Optimal Solubility of Diclofenac <i>β</i>‐Cyclodextrin in Combination with Local Anaesthetics for Mesotherapy Applications

Tringali, Giuseppe; Navarra, Pierluigi

doi:10.1155/2017/8321325

Cited by 5 publications

(7 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Local anaesthetic and NSAID admixtures may precipitate, however, and more studies of compatibility are required. Diclofenac solution and bupivacaine, levobupivacaine or ropivacaine admixtures are incompatible as precipitation occurs even in the presence of sodium bicarbonate [115]. Lidocaine and diclofenac are only compatible in an alkalinised solution [115] but mixing is not recommended in the product licence.…”

Section: Resultsmentioning

confidence: 99%

“…Diclofenac solution and bupivacaine, levobupivacaine or ropivacaine admixtures are incompatible as precipitation occurs even in the presence of sodium bicarbonate [115]. Lidocaine and diclofenac are only compatible in an alkalinised solution [115] but mixing is not recommended in the product licence. Intravenous diclofenac is associated with a high incidence of phlebitis, thrombosis [116] and injection site reactions are common [117].…”

Section: Resultsmentioning

confidence: 99%

“…Lidocaine and diclofenac are only compatible in an alkalinised solution [115] but mixing is not recommended in the product licence. Intravenous diclofenac is associated with a high incidence of phlebitis, thrombosis [116] and injection site reactions are common [117].…”

Section: Anaesthetic Adjunctsmentioning

confidence: 99%

See 2 more Smart Citations

Pharmacological and clinical implications of local anaesthetic mixtures: a narrative review

Nestor

Sepúlveda

et al. 2021

Anaesthesia

View full text Add to dashboard Cite

Summary Various techniques have been explored to prolong the duration and improve the efficacy of local anaesthetic nerve blocks. Some of these involve mixing local anaesthetics or adding adjuncts. We did a literature review of studies published between 01 May 2011 and 01 May 2021 that studied specific combinations of local anaesthetics and adjuncts. The rationale behind mixing long‐ and short‐acting local anaesthetics to hasten onset and extend duration is flawed on pharmacokinetic principles. Most local anaesthetic adjuncts are not licensed for use in this manner and the consequences of untested admixtures and adjuncts range from making the solution ineffective to potential harm. Pharmaceutical compatibility needs to be established before administration. The compatibility of drugs from the same class cannot be inferred and each admixture requires individual review. Precipitation on mixing (steroids, non‐steroidal anti‐inflammatory drugs) and subsequent embolisation can lead to serious adverse events, although these are rare. The additive itself or its preservative can have neurotoxic (adrenaline, midazolam) and/or chondrotoxic properties (non‐steroidal anti‐inflammatory drugs). The prolongation of block may occur at the expense of motor block quality (ketamine) or block onset (magnesium). Adverse effects for some adjuncts appear to be dose‐dependent and recommendations concerning optimal dosing are lacking. An important confounding factor is whether studies used systemic administration of the adjunct as a control to accurately identify an additional benefit of perineural administration. The challenge of how best to prolong block duration while minimising adverse events remains a topic of interest with further research required.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Pharmacological and clinical implications of local anaesthetic mixtures: a narrative review

Nestor

Sepúlveda

et al. 2021

Anaesthesia

View full text Add to dashboard Cite

show abstract

“…Furthermore, in case of an allergy, it is not possible to identify which of the individual drugs is responsible for the reaction. Although modest data exist to reduce the risk of physicochemical interactions between drugs [49], some studies have reported tolerability and efficacy with drug combinations (analgesics, anesthetics, muscle relaxants, etc.). More studies are needed to compare the combination with the single drug.…”

Section: Open Questions For the Next Clinical Researchmentioning

confidence: 99%

Mesotherapy: From Historical Notes to Scientific Evidence and Future Prospects

Mammucari

Maggiori

Russo³

et al. 2020

The Scientific World Journal

View full text Add to dashboard Cite

Intradermal therapy, known as mesotherapy, is a technique used to inject a drug into the surface layer of the skin. In particular, it involves the use of a short needle to deposit the drug in the dermis. The intradermal microdeposit modulates the drug’s kinetics, slowing absorption and prolonging the local mechanism of action. It is successfully applied in the treatment of some forms of localized pain syndromes and other local clinical conditions. It could be suggested when a systemic drug-sparing effect is useful, when other therapies have failed (or cannot be used), and when it can synergize with other pharmacological or nonpharmacological therapies. Despite the lack of randomized clinical trials in some fields of application, a general consensus is also reached in nonpharmacological mechanism of action, the technique execution modalities, the scientific rationale to apply it in some indications, and the usefulness of the informed consent. The Italian Mesotherapy Society proposes this position paper to apply intradermal therapy based on scientific evidence and no longer on personal bias.

show abstract

“…The current mesotherapeutic protocols suggest the administration of a single drug by local injection with needles of 27 Gauge × 4 mm and a low dose of the drug. It has also been recommended that the reflex effect produced by the needles has clinical benefits about pain 1,5,6…”

Section: Introductionmentioning

confidence: 99%

<p>Mesotherapy in the treatment of musculoskeletal pain in rehabilitation: the state of the art</p>

Paolucci¹,

Rg²,

Centra³

et al. 2019

JPR

View full text Add to dashboard Cite

Background Mesotherapy can be included as an ancillary treatment in the management of localized pain in rehabilitation, but there are no definitive treatment protocols for this approach. Objectives The purpose of this review was to examine new indications for more standard protocols of mesotherapy in rehabilitation. Materials and methods This systematic review was performed using the following resources: PubMed, Cochrane, PEDro, Scopus, and Google Scholar. The following algorithm was developed, based on the PICO acronym, to evaluate the effects of mesotherapy, with pain as the primary outcome (MESH terms): [mesotherapy AND pain], [mesotherapy AND musculoskeletal], [mesotherapy AND musculoskeletal disorder], [intradermal therapy AND pain], and [intradermal therapy AND musculoskeletal disorder]. Results Seven articles (N=7) satisfied the inclusion criteria and were considered in the review: two of them treated osteoarthritis of the knee (3 sessions) and pes anserine (9 sessions) emphasizing a good efficacy of mesotherapy. Five studies analyzed spine diseases (specifically, two was about chronic and nonspecific neck pain, two about acute low back pain and one about chronic spinal pain): the results of mesotherapy treatment are encouraging both for the resolution of acute and chronic musculoskeletal vertebral pain from one to five sessions. Conclusion Mesotherapy showed a good effect to reduce acute and chronic musculoskeletal pain and, also, it is a well-tolerated treatment. Nonetheless future randomized controlled trials should be desirable for more uniform treatment protocols.

show abstract

Optimal Solubility of Diclofenac β‐Cyclodextrin in Combination with Local Anaesthetics for Mesotherapy Applications

Cited by 5 publications

References 16 publications

Pharmacological and clinical implications of local anaesthetic mixtures: a narrative review

Pharmacological and clinical implications of local anaesthetic mixtures: a narrative review

Mesotherapy: From Historical Notes to Scientific Evidence and Future Prospects

<p>Mesotherapy in the treatment of musculoskeletal pain in rehabilitation: the state of the art</p>

Contact Info

Product

Resources

About