Cocaine diffuses through the epineurium with remarkable rapidity. The coefficient of diffusion of cocaine in the epineurium cannot be less than 0.44 x 10(-4) cm.(2)/min.; it probably is not less than 1.22 x 10(-4) cm.(2)/min. Lack of sodium markedly sensitizes the nerve fibers to the anesthetic action of cocaine. With sodium-deficient A fibers the action of cocaine develops in two phases. During the first phase cocaine substitutes for sodium and restores to A fibers the ability to conduct impulses; during the second phase cocaine produces anesthesia. It is suggested that cocaine anesthetizes the nerve fibers through the sodium mechanism; i.e., by interfering with some of those chemical reactions in which, directly or indirectly, the internal sodium takes part.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2147291PMC
http://dx.doi.org/10.1085/jgp.35.2.203DOI Listing

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