Editorial Views  |   August 2018
Intraneural Injection: Is the Jury Still Out?
Author Notes
  • From the Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts.
  • Corresponding article on page 241.
    Corresponding article on page 241.×
  • Accepted for publication June 11, 2018.
    Accepted for publication June 11, 2018.×
  • Address correspondence to Dr. Rathmell: jrathmell@bwh.harvard.edu
Article Information
Editorial Views / Central and Peripheral Nervous Systems / Pharmacology / Regional Anesthesia
Editorial Views   |   August 2018
Intraneural Injection: Is the Jury Still Out?
Anesthesiology 8 2018, Vol.129, 221-224. doi:10.1097/ALN.0000000000002352
Anesthesiology 8 2018, Vol.129, 221-224. doi:10.1097/ALN.0000000000002352
A SUCCESSFUL regional anesthetic has to result in a sensory (and often also motor) block that is reliable and completely reversible. From the site of injection all the way to the target nerve’s voltage-gated sodium channels, local anesthetics must penetrate several tissue barriers, with the perineurium causing the largest drop in concentration.1  The closer to the nerve fibers the local anesthetic is injected, in theory, the faster the onset and the more reliable the block.2  Injecting local anesthetic directly into the nerve rather than onto its outer surface might well speed the onset of the block and increase the success rate. In this issue of Anesthesiology, Cappelleri et al. test that hypothesis by conducting a dose-ranging study aimed to identify the smallest volume of intraneural local anesthetic needed to produce a reliable block of the sciatic nerve in the popliteal fossa.3