Prolonged Regional Nerve Blockade

Abstract

Prolonged percutaneous blockade of peripheral nerves is feasible. The recovery from blockade is complete, and plasma bupivacaine levels are far below the range associated with systemic toxicity. The mechanisms underlying the dexamethasone block-prolonging effect are under investigation.

Prolonged Local Anesthetic Action Through Slow Release from Poly(Lactic Acid Co Castor Oil)

“…Recent advances in experimental drug delivery permit huge doses of analgesic agent to be administered with a release which is slow, constant, effective and non-toxic (1)(2)(3)(4)(5). Such agents should improve the management of postoperative pain which is a major problem for the healing process after surgery.…”

In Vitro and In Vivo Drug Release from a Novel In Situ Forming Drug Delivery System

“…In general, the regional administration of local anesthetic drugs should be improved by the development of a drug delivery system leading to sustained release of the drug at the site of application while reducing systemic drug levels. This is particularly important with the highly potent but cardiovascular toxic bupivacaine hydrochloride (3).…”

“…The feasibility of prolonged regional blockade using polymers was shown with surgically implantable pellets (1,8) and injectable microparticle formulations (3,(9)(10)(11). The implantable pellets were prepared with bupivacaine hydrochloride in a polyanhydride matrix (1,8).…”

“…Injectable bupivacaine or tetracaine loaded poly(D,Llactide)(PLA) or poly(D,L-lactide-co-glycolide) (PLGA) microparticles have been prepared by the solvent evaporation/extraction method (3,9,10). Depending on the administered dose and additives (dexamethasone seems to prolong the effect of the local anesthetics by an unknown mechanism), the localized effects ranged for up to 5.5 days (3).…”

“…Depending on the administered dose and additives (dexamethasone seems to prolong the effect of the local anesthetics by an unknown mechanism), the localized effects ranged for up to 5.5 days (3). The prolonged blockade of peripheral nerves was shown to be feasible without any systemic side effects with these microparticle formulations.…”