Glucocorticoids Prolong Rat Sciatic Nerve Blockade In Vivo from Bupivacaine Microspheres

Castillo, Jenny; Curley, Joanne; Hotz, Joyce; Uezono, Megumi; Tigner, Joseph C.; Chasin, Mark; Wilder, Robert T.; Langer, Robert; Berde, Charles B.

doi:10.1097/00000542-199611000-00025

Cited by 164 publications

(141 citation statements)

References 21 publications

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“…doubling the number of hours by co-encapsulating dexamethasone (Colombo et al, 2005). In contrast, the addition of dexamethasone to 60 mm particles increases the duration of block from hours to days (Castillo et al, 1996;Kohane et al, 2003b), and the further addition of tetrodotoxin increases the duration to more than 9 days (Kohane et al, 2003b). Such durations of block could be difficult for smaller particles to achieve.…”

Section: Local Delivery For Local Therapymentioning

confidence: 99%

Microparticles and nanoparticles for drug delivery

Kohane

2006

Biotech & Bioengineering

444

283

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Particulate drug delivery systems have become important in experimental pharmaceutics and clinical medicine. The distinction is often made between micro-and nanoparticles, being particles with dimensions best described in micrometers and nanometers respectively. That size difference entails real differences at many levels, from formulation to in vivo usage. Here I will discuss those differences and provide examples of applications, for local and systemic drug delivery. I will outline a number of challenges of interest in particulate drug delivery.

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Section: Local Delivery For Local Therapymentioning

confidence: 99%

Microparticles and nanoparticles for drug delivery

Kohane

2006

Biotech & Bioengineering

444

283

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“…Dexamethasone, a high-potency, long-acting glucocorticoid with little mineralocorticoid effect, has been shown to prolong peripheral nerve blockade in animals [5][6][7][8] and, when added to bupivacaine microspheres, to extend the duration of analgesia in humans [9,10]. Although incompletely understood, dexamethasone's mechanism of action may stem from decreased nociceptive C-fibre activity via a direct effect on glucocorticoid receptors [11] and inhibitory potassium channels [12].…”

Section: Introductionmentioning

confidence: 99%

A systematic review and meta‐analysis of perineural dexamethasone for peripheral nerve blocks

2014

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SummaryWe systematically reviewed the safety and efficacy of perineural dexamethasone as an adjunct for peripheral nerve blockade in 29 controlled trials of 1695 participants. We grouped trials by the duration of local anaesthetic action (short-or medium-vs long-term). Dexamethasone increased the mean (95% CI) duration of analgesia by 233 (172-295) min when injected with short-or medium-term action local anaesthetics and by 488 (419-557) min when injected with long-term action local anaesthetics, p < 0.00001 for both. However, these results should be interpreted with caution due to the extreme heterogeneity of results, with I 2 exceeding 90% for both analyses. Meta-regression did not show an interaction between dose of perineural dexamethasone (4-10 mg) and duration of analgesia (r 2 = 0.02, p = 0.54). There were no differences between 4 and 8 mg dexamethasone on subgroup analysis.

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“…They relive pain by reducing inflammation and blocking transmission of nociceptive c-fibres and by suppressing ectopic neural discharge [9]. Some study demonstrated the analgesic effect of systemic corticosteroid in combination with bupivacaine [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

“…Various studies have been done using dexamethasone 8 mg as an adjuvant to local anaesthetics mixture in brachial plexus block resulting in variable effects on onset but prolonged duration of analgesia [12][13][14][15][16][17][18][19][20][21] and motor block [13,17,18,21] In this context the present study has been undertaken to evaluate the efficacy of dexamethasone in the onset of sensory and motor blockade as well as duration of analgesia.…”

Section: Introductionmentioning

confidence: 99%

Supraclavicular Brachial Plexus Block with and without Dexamethasone as an Adjuvant to local anaesthetics: a Comparative Study

Dhumane

Shakir

2016

Int J of Biomed & Adv Res

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Aim and Objectives: To assess the effect of dexamethasone on onset and duration of anaesthesia as well as duration of analgesia when added to local anaesthetic solution for supraclavicular brachial plexus block. Methods: A randomized comparative study included total 60 patients of either sex, age between 18-70 years belonging to ASA Grade I and II undergoing elective or emergency surgeries of upper limb under supraclavicular brachial plexus block. Patients were randomly divided in group A (40 ml volume of lignocaine 2% with adrenaline (1:200000) + 0.5% bupivacaine) and group B (40 ml volume of lignocaine 2% with adrenaline (1:200000) + 0.5% bupivacaine with dexamethasone 8 mg). The onset and duration of sensory and motor block as well as duration of analgesia in the two groups were compared and any complications of the procedure were noted. Result: Group B had early onset and prolonged duration of sensory and motor block as well as prolonged duration of analgesia as compared to group A. None of the patients had bradycardia, hypotension or any other side effects. Conclusion:We concluded that addition of 8 mg dexamethasone to local anaesthetics in supraclavicular brachial plexus block reduces the time to onset of sensory and motor blockage and prolonged duration of postoperative analgesia.

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Glucocorticoids Prolong Rat Sciatic Nerve Blockade In Vivo from Bupivacaine Microspheres

Abstract: Glucocorticoids prolong blockade from bupivacaine microspheres. The mechanism appears unrelated to the kinetics of bupivacaine release in vivo.

Cited by 164 publications

References 21 publications

Microparticles and nanoparticles for drug delivery

Microparticles and nanoparticles for drug delivery

A systematic review and meta‐analysis of perineural dexamethasone for peripheral nerve blocks

Supraclavicular Brachial Plexus Block with and without Dexamethasone as an Adjuvant to local anaesthetics: a Comparative Study

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