DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20161492

Innovations in existing routes and novel drug delivery systems for local anaesthetics

Diwanshu Sharma, Anshu Gupta

Abstract


New drug delivery systems (NDDS) are developed for improvement in efficacy of the drugs, provide maximum benefit to the patient and to minimize the adverse drug reactions. For local anaesthetics (LAs), the development of new effective delivery systems modulate the release rate, extend their anaesthetic effect , and helps to enhance their localisation as desired. The various routes of local anaesthetic delivery (epidural, peripheral, wound catheters, intra-nasal, intra-vesical, intra-articular, intra-osseous) are under innovation these days. Different methods such as include iontophoresis, electroporation, sonophoresis, and magnetophoresis are being used to enhance local anaesthetic permeation. Adjuvants are added to potentiate drug effects. The use of different delivery systems should  help to keep the LA at  the  target  site  for  longer  periods  prolonging  the  anesthetic  or  analgesic  effect  with an extended range of agents


Keywords


NDDS, Clinical techniques, Sonophoresis, Magnetophoresis, Micropolations

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References


Sultan J. The effect of warming local anaesthetics on pain of infiltration. Emerg Med J. 2007;24(11):791-3.

Kampe S, Warm M, Kasper S, Diefenbach M. Concept for postoperative analgesia after pedicled TRAM flaps: continuous wound instillation with 0.2% ropivacaine via multilumen catheters. a report of two cases. British Journal of Plastic Surgery.2003;56(5):478-83.

Viscusi ER. Patient-controlled drug delivery for acute postoperative pain management: a review of current and emerging technologies. Regional Anesthesia and Pain Medicine. 2008;33(2):146-158.

Jorgensen H, Wetterslev J. Moiniche S, Dahl JB. Epidural local anaesthetics versus opioid-based analgesic regimens on postoperative gastrointestinal paralysis, PONV and pain after abdominal surgery. Cochrane Database Syst Rev. 2000;(4):CD001893.

Taenzer AH, Clark C. Efficacy of postoperative epidural analgesia in adolescent scoliosis surgery: a meta-analysis. Paediatric Anaesthesia. 2010;20(2):135-43.

Gan TJ, Diemunsch P, Habib AS, Kovac A, Kranke P, Meyer TA, et al. Consensus guidelines for managing postoperative nausea and vomiting. Anesthesia and Analgesia. 2003;97(1):62-71.

Apfel CC, Korttila K, Abdalla M Kerger H, Turan A, Vedder I, et al. A factorial trial of six interventions for the prevention of postoperative nausea and vomiting. New England Journal of Medicine. 2004;350(24):2441-534.

Brown SL, Morrison AE. Local anesthetic infusion pump systems adverse events reported to the food and drug administration. Anesthesiology. 2004;100(5):1305-6.

Chadha NK, Repanos C, Carswell AJ. Local anaesthesia for manipulation of nasal fractures: systematic review. Journal of Laryngology and Otology. 2008;123(8):830-6.

Sunkaraneni VS, Jones SE. Topical anaesthetic or vasoconstrictor preparations for flexible fibre-optic nasal pharyngoscopy and laryngoscopy. Cochrane Database of Systematic Reviews. 2011;3:CD005606.

Giannantoni A, Stasi SM, Chancellor MB, Costantini E, Porena M. New frontiers in intravesical therapies and drug delivery. European Urology. 2006;50(6):1183-93.

Guhasarkar S, Banerjee R. Intravesical drug delivery: challenges, current status, opportunities and novel strategies. Journal of Controlled Release. 2010;148(2):147-59.

Murthy SN, Sammeta SM, Bowers C. Magnetophoresis for enhancing transdermal drug delivery: mechanistic studies and patch design. Journal of Controlled Release. 2010;148(2):197-203.

Clark TM,Yagiela JA. Advanced techniques and armamentarium for dental local anesthesia. Dental Clinics of North America. 2010;54(4):757-68.

Sammeta SM, Vaka SRK, Murthy SN. Transdermal drug delivery enhanced by low voltage electropulsation (LVE). Pharmaceutical Development and Technology. 2009;14(2):159-164.

Polat BE, Hart D, Langer R, Blankschtein D. Ultrasound-mediated transdermal drug delivery: mechanisms, scope, and emerging trends. Journal of Controlled Release. 2011;152(3):330-48.

Polat BE, Blankschtein D, Langer R. Low-frequency sonophoresis: application to the transdermal delivery of macromolecules and hydrophilic drugs. Expert Opinion on Drug Delivery.2010;7(12):1415-32.

Kim TY, Jung DI, Kim YI, Yang JH, Shin SC. Anesthetic effects of lidocaine hydrochloride gel using low frequency ultrasound od 0.5 MHz. Journal of Pharmacy and Pharmaceutical Sciences.2007;10(1):1-8.

Banga AK. Microporation applications for enhancing drug delivery. Expert Opinion on Drug Delivery. 2009;6(4):343-54.

Bachhav YG, Summer S, Heinrich A, Bragagna T, Bohler C, Kalia YN. Effect of controlled laser microporation on drug transport kinetics into and across the skin. Journal of Controlled Release. 2010;146(1):31-6.

Masud S, Wasnich RD, Ruckle JL. Contribution of a heating element to topical anesthesia patch efficacy prior to vascular access: results from two randomized, double-blind studies. Journal of Pain and Symptom Management. 2010;40(4):510-9.

Eidelman A, Weiss JM, Enu IK, Lau J, Carr DB. Comparative efficacy and costs of various topical anesthetics for repair of dermal lacerations: a systematic review of randomized, controlled trials. Journal of Clinical Anesthesia. 2005;17(2):106-16.

Eidelman A, Weiss JM, Lau J, Carr DB. Topical anesthetics for dermal instrumentation: a systematic review of randomized, controlled trials. Annals of Emergency Medicine. 2005;46(4):343-51.

Brisman M, Ljung BML, Otterbom LE, Larsson, Andreasson SE. Methaemoglobin formation after the use of EMLA cream in term neonates. Acta Paediatrica. 1998;87(11):1191-4.

Sawyer J, Febbraro S, Masud S, Ashburn MA, Campbell JC. Heated lidocaine/tetracaine patch (Synera, Rapydan) compared with lidocaine/prilocaine cream (EMLA) for topical anaesthesia before vascular access. British Journal of Anaesthesia. 2009;102(2):210-5.

Wakita R, Oono Y, Oogami S, Hayashi S, Umino M. The relation between epinephrine concentration and the anesthetic effect of lidocaine iontophoresis. Pain Practice. 2009;9(2):115-121.

Gratieri T, Kalaria D, Kalia YN. Non-invasive iontophoretic delivery of peptides and proteins across the skin. Expert Opinion on Drug Delivery. 2011;8(5):633-45.

Hirvonen J, Hueber F, Guy RH. Current profile regulates iontophoretic delivery of amino acids across the skin. Journal of Controlled Release. 1995;37(3):239-49.

Kanebako M, Inagi T, Takayama K. Transdermal delivery of indomethacin by iontophoresis. Biological and Pharmaceutical Bulletin. 2002; 25(6):779-82.

Spierings ELH, Brevard JH, Katz NP. Two minute skin anesthesia through ultrasound pretreatment and iontophoretic delivery of a topical anesthetic: a feasibility study. Pain Medicine. 2008;9(1):55-9.

Draper DO, Coglianese M, Castel C. Absorption of iontophoresis-driven 2% lidocaine with epinephrine in the tissues at 5 mm below the surface of the skin. Journal of Athletic Training. 2011;46(3):277-81.