Effect of cutaneously applied nonionic surfactants and local anesthetic bases on thermal sensations

With cutaneously applied local anesthetic bases various effects may be observed, such as a decrease in pricking pain and a change in burning, itch, and thermal sensations. These effects occur after skin penetration and may be attributed to the action of the anesthetics on nociceptors and thermoreceptors, i.e., on C and A delta nerve fibers, respectively. As little is known about the pharmacodynamic response of nonionic surfactants with a potentially anesthetic action such as polidocanol, this study characterizes nonionic surfactants pharmacodynamically by measuring thermal thresholds with a thermal sensory analyzer after cutaneous application. The results obtained with the nonionic surfactants were compared with data resulting from the cutaneous application of local anesthetic bases such as mepivacaine, bupivacaine, prilocaine, lidocaine, the 1:1 mixture of lidocaine and prilocaine contained in EMLA and a triple mixture consisting of lidocaine, prilocaine and tetracaine (1:1:1). The results show that none of the investigated surfactants affect thermal thresholds probably due to their high molecular weight. The same was observed with the anesthetics mepivacaine and bupivacaine. In contrast, prilocaine, lidocaine, the 1:1 mixture of lidocaine and prilocaine and the triple mixture consisting of lidocaine, prilocaine and tetracaine (1:1:1) proved to be potent local anesthetics. However, their pharmacodynamic responses do not differ significantly from each other.