Several advancements have been made on the exact release of local anaesthetics formulation and its efficiency at inducing motor and sensory block for an extended time has been harnessed in clinical practice. The use of sustained release formulations delivers analgesia for a lengthier period of time with one administration, thereby reducing complications that usually arise with administration of conventional analgesia. In addition, controlled release of an anaesthetic drug is said to prevent overdosing, reduced side effects, especially cardiotoxicity, neurotoxicity and tissue lesions. The use of nanotechnology knowledge via liposomal formulation has recorded high successful results in pain control and quick patient recovery.
Prolonged delivery of analgesic drugs at target sites remains a critical issue for efficient pain management. The use of nano-carriers has been reported to facilitate applicable delivery of these agents to target sites with a reduced level of systemic toxicity. Different analgesics have been loaded onto various nano carriers, including those that are natural, synthetic and copolymer, for various medical applications. In this review, we will discuss the concept of nano-formulated carriers for analgesic drugs and their impacts on the field of pain management.
Local infiltrations and regional blocks have been some of the effective ways employed to manage and control post-operative pain. One of the limitations of administration of local anesthesia drugs in post-operative conditions is its inability to act for a longer period of time. Multi-vesicular liposomes made up of bupivacaine have been progressively used for their increased duration of action. Compared to bupivacaine HCL, local infiltration of liposomal bupivacaine have shown to have a significantly increase the duration and delay in peak plasma concentration. In this article, we attempt to compare liposomal bupivacaine and bupivacaine based on available clinical literatures. Liposomal bupivacaine has been demonstrated to have promising implications in post- operative pain control resulting in increased patient satisfaction; reduced hospital admission and opioid induced adverse events. Clinical studies have identified liposomal bupivacaine to be effective in delivering increased post-operative pain control. The purpose of this review is to give a comprehensive comparison between bupivacaine liposomal and conventional bupivacaine based on reported clinical trials.
Aim The purpose of this study was to evaluate the antinociceptive interaction between bupivacaine and Artemisia aucheri. L encapsulated nanoparticles. Methods and materials The effect of bupivacaine and Artemisia aucheri.L alone, and their encapsulated co-administration was assessed using the 3% formalin test in rat. Increasing doses of bupivacaine (31.6, 100, 178, and 316 mg/kg) or Artemisia aucheri.L (5.6, 10, 17.8, and 31.6 mg/kg) were given i.p. 10 min before 3% formalin administration. Results The possible mechanism(s) of action were analyzed for the encapsulated co-administration, naloxone (1 mg/kg) and N (G)-nitro-L-arginine methyl ester (L-NAME) (3 mg/kg) were used. Interaction index and isobolographic analysis and the demonstrated a synergistic effect. The experimental ED30 was lower as compared with theoretical ED30. Naloxone was shown to reduce the antinociceptive effect of the encapsulated co-administration. Discussion These data suggest that the bupivacaine and Artemisia aucheri.L encapsulated nanoparticles gave a synergistic effect.
Background: Administration of celecoxib reduces pain and inflammation and is associated with greater patient satisfaction. Objective: This study was designed to evaluate the efficacy of two different doses of oral celecoxib for reducing postoperative pain. Methods: This randomized clinical trial was performed on 90 patients undergoing cystocele and rectocele repair under spinal anesthesia. Patients were randomly divided into 3 groups: the first group received 200 mg/day celecoxib, the second group received 400 mg/day celecoxib and the third group was placebo. The pain was measured at 8, 16 and 24 hours after surgery using the VAS (Visual Analogue Scale) method. If the pain score was greater than 5, pethidine 1 mg/kg was prescribed. Pain score at 8, 16 and 24 hours, the need for pethidine, side effects and satisfaction score were recorded during the first 24 hours after surgery. Results: The pain score at postoperative 8 hours was 7.7, 3.9, and 8.1 in the 200 mg/day celecoxib, 400 mg/day celecoxib, and placebo group, respectively (p<0.001). Furthermore, the need for pethidine was significantly less in 400 mg/day group and with the greatest satisfaction score, p<0.01, respectively. Conclusion: Our study concludes that 400 mg/day of celecoxib can be effective against postoperative pain, following the cystocele and rectocele repair, as compared to 200 mg/day and placebo groups. Unwanted use of opioids can be avoided with economically cheaper and safer drugs.
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