Prolonged sensory-selective nerve blockade
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Edited* by Robert Langer, Massachusetts Institute of Technology, Cambridge, MA, and approved January 8, 2010 (received for review October 6, 2009)

Abstract
Sensory-selective local anesthesia has long been a key goal in local anesthetic development. For example, it allows women to be pain-free during labor without compromising their ability to push. Here we show that prolonged sensory-selective nerve block can be produced by specific concentrations of surfactants—such as are used to enhance drug flux across skin—in combination with QX-314, a lidocaine derivative that has relative difficulty penetrating nerves. For example, injection of 25 mM QX-314 in 30 mM octyltrimethylammonium bromide (OTAB) lasted up to 7 h. Sensory selectivity was imparted to varying degrees by cationic, neutral, and anionic surfactants, and also was achieved with another lidocaine derivative, QX-222. Simultaneous injection of OTAB at a s.c. injection site remote from the sciatic nerve did not result in prolonged sensory-specific nerve blockade from QX-314, suggesting that the observed effect is due to a local interaction between the surfactant and the lidocaine derivative, not a systemic effect.
Footnotes
- 1To whom correspondence should be addressed. E-mail: daniel.kohane{at}childrens.harvard.edu.
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Author contributions: I.S. and D.S.K. designed research, performed research, analyzed data, and wrote the paper.
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The authors declare no conflict of interest.
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↵*This Direct Submission article had a prearranged editor.
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This article contains supporting information online at www.pnas.org/cgi/content/full/0911542107/DCSupplemental.
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