Comparative evaluation of a local anesthetic effect between lignocaine and lignocaine administered with epinephrine in healthy children

Abstract

Lignocaine a first amino amide–type local anesthetic, when combined or co-administered with epinephrine, a sympathomimetic amine, allows to administer larger doses for numbing, to decrease bleeding, and to make the numbing effect last longer. The study presented here focuses on measures to prove this activity in patients with abdominal surgery. Liposomal formulations of lignocaine and lignocaine plus epinephrine were prepared by a thin film evaporation method. This formulation was injected successfully as liposomal infusion. Thus prepared liposomes were found to be fit for drug delivery when evaluated as per physicochemical parameters. The smooth, even surfaced liposomes with PDI of 0.298 (p<0.05) were found to be efficient in delivering the drug when tested in-vitro (lignocaine as a single drug was at 93.78%, and from combined dosage lignocaine was at 96.29% with 94.62% of release of epinephrine). The randomized, controlled trial was conducted with a population of children that had undergone abdominal surgery and who were grouped into three groups depending upon the type of formulation they received. The three groups of subjects were first one receiving lignocaine liposomal infusion only; second one with lignocaine plus epinephrine liposomal infusion; the third group served as control and received a saline solution only. The serum Cortisol concentration was found to be the least in Group II when compared to Group I. Similarly, end point measurements such as the cool sensation, warm sensation, hot pain, and the sensory blockade test had indicated the superiority of combination of lignocaine with epinephrine in lowering the pain threshold. The result obtained from the above study has shown that epinephrine markedly enhances the local anesthetic activity of lignocaine.