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Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
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The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...
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Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
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Local anesthetics (LAs) are drugs that induce a temporary loss of sensation in a limited body area, preventing pain. Cocaine was the first local anesthetic discovered in the late 19th century. Cocaine is a benzoic acid ester obtained from the leaves of coca shrubs and was often used for its psychotropic effects. Cocaine was first isolated in 1860 by Albert Niemann. Sigmund Freud studied the physiological actions of cocaine. Carl Koller later introduced it into clinical practice in 1884 as a...
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Accelerating Topical Anaesthesia Using Microneedles.

Lleucu B Davies1, Christopher Gateley, Phillip Holland

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Microneedle pre-treatment significantly enhances tetracaine permeation through the skin, potentially halving the onset time for topical anaesthesia during venous access procedures in children.

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Area of Science:

  • Dermatology
  • Pharmacology
  • Biomedical Engineering

Background:

  • Topical anaesthetics are used to reduce pain during pediatric venous access.
  • Delayed onset of action due to stratum corneum barrier limits clinical use.
  • Microneedles offer a potential solution to overcome skin barrier limitations.

Purpose of the Study:

  • To evaluate microneedle pre-treatment of ex vivo human skin.
  • To assess the impact of microneedles on tetracaine permeation rate.
  • To determine if microneedles can accelerate topical anaesthesia onset.

Main Methods:

  • Utilized Franz-type diffusion cells for ex vivo human skin permeation studies.
  • Compared tetracaine permeation from Ametop gel through microneedle-treated and untreated epidermis.
  • Visually characterized epidermal membranes post-permeation.

Main Results:

  • Tetracaine permeation was 12.13 µg/cm² in microneedle-treated skin versus 5.43 µg/cm² in untreated skin at 30 min.
  • Microneedle treatment created a significantly larger punctured surface area (75,000 μm²) compared to hypodermic needles (4,250 μm²).

Conclusions:

  • Microneedle pre-treatment substantially increases tetracaine permeation.
  • Microneedles show potential to reduce Ametop gel anaesthesia onset time by over 50%.
  • This approach could improve pain management during pediatric procedures.