Prolonged sensory-selective nerve blockade

Proc Natl Acad Sci U S A. 2010 Feb 23;107(8):3740-5. doi: 10.1073/pnas.0911542107. Epub 2010 Feb 4.

Abstract

Sensory-selective local anesthesia has long been a key goal in local anesthetic development. For example, it allows women to be pain-free during labor without compromising their ability to push. Here we show that prolonged sensory-selective nerve block can be produced by specific concentrations of surfactants-such as are used to enhance drug flux across skin-in combination with QX-314, a lidocaine derivative that has relative difficulty penetrating nerves. For example, injection of 25 mM QX-314 in 30 mM octyltrimethylammonium bromide (OTAB) lasted up to 7 h. Sensory selectivity was imparted to varying degrees by cationic, neutral, and anionic surfactants, and also was achieved with another lidocaine derivative, QX-222. Simultaneous injection of OTAB at a s.c. injection site remote from the sciatic nerve did not result in prolonged sensory-specific nerve blockade from QX-314, suggesting that the observed effect is due to a local interaction between the surfactant and the lidocaine derivative, not a systemic effect.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Anesthetics, Local / administration & dosage*
  • Animals
  • Drug Interactions
  • Injections, Subcutaneous
  • Lidocaine / administration & dosage
  • Lidocaine / analogs & derivatives*
  • Male
  • Nerve Block / methods*
  • Quaternary Ammonium Compounds / administration & dosage*
  • Rats
  • Rats, Sprague-Dawley
  • Sciatic Nerve / drug effects
  • Sensory Receptor Cells / drug effects*
  • Surface-Active Agents / administration & dosage*

Substances

  • Anesthetics, Local
  • Quaternary Ammonium Compounds
  • Surface-Active Agents
  • octyltrimethylammonium
  • QX-222
  • QX-314
  • Lidocaine