Subcutaneous injection of inhaled anesthetics produces cutaneous analgesia

Chu, Cordia Ming-Yeuk; Wu, Su Z.; Su, Wan L.; Shieh, Ja Ping; Kao, Cheng Hsing; Ho, Shung Tai; Wang, Jhi J.

doi:10.1007/bf03017206

Cited by 15 publications

(11 citation statements)

References 15 publications

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“…Twelfth cleaning with sevoflurane 0⋅04 24⋅5 4 ⋅2 5 ⋅4 on concentration, probably caused by sufficient partial pressure in the peripheral nociceptors that blocks the pain stimulus transmission (24)(25)(26)(27)(28). However, the exact mechanism of action of the analgesic effect is unknown.…”

Section: Discussionmentioning

confidence: 99%

Healing of chronic venous ulcer with topical sevoflurane

Imbernón-Moya

Frutos

Sanjuan-Alvarez

et al. 2017

International Wound Journal

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The present study assesses the efficacy and safety of topical sevoflurane in chronic venous ulcers and its impact on analgesia and healing. This retrospective study included 30 patients older than 65 years with painful refractory chronic venous ulcers. Patients were treated with topical sevoflurane prior to the usual ulcer cleaning every 2 days for a period of 1 month. Treatment was initiated with a saline solution, followed by direct irrigation of 1 ml of liquid sevoflurane over the wound size, which was measured as cm . Sevoflurane had a fast, intense and long-lasting analgesic effect. Latency time ranged from 2 to 7 minutes (3·9 ± 1·5 minutes), and duration varied from 8 to 18 hours (12 ± 2·9). The mean ulcer size was 8·4 ± 9·7 cm . There was a progressive decrease in size in all patients, with a mean size of 4·2 ± 5·4 cm at the end of the study. There were no adverse systemic effects. Local adverse effects were mild and transient, including pruritus, erythema and heat. Topical sevoflurane is a new, efficient and safe therapeutic alternative in painful chronic venous ulcers, refractory to usual analgesic treatment. It can improve the ulcer-healing process that shortens the cicatrisation period.

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Section: Discussionmentioning

confidence: 99%

Healing of chronic venous ulcer with topical sevoflurane

Imbernón-Moya

Frutos

Sanjuan-Alvarez

et al. 2017

International Wound Journal

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“…It is also suggested that a reversible peripheral concentration-dependent analgesic effect is probably caused by sufficient partial pressure in the peripheral nociceptors, which blocks the transmission of the pain stimulus. 20 , 21 , 22 , 23 , 24 The absence of harmful effects is probably due to no or negligible slow and incomplete systemic absorption.…”

Section: Discussionmentioning

confidence: 99%

Pain, Quality of Life, and Functional Capacity With Topical Sevoflurane Application for Chronic Venous Ulcers: A Retrospective Clinical Study

Imbernón-Moya

Frutos

Sanjuan-Alvarez

et al. 2017

EJVES Short Reports

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IntroductionChronic venous ulcers (CVU) commonly have poorly controlled pain.ReportThirty patients older than 65 years of age with painful CVU were reviewed. At the initial visit, cleaning without sevoflurane was performed. Cleaning visits with sevoflurane every 2 days for 1 month were scheduled. The results of subsequent treatment with sevoflurane at the first, second, seventh, and twelfth cleanings were analysed. Pain was measured using a visual analog scale (VAS), quality of life by the Charing Cross Venous Leg Ulcer Questionnaire, and functional capacity by the Barthel Index.DiscussionInitial VAS was 8.8 ± 1.3 points and at the twelfth cleaning VAS was 0.8 ± 1 points (p = .001). Latency time ranged between 2 and 7 m and duration ranged between 8 and 18 h. It improved quality of life (83 ± 14 points before treatment vs. 50 ± 14 at the twelfth cleaning) and functional capacity (82 ± 13.3 before treatment vs. 91 ± 11.6 points at the twelfth cleaning) (p = .001). The safety profile was favourable with mild and self limited local cutaneous adverse effects, including pruritus, erythema, and heat. No systemic toxicity was detected. Topical sevoflurane may be a therapeutic alternative for painful CVU with a fast, intense, and long-lasting analgesic effect.

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“…On the other hand, Fassoulaki et al found a mild local analgesic effect of isoflurane solution applied on the forearm of healthy volunteers, what suggests that isoflurane may have an analgesic effect in the peripheral tissues (11). Even more, Chu et al found that, after subcutaneous injection, several inhaled anesthetics (isoflurane, halothane, enflurane) produced a reversible, concentration-dependent cutaneous analgesic effect at the site of injection (12). Regarding our patient it is reasonable to suppose that, with direct irrigation of a wound, the nociceptors were exposed to a very high partial pressure of sevoflurane, high enough to block the transmission of painful stimuli.…”

Section: Discussionmentioning

confidence: 99%

Analgesic effect of topical sevoflurane on venous leg ulcer with intractable pain

Gerónimo-Pardo¹,

Martínez-Monsalve²,

Martínez-Serrano³

2011

Phlebologie

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SummaryWe are presenting the case of a patient with a very painful venous ulcer for whom therapy with different analgesic combinations (including acetaminophen, metamizol, tramadol, morphine, fentanyl, buprenorphine, pregabal-in, gabapentin, as well as applications of lido-caine/prilocaine eutectic cream and infusion of epidural ropivacaine) was unsatisfactory. Analgesic control was finally achieved through applications of liquid sevoflurane to the wound, which resulted in immediate, intense, and long-lasting analgesia. To the patients satisfaction, the same response was obtained throughout the 16 days it took the ulcer to heal. The compassionate use of sevoflurane in this innovative and promising manner warrants further research to evaluate its efficacy and safety.

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Subcutaneous injection of inhaled anesthetics produces cutaneous analgesia

Cited by 15 publications

References 15 publications

Healing of chronic venous ulcer with topical sevoflurane

Healing of chronic venous ulcer with topical sevoflurane

Pain, Quality of Life, and Functional Capacity With Topical Sevoflurane Application for Chronic Venous Ulcers: A Retrospective Clinical Study

Analgesic effect of topical sevoflurane on venous leg ulcer with intractable pain

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