Long-Acting Local Anesthetics: Present and Future

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Presentation transcript:

Long-Acting Local Anesthetics: Present and Future Joseph Cravero MD FAAP 34th SSAI Congress Sept 8 2017

Current Issues in Local Anesthesia Use Drugs are relatively toxic Low potency Multiple effects and actions Influenced by pH Must dissolve and diffuse Short duration

Long Acting Options Liposomes Polymer Microparticles Bupivacaine in Lipid Depot Foam (Exparel®)

Site 1 Sodium Channel Blockers Derived from Marine Toxins Animal Studies document effectiveness Human trials from Chile – display long-acting effectiveness and unique safety profile. Boston Children’s Trial – increasing doses increase duration of the block and adding epinephrine further increases duration. Potentially EXTREMELY useful adjunct to local anesthesia toolbox.