Effects of macromolecular adjuvants on the duration of prilocaine

Abstract

Sodium hyaluronate (HA) and dextran (Dx) of different molecular weights and concentrations were used as adjuvants to prilocaine for studies of the duration of infraorbital nerve block in the rat (IONB) and spinal anaesthesia in the mouse (SA). A positive relation was found between duration of block on the one hand and the concentration as well as the molecular weight of the adjuvant on the other. A direct relation was found between the duration of block and the viscosity of the anaesthetic solution. Low-sodium-content solutions of plain prilocaine caused a markedly prolonged duration of the most profound degrees of IONB as compared to medium- or high-sodium-content solutions, while no differences between the solutions were found for the weakest intensity of IONB studied or for SA. Solutions of low-sodium-content containing prilocaine and HA were associated with significant prolongations of IONB and SA as compared to corresponding solutions of medium- or high-sodium content. Inclusion of adrenaline, 5 micrograms/ml, in solutions containing prilocaine and Dx significantly prolonged the duration of the most profound degrees of IONB and of SA. By contrast, the inclusion of adrenaline in solutions containing prilocaine and HA did not prolong the duration of IONB or SA. It is concluded that modulations of the viscosity of local anaesthetic solutions by the addition of macromolecular compounds strongly affect the duration of peripheral and central nerve blocks in experimental animals. A further prolongation is accomplished by reducing the sodium content of the solutions and, in the case of Dx-containing solutions, by inclusion of adrenaline in the anaesthetic solution. The possible mechanisms of these actions are discussed.