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Tetrodotoxin for prolonged local anesthesia with minimal myotoxicity
Author(s) -
Padera Robert F.,
Tse Julie Y.,
Bellas Evangelia,
Kohane Daniel S.
Publication year - 2006
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.20618
Subject(s) - bupivacaine , myotoxin , tetrodotoxin , anesthesia , medicine , neurotoxicity , blockade , epinephrine , local anesthetic , pharmacology , chemistry , toxicity , endocrinology , venom , biochemistry , snake venom , receptor
Conventional local anesthetics such as bupivacaine cause considerable myotoxicity and neurotoxicity, whereas tetrodotoxin (TTX) does not. Tetrodotoxin combined with bupivacaine or vasoconstrictors produces long‐duration nerve blockade. To assess whether these prolonged blocks can be produced without increased myotoxicity, Sprague‐Dawley rats were injected with bupivacaine, TTX, and both, or TTX plus epinephrine. Median durations of thermal nociceptive blockade were, respectively, 188, 401, 882, and 972 min. On dissection 4 days later, all tissues appeared macroscopically pristine. Muscle injury was at most mild to moderate in all animals, and the muscle injury scores for the combination formulations were not higher than for bupivacaine alone. Similarly, in differentiated cells from a myoblast cell line (C2C12), TTX caused either no or minimal worsening of cell viability from bupivacaine at 2 or 7 days. Epinephrine did not worsen TTX's relatively minimal cytotoxicity. Tetrodotoxin may thus be useful in producing prolonged nerve block with minimal myotoxicity and perhaps neurotoxicity. Muscle Nerve, 2006