From cell to nerve in regional anesthesia

This thesis addresses questions in the realm of regional anesthesia, spanning diverse topics from diabetes mellitus as a co-morbidity to the application of stem cells in this field. The first part focuses on the clinical relevance of diabetes mellitus, revealing altered responses to regional anesthesia in diabetic rodents. Pharmacodynamic and pharmacokinetic aspects are investigated in sciatic nerve blocks in diabetic rats, shedding light on heightened responsiveness and prolonged retention of local anesthetics in diabetic neuropathic nerves. Findings of the applied anatomy of the saphenous and obturator nerves for nerve blocks provide valuable insights into the negligible involvement of both nerves in the corresponding blocks. The minimal volume of local anesthetic required for a saphenous nerve block is determined, while we compare the femoral nerve block and adductor canal block in anterior cruciate ligament surgery. The final part of this thesis introduces stem cells to regional anesthesia research. The potential of induced pluripotent stem cells (iPSCs) is discussed as a model for pain signaling, emphasizing their role in pharmaceutical research. We present a functional study with iPSC-derived dorsal root ganglion nociceptors, demonstrating their responsiveness to lidocaine and proposing a model for comprehensive preclinical investigations of analgesics.