C-fiber-Selective Peripheral Nerve Blockade
Suzuko Suzuki1, *, Peter Gerner2, Anna C Colvin3, Alexander M. Binshtok4
Identifiers and Pagination:Year: 2009
First Page: 24
Last Page: 29
Publisher Id: TOPAINJ-2-24
Article History:Received Date: 15/12/2008
Revision Received Date: 16/01/2009
Acceptance Date: 26/01/2009
Electronic publication date: 24/3/2009
Collection year: 2009
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Despite the clinical demand, current uses of local anesthetics do not allow selective blockade of nociceptive fibers. Regional anesthesia produces an analgesic effect accompanied with undesired side effects due to block of motor, non-nociceptive sensory and autonomic fibers. These side effects limit the clinical use of local anesthetics and affect the recovery and rehabilitation period after surgical procedures. Therefore one main goal of research in the field of regional anesthesia is selectively targeting nociceptive fibers. Recent studies describing the role of nociceptive specific sodium channels in generation and propagation of nociceptive signals make these channels ideal targets for pain selective blockade. In addition, novel methods of targeted delivery of charged local anesthetics selectively into nociceptors provide another potentially successful approach for c-fiber specific nerve block. This review summarizes currently on-going studies on several promising targets and methods to achieve pain selective anesthesia.