Prolonged Duration Local Anesthesia by Combined Delivery of Capsaicin- and Tetrodotoxin-Loaded Liposomes.

Abstract:

BACKGROUND:Capsaicin, the active component of chili peppers, can produce sensory-selective peripheral nerve blockade. Coadministration of capsaicin and tetrodotoxin, a site-1 sodium channel blocker, can achieve a synergistic effect on duration of nerve blocks. However, capsaicin can be neurotoxic, and tetrodotoxin can cause systemic toxicity. We evaluated whether codelivery of capsaicin and tetrodotoxin liposomes can achieve prolonged local anesthesia without local or systemic toxicity. METHODS:Capsaicin- and tetrodotoxin-loaded liposomes were developed. Male Sprague-Dawley rats were injected at the sciatic nerve with free capsaicin, capsaicin liposomes, free tetrodotoxin, tetrodotoxin liposomes, and blank liposomes, singly or in combination. Sensory and motor nerve blocks were assessed by a modified hotplate test and a weight-bearing test, respectively. Local toxicity was assessed by histologic scoring of tissues at the injection sites and transmission electron microscopic examination of the sciatic nerves. Systemic toxicity was assessed by rates of contralateral nerve deficits and/or mortality. RESULTS:The combination of capsaicin liposomes and tetrodotoxin liposomes achieved a mean duration of sensory block of 18.2 hours (3.8 hours) [mean (SD)], far longer than that from capsaicin liposomes [0.4 hours (0.5 hours)] (P < .001) or tetrodotoxin liposomes [0.4 hours (0.7 hours)] (P < .001) given separately with or without the second drug in free solution. This combination caused minimal myotoxicity and muscle inflammation, and there were no changes in the percentage or diameter of unmyelinated axons. There was no systemic toxicity. CONCLUSIONS:The combination of encapsulated tetrodotoxin and capsaicin achieved marked prolongation of nerve block. This combination did not cause detectable local or systemic toxicity. Capsaicin may be useful for its synergistic effects on other formulations even when used in very small, safe quantities.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Shomorony A,Santamaria CM,Zhao C,Rwei AY,Mehta M,Zurakowski D,Kohane DS

doi

10.1213/ANE.0000000000004108

subject

Has Abstract

pub_date

2019-09-01 00:00:00

pages

709-717

issue

3

eissn

0003-2999

issn

1526-7598

pii

00000539-201909000-00016

journal_volume

129

pub_type

杂志文章
  • Inhibiting a spinal dynorphin A component enhances intrathecal morphine antinociception in mice.

    abstract::Morphine given intracerebroventricularly releases spinal dynorphin A (Dyn) in mice. The present study was undertaken to determine whether morphine given intrathecally (IT) released Dyn. We demonstrated that the antinociceptive action of morphine was enhanced by procedures that are known to attenuate Dyn action. First,...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199312000-00015

    authors: Holmes BB,Fujimoto JM

    更新日期:1993-12-01 00:00:00

  • Spinal cord stimulation in postherpetic neuralgia and in acute herpes zoster pain.

    abstract:UNLABELLED:We studied the effects of spinal cord stimulation (SCS) on postherpetic neuralgia (PHN). Data of 28 patients were prospectively investigated over a median period of 29 (quartiles 9--39) mo. In addition, four patients with acute herpes zoster (HZ) pain were studied simultaneously. After intractable pain for m...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200203000-00040

    authors: Harke H,Gretenkort P,Ladleif HU,Koester P,Rahman S

    更新日期:2002-03-01 00:00:00

  • Alterations in spinal, but not cerebral, cerebrospinal fluid Na+ concentrations affect the isoflurane minimum alveolar concentration in rats.

    abstract:BACKGROUND:Previous studies demonstrated that MAC (the minimum alveolar concentration of an inhaled anesthetic that produces immobility in 50% of subjects exposed to noxious stimulation) for halothane directly correlates with the central nervous system concentration of Na+. However, those studies globally altered Na+ c...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000278090.88402.26

    authors: Laster MJ,Zhang Y,Eger EI 2nd,Shnayderman D,Sonner JM

    更新日期:2007-09-01 00:00:00

  • Nonlinear heart rate variability analysis may predict atrial fibrillation after coronary artery bypass grafting.

    abstract:BACKGROUND:Heart rate variability might predict arrhythmias after coronary artery bypass grafting. METHODS:Off-line processing of 10-min electrocardiogram recordings of consecutive patients provided R-R intervals for time domain, frequency domain, Poincaré, and point correlation analyses and subsequent association wit...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000239330.45658.76

    authors: Chamchad D,Djaiani G,Jung HJ,Nakhamchik L,Carroll J,Horrow JC

    更新日期:2006-11-01 00:00:00

  • Serum anticholinergic activity and postoperative cognitive dysfunction in elderly patients.

    abstract:BACKGROUND:Cerebral cholinergic transmission plays a key role in cognitive function, and anticholinergic drugs administered during the perioperative phase are a hypothetical cause of postoperative cognitive dysfunction (POCD). We hypothesized that a perioperative increase in serum anticholinergic activity (SAA) is asso...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1213/ANE.0000000000000390

    authors: Rossi A,Burkhart C,Dell-Kuster S,Pollock BG,Strebel SP,Monsch AU,Kern C,Steiner LA

    更新日期:2014-10-01 00:00:00

  • Distal tourniquet or leg position after injection enhances the efficacy of sciatic nerve blockade by the popliteal approach.

    abstract:BACKGROUND:In this study, we hypothesized that leg positioning and distal tourniquet application, when compared with neutral positioning of the leg, alters the efficacy of sciatic nerve block performed by the double-stimulation technique. METHODS:Ninety randomized, consecutive, ASA physical status I to III patients un...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ANE.0b013e31822f8b99

    authors: Sertoz N,Deniz MN,Ayanoglu HO

    更新日期:2011-12-01 00:00:00

  • Pancuronium infusion for neuromuscular block in children in the pediatric intensive care unit.

    abstract::When neuromuscular blockade becomes necessary in the intensive care unit, there are several options available in regard to both the drug and the mode of delivery (continuous versus intermittent administration). Despite extensive experience with intermediate acting drugs such as atracurium or vecuronium, these muscle r...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1097/00000539-199507000-00003

    authors: Tobias JD,Lynch A,McDuffee A,Garrett JS

    更新日期:1995-07-01 00:00:00

  • Systemic ondansetron antagonizes the sensory block produced by intrathecal lidocaine.

    abstract::In this prospective randomized, double-blind study, we investigated the effect of ondansetron on the lidocaine subarachnoid block. Fifty-four male patients scheduled for transurethral surgery under subarachnoid anesthesia received oral ondansetron 4 mg the evening before surgery and 4 mg IV 15 min before subarachnoid ...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1213/01.ANE.0000152616.57107.F6

    authors: Fassoulaki A,Melemeni A,Zotou M,Sarantopoulos C

    更新日期:2005-06-01 00:00:00

  • Determination of Geolocations for Anesthesia Specialty Coverage and Standby Call Allowing Return to the Hospital Within a Specified Amount of Time.

    abstract:BACKGROUND:For emergent procedures, in-house teams are required for immediate patient care. However, for many procedures, there is time to bring in a call team from home without increasing patient morbidity. Anesthesia providers taking subspecialty or backup call from home are required to return to the hospital within ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000003320

    authors: Epstein RH,Dexter F,Diez C,Potnuru P

    更新日期:2019-11-01 00:00:00

  • The impact of saline flush of the epidural catheter on resolution of epidural anesthesia in volunteers: a dose-response study.

    abstract:UNLABELLED:We evaluated the effect of 1, 20, and 40 mL of epidural saline flush on recovery from lidocaine epidural anesthesia. Eight volunteers were studied for three study periods, each separated by 72 h. The volume of saline was randomized, and a new catheter was inserted for each study period. A standardized dose o...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-199910000-00034

    authors: Chan VW,Nazarnia S,Kaszas Z,Perlas A

    更新日期:1999-10-01 00:00:00

  • Variable rate infusion of alfentanil as a supplement to nitrous oxide anesthesia for general surgery.

    abstract::In this study we attempted to define the minimal dosage of alfentanil (AF) needed in combination with nitrous oxide to provide satisfactory anesthetic conditions for lower abdominal gynecologic surgery. General anesthesia was induced in 12 women with AF (150 micrograms X kg-1) and 66% N2O in O2. An infusion of AF was ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Ausems ME,Hug CC Jr,de Lange S

    更新日期:1983-11-01 00:00:00

  • Development, Reporting, and Evaluation of Clinical Practice Guidelines.

    abstract::Clinical practice parameters have been published with greater frequency by professional societies and groups of experts. These publications run the gamut of practice standards, practice guidelines, consensus statements or practice advisories, position statements, and practice alerts. The definitions of these terms hav...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审

    doi:10.1213/ANE.0000000000004441

    authors: Benzon HT,Joshi GP,Gan TJ,Vetter TR

    更新日期:2019-12-01 00:00:00

  • Perioperative changes in blood pressure and heart rate.

    abstract::In order to evaluate the possible physiologic significance of intra- and postoperative hypotension, we monitored arterial blood pressure and heart rate continuously for 36 hr starting the night before and ending the morning after operation in 34 gynecologic patients. The lowest pressures that occurred during physiolog...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Berger JJ,Donchin M,Morgan LS,van der Aa J,Gravenstein JS

    更新日期:1984-07-01 00:00:00

  • Effects of halothane on the cyclic 3',5'-adenosine monophosphate enzyme system in human platelets.

    abstract::A study of the effects of halothane on the cyclic 3',5'-adenosine monophosphate (cAMP) system in human platelets was undertaken since cAMP has been implicated in the regulation of the process of platelet aggregation and this anesthetic has been reported to decrease platelet aggregation and, in other tissues, to increa...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Walter F,Vulliemoz Y,Verosky Y,Triner L

    更新日期:1980-11-01 00:00:00

  • Determination of Perioperative Blood Loss: Accuracy or Approximation?

    abstract:BACKGROUND:Various different interventions can be used to reduce surgical blood loss; however, there is no "gold standard" for accurately measuring the volume of perioperative blood loss, and this makes it difficult to assess the efficacy of these interventions. METHODS:We used data from a previous multicenter double-...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1213/ANE.0000000000001992

    authors: Lopez-Picado A,Albinarrate A,Barrachina B

    更新日期:2017-07-01 00:00:00

  • Electronic Audit and Feedback With Positive Rewards Improve Anesthesia Provider Compliance With a Barcode-Based Drug Safety System.

    abstract:BACKGROUND:We implemented a previously described barcode-based drug safety system in all of our anesthetizing locations. Providers were instructed to scan the barcode on syringes using our Anesthesia Information Management System before drug administration, but the rate of provider adherence was low. We studied an impl...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000003861

    authors: Bowdle TA,Jelacic S,Nair B,Zucker F,Bussey LS,Togashi K,Yang JT,Lang J

    更新日期:2019-08-01 00:00:00

  • Management of 1-Lung Ventilation-Variation and Trends in Clinical Practice: A Report From the Multicenter Perioperative Outcomes Group.

    abstract:BACKGROUND:Lung-protective ventilation (LPV) has been demonstrated to improve clinical outcomes in surgical patients. There are very limited data on the current use of LPV for patients undergoing 1-lung ventilation (1LV) despite evidence that 1LV may be a particularly important setting for its use. In this multicenter ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,多中心研究

    doi:10.1213/ANE.0000000000002642

    authors: Colquhoun DA,Naik BI,Durieux ME,Shanks AM,Kheterpal S,Bender SP,Blank RS,MPOG Investigators.

    更新日期:2018-02-01 00:00:00

  • The analgesic effect of epidural clonidine after spinal surgery: a randomized placebo-controlled trial.

    abstract:BACKGROUND:Clonidine is an alpha(2) adrenoreceptor and imidazoline receptor agonist, which has analgesic, sedative, and minimum alveolar anesthetic concentration-sparing effects. It has been used orally, IV, and epidurally. In spinal surgery, there is a reluctance to use local anesthetic-based epidural analgesia postop...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ane.0b013e31818e61b8

    authors: Farmery AD,Wilson-MacDonald J

    更新日期:2009-02-01 00:00:00

  • Central venous access: the effects of approach, position, and head rotation on internal jugular vein cross-sectional area.

    abstract:UNLABELLED:We investigated the effects of approach (lateral versus anterior), position (supine versus Trendelenburg), and head rotation (0 degrees, 20 degrees, and maximum) during central venous catheterization on the area of the right internal jugular vein. Twenty-four patients were placed in supine position, followed...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200212000-00010

    authors: Suarez T,Baerwald JP,Kraus C

    更新日期:2002-12-01 00:00:00

  • The effects of femoral nerve blockade in conjunction with epidural analgesia after total knee arthroplasty.

    abstract::Either epidural analgesia or femoral nerve blockade improves analgesia and rehabilitation after total knee arthroplasty. No study has evaluated the combination of femoral nerve blockade and epidural analgesia. In this prospective, randomized, blinded study we investigated combining femoral nerve blockade with epidural...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1213/01.ANE.0000159150.79908.21

    authors: YaDeau JT,Cahill JB,Zawadsky MW,Sharrock NE,Bottner F,Morelli CM,Kahn RL,Sculco TP

    更新日期:2005-09-01 00:00:00

  • Transesophageal Doppler cardiac output monitoring: performance during aortic reconstructive surgery.

    abstract::Transesophageal Doppler (TED) monitoring provides continuous, noninvasive monitoring of cardiac output by measurement of aortic flow velocities. Because of the effects on aortic flow dynamics resulting from atherosclerosis, aortic cross-clamping, and wide variations in arterial blood pressure, the validity of TED moni...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199112000-00006

    authors: Perrino AC Jr,Fleming J,LaMantia KR

    更新日期:1991-12-01 00:00:00

  • One-lung anesthesia: percent shunt and arterial oxygen tension during continuous insufflation of oxygen to the nonventilated lung.

    abstract::Twenty-four male patients scheduled for elective pulmonary resection were studied to determine whether continuous insufflation of oxygen to the nonventilated lung would reduce intrapulmonary shunting (Qs/Qt) and arterial oxygen desaturation. Measurements of physiologic variables were made using pulmonary arterial and ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Rees DI,Wansbrough SR

    更新日期:1982-06-01 00:00:00

  • COVID-19-Associated Coagulopathy and Inflammatory Response: What Do We Know Already and What Are the Knowledge Gaps?

    abstract::Patients with coronavirus disease 2019 (COVID-19) frequently experience a coagulopathy associated with a high incidence of thrombotic events leading to poor outcomes. Here, biomarkers of coagulation (such as D-dimer, fibrinogen, platelet count), inflammation (such as interleukin-6), and immunity (such as lymphocyte co...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审

    doi:10.1213/ANE.0000000000005147

    authors: Görlinger K,Dirkmann D,Gandhi A,Simioni P

    更新日期:2020-11-01 00:00:00

  • Postoperative epidural analgesia and oral anticoagulant therapy.

    abstract::The relative safety of epidural catheter placement with subsequent heparinization has been well documented. However, what is the risk of neurologic sequelae in such patients who receive warfarin perioperatively? This study retrospectively evaluates the risk of spinal hematoma in patients receiving postoperative epidur...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199407000-00017

    authors: Horlocker TT,Wedel DJ,Schlichting JL

    更新日期:1994-07-01 00:00:00

  • Cardiac electrophysiologic effects of pancuronium.

    abstract::A microelectrode examination of guinea pig left ventricular papillary muscle was performed to determine whether there was a direct effect of pancuronium on cardiac cells and, if so, to attempt to ascertain the mechanism of this effect. Electrical events were measured before and during superfusion with pancuronium, epi...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Jacobs HK,Lim S,Salem MR,Rao TL,Mathru M,Smith BD

    更新日期:1985-07-01 00:00:00

  • Recombinant activated factor VII in obstetric hemorrhage: experiences from the Australian and New Zealand Haemostasis Registry.

    abstract:OBJECTIVE:Through the Australian and New Zealand Haemostasis Registry, we report on the Australian and New Zealand experience with recombinant activated factor VII (rFVIIa) in obstetric patients. METHODS:The role of rFVIIa for off-label indications, including trauma, cardiac surgery, and severe postpartum hemorrhage, ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0b013e3181c039e6

    authors: Phillips LE,McLintock C,Pollock W,Gatt S,Popham P,Jankelowitz G,Ogle R,Cameron PA,Australian and New Zealand Haemostasis Registry.

    更新日期:2009-12-01 00:00:00

  • The anesthetic and recovery profile of two doses (60 and 80 mg) of plain mepivacaine for ambulatory spinal anesthesia.

    abstract:UNLABELLED:Reports of transient neurological symptoms with the use of subarachnoid lidocaine has generated interest in alternate local anesthetics of intermediate duration, such as mepivacaine. This prospective randomized, double-blinded, dose-response study examined the anesthetic and recovery profiles of 60- and 80-m...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-200009000-00015

    authors: Pawlowski J,Sukhani R,Pappas AL,Kim KM,Lurie J,Gunnerson H,Corsino A,Frey K,Tonino P

    更新日期:2000-09-01 00:00:00

  • A review of intrathecal and epidural analgesia after spinal surgery in children.

    abstract::In view of the overall experience regarding regional anesthetic techniques to control postoperative pain in infants and children, it is feasible that a similar efficacy and safety profile can be obtained when using such techniques after major orthopedic procedures such as anterior or posterior spinal fusion. I reviewe...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审

    doi:10.1213/01.ane.0000107938.80562.75

    authors: Tobias JD

    更新日期:2004-04-01 00:00:00

  • Validating the Physiologic Model HumMod as a Substitute for Clinical Trials Involving Acute Normovolemic Hemodilution.

    abstract:BACKGROUND:Blood conservation strategies and transfusion guidelines remain a heavily debated clinical topic. Previous investigational trials have shown that acute isovolemic hemodilution does not limit adequate oxygen delivery; however, a true critical hemoglobin level has never been investigated or defined due to safe...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000002430

    authors: Sims CR 3rd,Delima LR,Calimaran A,Hester R,Pruett WA

    更新日期:2018-01-01 00:00:00

  • Cardiac dysrhythmias induced by infusion of local anesthetics into the lateral cerebral ventricle of cats.

    abstract::The hypothesis that neurogenically mediated cardiac arrhythmias can be induced by the intracerebroventrical (ICV) infusion of local anesthetic solutions was tested in 11 chronically prepared, unmedicated cats. Test substances were bupivacaine (0.1%), lidocaine (0.4%), procaine (0.4 or 0.8%), or saline (pH 5.8). Cats r...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Heavner JE

    更新日期:1986-02-01 00:00:00