I have observed not much difference in the onset of action of different local anesthetics ( bupivacaine, lignocaine and ropivacaine) when used for peripheral nerve /plexus blocks. Although studies are warranted for proof, it is just my observation. Please share your views and experiences
The onset of local anesthetic (LA) during perpheral nerve block is mulltifactoral.
It is not only depend on concentration and volume of local anesthesia but also anatomy of nerve, proximity of LA deposition to the nerve, structures surrounding tne nerve and techniques used i.e. landmark, perphral nerve stimulator or ultrasound. The onset of plane blocks as in QL, ESP etc are more complex and variable.
Taboada M, Alvarez J, Cortés J, et al. The effects of three different approaches on the onset time of sciatic nerve blocks with 0.75% ropivacaine. Anesth Analg. 2004;98(1):. doi:10.1213/01.ane.0000093311.29111.59
Thank you Dr Prajjwal. As you have stated, there is no doubt that the onset of action of LA for PNB is multifactorial. However, my query was, under similar conditions and assuming all the factors to be identical, would the onset of action differ between the so called "faster" onset LA and "delayed" onset LA during a peripheral nerve or plexus block ?... In my observation, I have found no difference in the time of onset ( both sensory and motor) between lidocaine, bupivacaine and ropivacaine while using for peripheral nerve blocks or plexus blocks. They seem to be similar in terms of onset during PNB or plexus blocks....for spinal anesthesia and local infiltration , the classification however stands true....wanted to share my observation and also know others' experiences.....
Yes, the differential blockade do really seen mostly in neuraxial techniques compared to peripheral nerve blockade.
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