Related Experiment Video
Updated: Sep 26, 2025
08:16
Optogenetic Activation of Afferent Pathways in Brain Slices and Modulation of Responses by Volatile Anesthetics
Published on: July 23, 2020
2.4K
Novel Local Anesthetics in Clinical Practice: Pharmacologic Considerations and Potential Roles for the Future
Alan D Kaye1, Amber N Edinoff2, Justin Y Yan3
1Department of Anesthesiology, Louisiana State University Health Science Center, Shreveport, Los Angeles, USA.
Anesthesiology and Pain Medicine
|April 18, 2022
Summary
Novel anesthetic formulations, including liposomal bupivacaine and tetrodotoxin, show promise for extending the duration of single-injection nerve blocks. Further research is needed to confirm their efficacy and safety for pain management.
Area of Science:
- Anesthesiology
- Pharmacology
- Pain Management
Background:
- Effective pain management is crucial in acute and chronic settings.
- Peripheral nerve blocks (PNBs) are a key intervention, with single-injection PNBs preferred for shorter hospital stays.
- The primary limitation of single-injection PNBs is their short duration of action.
Purpose of the Study:
- To review novel anesthetic formulations designed to prolong the duration of single-injection PNBs.
- To explore the potential of these new preparations in improving pain management strategies.
Main Methods:
- Review of emerging extended-release local anesthetics.
- Examination of novel formulations such as liposomal bupivacaine (Exparel) and bupivacaine/meloxicam combination (HTX-011).
- Inclusion of neurotoxins like tetrodotoxin and neosaxitoxin investigated for nerve conduction blockade.
Main Results:
- Liposomal bupivacaine utilizes a controlled-release system for sustained medication delivery.
- HTX-011 combines bupivacaine with meloxicam for extended anesthetic effect.
- Tetrodotoxin and neosaxitoxin demonstrate potential for reversible nerve conduction blockade.
Conclusions:
- Novel formulations offer promising solutions to extend the duration of single-injection PNBs.
- These advancements could significantly impact future pain management protocols.
- Continued research is essential to validate the efficacy and safety profiles of these innovative treatments.
Keywords:
ExparelHTX-011MeloxicamNeosaxitoxinNovel Local AnestheticsPeripheral Nerve BlocksPostoperative PainTetrodotoxinMore Related Videos
Related Concept Videos
01:23Local Anesthetics: Common Agents and Their Applications
582
Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
582
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
512
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.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
512
01:27Local Anesthetics: Chemistry and Structure-Activity Relationship
5.5K
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...
5.5K
01:30Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
1.3K
Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
1.3K
01:13Local Anesthetics: Pharmacokinetics
891
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...
891
01:11Local Anesthetics: Clinical Application as Spinal Anesthesia
847
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
847