Should the wheel be reinvented in a human study?

Area of Science:

• Anesthesiology
• Pharmacology
• Medical Devices

Background:

• A recent study reported the lack of analgesic efficacy of intraperitoneal nebulization of bupivacaine using the Insuflow device during laparoscopic cholecystectomy.
• This finding aligns with prior in vitro research from 2008 demonstrating that hot evaporation devices cannot effectively transport drug molecules dissolved in aqueous solutions.

Discussion:

• The physical principle underlying this limitation is that hot evaporation primarily vaporizes the solvent (e.g., water), leaving the solute (e.g., bupivacaine) behind.
• The Insuflow device, operating on a hot evaporation principle, is therefore unlikely to deliver bupivacaine effectively for intraperitoneal administration.

Key Insights:

• Hot evaporation devices are unsuitable for nebulizing solutions containing non-volatile solutes like bupivacaine.