tetrodotoxin-bupivacaine-epinephrine combinations for prolonged local anesthesiatetrodotoxin-bupivacaine-epinephrine组合长局部麻醉.pdfVIP

Mar. Drugs 2011, 9, 2717-2728; doi:10.3390/md9122717 OPEN ACCESS Marine Drugs ISSN 1660-3397 /journal/marinedrugs Article Tetrodotoxin-Bupivacaine-Epinephrine Combinations for Prolonged Local Anesthesia Charles B. Berde 1,*, Umeshkumar Athiraman 1, Barak Yahalom 1, David Zurakowski 1, 2 1 Gabriel Corfas and Christina Bognet 1 Department of Anesthesiology, Perioperative and Pain Medicine, Children’s Hospital Boston, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA; E-Mails: ukathiraman@ (U.A.); barak.yahalom@ (B.Y.); david.zurakowski@ (D.Z.); cbognet@ (C.B.) 2 Departments of Otolaryngology and Neuroscience, Children’s Hospital Boston, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA; E-Mail: gabriel.corfas@ * Author to whom correspondence should be addressed; E-Mail: charles.berde@; Tel.: +1-617-355-5015; Fax: +1-617-730-0199. Received: 9 October 2011; in revised form: 18 November 2011 / Accepted: 21 November 2011 / Published: 15 December 2011 Abstract: Currently available local anesthetics have analgesic durations in humans generally less than 12 hours. Prolonged-duration local anesthetics will be useful for postoperative analgesia. Previous studies showed that in rats, combinations of tetrodotoxin (TTX) with bupivacaine had supra-additive effects on sciatic block durations. In those studies, epinephrine combined with TTX prolonged blocks more than 10-fold, whil