Long-acting analgesic: the same as usual, but in liposomes
Daniel Cohane from Harvard Medical School, using liposomes, managed to increase the duration of local anesthesia with saxitoxin to 48 hours and up to 7 days in combination with dexamethasone. Thus, the authors of the publication in PNAS proposed a solution to a very serious problem in medicine.
The fact is that anesthetics that block the possibility of excitation along the nerve fiber are very toxic to the muscles and the nerves themselves. If we are talking about a small concentration, sufficient to apply stitches or put a seal, then the side effect is practically not noticeable here.
The pharmaceutical market allows you to find suitable options for the longest operations, however, the inability to increase the concentration due to the toxic effect imposes restrictions on the methods of treating pain syndrome that develops with extensive injuries. Traditionally, the steroid hormone dexamethasone is used for this purpose, which slows down the absorption of the drug. However, dexamethasone slows down regeneration and has systemic effects, which in some cases does not satisfy doctors.
Therefore, Cohen proposed to link an anesthetic, in this case saxitoxin, with liposomes – micro-sized spheres of membranes similar to cellular ones. Liposomes have long been used as containers for fat-soluble medicines, and in the wake of "nanomedicine" interest in them has only intensified. In this form, one injection blocked the conduction of impulses along the sciatic nerve for 48 hours, and in combination with dexamethasone – for a whole week. The complete absence of toxic effects will surely attract manufacturers who are able to conduct preclinical and clinical trials much faster than scientists.
The disadvantages of the new method, as well as other "liposomal" techniques, include the instability of the drug – you will have to prepare the dosage form right before the injection.
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