Infraclavicular Nerve Block Medication

Updated: Aug 29, 2016
  • Author: Alma N Juels, MD; Chief Editor: Meda Raghavendra (Raghu), MD  more...
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Medication

Medication Summary

The goal of pharmacotherapy is to achieve pain control perioperatively or postoperatively.

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Local Anesthetics

Class Summary

Mepivacaine, bupivacaine and ropivacaine are all amide local anesthetics. They work by decreasing the permeability to sodium ions in neuronal membranes. This results in the inhibition of depolarization, blocking the transmission of nerve impulses. Mepivacaine has a fast onset, 5 minutes, but a short duration. Duration can be prolonged by 3 hours with 1:400,000 of epinephrine added. Bupivacaine and ropivacaine are both used for longer analgesia, more than 12 hours, but have a longer onset, about 20-plus minutes. Ropivacaine has a safer side-effect profile being less cardiotoxic.

Tetracaine is an ester local anesthetic. It works the same as the amides by decreasing the permeability to sodium ions in neuronal membranes. This results in the inhibition of depolarization, blocking the transmission of nerve impulses. Tetracaine has a slow onset with a long duration.

Mepivacaine (Carbocaine, Polocaine, Polocaine-MPF)

Mepivacaine decreases permeability to sodium ions in neuronal membranes. This results in the inhibition of depolarization, blocking the transmission of nerve impulses.

Bupivacaine (Marcaine, Sensorcaine, Sensorcaine MPF)

Bupivacaine decreases permeability to sodium ions in neuronal membranes. This results in the inhibition of depolarization, blocking the transmission of nerve impulses. It is a longer acting-agent. It is more cardiotoxic than ropivacaine.

Ropivacaine (Naropin)

Ropivacaine decreases permeability to sodium ions in neuronal membranes. This results in the inhibition of depolarization, blocking the transmission of nerve impulses. It is a longer-acting agent.

Tetracaine (Tetcaine, Tetracaine ophthalmic)

Tetracaine decreases permeability to sodium ions in neuronal membranes. This results in the inhibition of depolarization, blocking the transmission of nerve impulses. This is an option for longer analgesia.

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