Corneal Anesthesia With Site 1 Sodium Channel Blockers and Dexmedetomidine
Identifieur interne : 000105 ( Main/Exploration ); précédent : 000104; suivant : 000106Corneal Anesthesia With Site 1 Sodium Channel Blockers and Dexmedetomidine
Auteurs : James Brian Mcalvin [États-Unis] ; Changyou Zhan [États-Unis] ; Jenny C. Dohlman [États-Unis] ; Paraskevi E. Kolovou [États-Unis] ; Borja Salvador-Culla [États-Unis] ; Daniel S. Kohane [États-Unis]Source :
- Investigative Ophthalmology & Visual Science [ 0146-0404 ] ; 2015.
Abstract
Amino-amide or amino-ester local anesthetics, which are currently used for topical ocular anesthesia, are short acting and may delay corneal healing with long-term use. In contrast, site 1 sodium channel blockers (S1SCBs) are potent local anesthetics with minimal adverse tissue reaction. In this study, we examined topical local anesthesia with two S1SCBs, tetrodotoxin (TTX) or saxitoxin (STX) individually or in combination with α2-adrenergic receptor agonists (dexmedetomidine or clonidine), and compared them with the amino-ester ocular anesthetic proparacaine. The effect of test solutions on corneal healing was also studied.
Solutions of TTX ± dexmedetomidine, TTX ± clonidine, STX ± dexmedetomidine, dexmedetomidine, or proparacaine were applied to the rat cornea. Tactile sensitivity was measured by recording the blink response to probing of the cornea with a Cochet-Bonnet esthesiometer. The duration of corneal anesthesia was calculated. Cytotoxicity from anesthetic solutions was measured in vitro. The effect on corneal healing was measured in vivo after corneal debridement followed by repeated drug administration.
Addition of dexmedetomidine to TTX or STX significantly prolonged corneal anesthesia beyond that of either drug alone, whereas clonidine did not. Tetrodotoxin or STX coadministered with dexmedetomidine resulted in two to three times longer corneal anesthesia than did proparacaine. S1SCB-dexmedetomidine formulations were not cytotoxic. Corneal healing was not delayed significantly by any of the test solutions.
Coadministration of S1SCBs with dexmedetomidine provided prolonged corneal anesthesia without delaying corneal wound healing. Such formulations may be useful for the management of acute surgical and nonsurgical corneal pain.
Url:
DOI: 10.1167/iovs.15-16591
PubMed: 26066750
PubMed Central: 4468909
Affiliations:
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<front><div type="abstract" xml:lang="en"><sec id="st1"><title>Purpose.</title>
<p>Amino-amide or amino-ester local anesthetics, which are currently used for topical ocular anesthesia, are short acting and may delay corneal healing with long-term use. In contrast, site 1 sodium channel blockers (S1SCBs) are potent local anesthetics with minimal adverse tissue reaction. In this study, we examined topical local anesthesia with two S1SCBs, tetrodotoxin (TTX) or saxitoxin (STX) individually or in combination with α<sub>2</sub>
-adrenergic receptor agonists (dexmedetomidine or clonidine), and compared them with the amino-ester ocular anesthetic proparacaine. The effect of test solutions on corneal healing was also studied.</p>
</sec>
<sec id="st2"><title>Methods.</title>
<p>Solutions of TTX ± dexmedetomidine, TTX ± clonidine, STX ± dexmedetomidine, dexmedetomidine, or proparacaine were applied to the rat cornea. Tactile sensitivity was measured by recording the blink response to probing of the cornea with a Cochet-Bonnet esthesiometer. The duration of corneal anesthesia was calculated. Cytotoxicity from anesthetic solutions was measured in vitro. The effect on corneal healing was measured in vivo after corneal debridement followed by repeated drug administration.</p>
</sec>
<sec id="st3"><title>Results.</title>
<p>Addition of dexmedetomidine to TTX or STX significantly prolonged corneal anesthesia beyond that of either drug alone, whereas clonidine did not. Tetrodotoxin or STX coadministered with dexmedetomidine resulted in two to three times longer corneal anesthesia than did proparacaine. S1SCB-dexmedetomidine formulations were not cytotoxic. Corneal healing was not delayed significantly by any of the test solutions.</p>
</sec>
<sec id="st4"><title>Conclusions.</title>
<p>Coadministration of S1SCBs with dexmedetomidine provided prolonged corneal anesthesia without delaying corneal wound healing. Such formulations may be useful for the management of acute surgical and nonsurgical corneal pain.</p>
</sec>
</div>
</front>
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<affiliations><list><country><li>États-Unis</li>
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<name sortKey="Dohlman, Jenny C" sort="Dohlman, Jenny C" uniqKey="Dohlman J" first="Jenny C." last="Dohlman">Jenny C. Dohlman</name>
<name sortKey="Kohane, Daniel S" sort="Kohane, Daniel S" uniqKey="Kohane D" first="Daniel S." last="Kohane">Daniel S. Kohane</name>
<name sortKey="Kolovou, Paraskevi E" sort="Kolovou, Paraskevi E" uniqKey="Kolovou P" first="Paraskevi E." last="Kolovou">Paraskevi E. Kolovou</name>
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<name sortKey="Zhan, Changyou" sort="Zhan, Changyou" uniqKey="Zhan C" first="Changyou" last="Zhan">Changyou Zhan</name>
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