropharmacology of peripheral nerve. Pharmacol Rev 4:168–218PubMedGoogle Scholar
  220. Torebjörk HE, Hallin RG (1973) Perceptual changes accompanying controlled preferential blocking of A- and C-fibre responses in intact human skin nerves. Exp Brain Res 16:321–332PubMedGoogle Scholar
  221. Torebjörk HE, Hallin RG (1974) Responses in human A- and C-fibres to repeated electrical intradermal stimulation. J Neurol Neurosurg Psychiatr 37:653–664PubMedGoogle Scholar
  222. Torebjörk HE, Hallin RG (1979) Microneurographic studies of peripheral pain mechanisms in man. In: Bonica JJ et al. (ed) Advances in pain research and therapy. Raven, New York, pp 121–131Google Scholar
  223. Torebjörk HE, Ochoa JL (1980) Specific sensations evoked by activity in single identified sensory units in man. Acta Physiol Scand 110:445–447PubMedGoogle Scholar
  224. Torebjörk HE, Ochoa JL, Schady W (1984 a) Referred pain from intraneural stimulation of muscle fascicles in median nerve. Pain 18:145–156PubMedGoogle Scholar
  225. Torebjörk HE, LaMotte R, Robinson CT (1984 b) Peripheral neural correlates of magnitude of cutaneous pain and hyperalgesia: simultaneous recordings in humans of sensory judgements of pain and evoked responses in nociceptors with C-fibers. J Neurophysiol 51:341–355Google Scholar
  226. Tucker GT, Mather LE (1980) Absorption and disposition of local anesthetics: pharmacokinetics. In: Cousins MJ, Bridenbaugh PO (eds) Neural blockade. Lippincott, Philadelphia, pp 45–85Google Scholar
  227. Uehara Y (1958) Conduction of nervous impulses in NaCl deficient media. Jpn J Physiol 8:282–291PubMedGoogle Scholar
  228. Uehara Y (1960) Narcotic and NaCl deficiency as blocking agents. Jpn J Physiol 10: 267–274PubMedGoogle Scholar
  229. Ulbricht W (1981) Kinetics of drug action and equilibrium results at the node of Ranvier. Physiol Rev 61:785–828PubMedGoogle Scholar
  230. Urban BJ, McKain CW (1982) Onset and progression of intravenous regional anesthesia with dilute lidocaine. Anesth Analg 61:834–838PubMedGoogle Scholar
  231. Vallbo AB, Hagbarth KE, Torebjork HE, Hallin BG (1979) Somatosensory, proprioceptive, and sympathetic activity in human peripheral nerves. Physiol Rev 59:919–957PubMedGoogle Scholar
  232. Wall PD (1971) Somatosensory mechanisms. In: Remond A (ed) Handbook EEG and clinical neurophysiology, vol 9. Somatic sensation. Elsevier, Amsterdam pp 1–6Google Scholar
  233. Wall PD (1979) Changes in damaged nerve and their sensory consequences. In: Bonica JJ (ed) Advances in pain research and therapy, vol 3 Raven, New York, pp 39–52Google Scholar
  234. Wall PD (1980) The role of substantia gelatinosa as a gate control. Res Publ Assoc Res Nerv Ment Disease 58:205–231Google Scholar
  235. Wall PD (1982) The effect of peripheral nerve lesions and of neonatal capsaicin in the rat on primary afferent depolarization. J Physiol (Lond) 329:21–35Google Scholar
  236. Wall PD (1984) Mechanisms of acute chronic pain. In: Kruger L, Liebeskind JC (eds) Advances in pain research and therapy, vol 6. Neural mechanisms of pain. Raven, New York, pp 95–104Google Scholar
  237. Wall PD, Devor M (1982) Consequences of peripheral nerve damage in the spinal cord and in neighboring intact peripheral nerves. In: Culp WJ, Ochoa J (eds) Abnormal nerves and muscles as impulse generators. Oxford University Press, New York, pp 588–603Google Scholar
  238. Wall PD, Fitzgerald M, Nussbaumer JC, Loos H van der, Devor M (1982) Somatotopic maps are disorganized in adult rodents treated with capsaicin as neonates. Nature 295:691–693PubMedGoogle Scholar
  239. Watson PJ (1967) Interaction between acetylcholine and guanethidine on sensory C-fibers. Eur J Pharmacol 1:407–413PubMedGoogle Scholar
  240. Waxman SG (1981) Cellular aspects of conduction in myelinated nerve fibers in relation to clinical deficit. In: Dorfman LJ, Cummins KL, Leifer LJ (eds) Conduction velocity distributions: a population approach to electrophysiology of nerve. AR Liss, New York, pp 1–15Google Scholar
  241. Wildsmith JAW, Gissen AJ, Gregus J, Covino BG (1985) The differential nerve blocking activity of amino-ester local anaesthetics. Br J Anaesth 57:612–620PubMedGoogle Scholar
  242. Willis WD (1980) Neurophysiology of nociception and pain in the spinal cord. Res Pub Assoc Res Nerve Ment Dis 58:77–92Google Scholar
  243. Winnie AP, Collins YJ (1968) The Pain Clinic. I. Differential neural blockade in pain syndromes of questionable etiology. Med Clin North Am 52:123–129PubMedGoogle Scholar
  244. Wood KM (1978) The use of phenol as a neurolytic agent: a review. Pain 5:205–229PubMedGoogle Scholar
  245. Young RF, Feldman RA, Kroening R, Fulton W, Morris J (1984) Electrical stimulation of the brain in the treatment of chronic pain in man. In: Kruger L, Liebeskind JC (eds) Advances in pain research and therapy, vol 6. Raven, New York, pp 289–303Google Scholar
  246. Zimmermann M (1968) Selective activation of C-fibers. Pfluegers Arch 301:329–333Google Scholar
  247. Zimmermann M (1979) Peripheral and central nervous mechanisms of nociception, pain, and pain therapy: facts and hypotheses. In: Bonica JJ (ed), Advances in pain research and therapy, vol 3, Raven, New York, pp 3–32Google Scholar
  248. Zimmermann M, Sanders K (1982) Responses of nerve axons and receptor endings to heat, ischemia, and algesic substances. Abnormal excitability of regenerating nerve endings. In: Culp WJ, Ochoa J (eds) Abnormal nerves and muscles as impulse generators. Oxford University Press, New York, pp 513–532Google Scholar
  249. Zotterman Y (1939) Touch pain and tickling: an electrophysiological investigation on cutaneous sensory nerves. J Physiol (Lond) 95:1–28Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1987

Authors and Affiliations

  • S. A. Raymond
  • A. J. Gissen

There are no affiliations available

Personalised recommendations