Local Anesthestics

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Dryacku

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This maybe a stupid last minute question, but different sources state different things.

Which nerve fibers are the most sensitivity to LA?

thanks

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The larger faster nerve fibers are more sensitive so:
A more sensitive than B more sensitive than C

I think thats wrong. Its very confusing. The smaller, the more sensitive. The more mylenation, the more resistant. The more active the nerve fires, the more sensitive.

B fibers are probably the most sensitive. Followed by C, and A fibers are the most resistant.
 
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I think thats wrong. Its very confusing. The smaller, the more sensitive. The more mylenation, the more resistant. The more active the nerve fires, the more sensitive.

B fibers are probably the most sensitive. Followed by C, and A fibers are the most resistant.

Miller says
small myelinated axons are the most susceptible
then large myelinated fibers
the least susceptible are the small, nonmyelinated C fibers.
"The generalized notion that local anesthetics block the smallest fibers first or most is clearly wrong."
 
Two things controlling affinity are diameter and myelination. Smaller diameter are more sensitive, and more myelination are more sensitive. The former factor plays a more prominent role. That's why A-delta are the first to get affected, followed by A-beta etc etc.
 
Its very confusing. I looked up in Margan Mikhail and it says "small diameter and lack of myelin enhance sensitivity to local anesthetics. Thus, in spinal nerves sensitivity to local anesthetics is autonomic> sensory > motor."

Guess I'm wrong...but I'm also not making things up either.
 
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