Editorial
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 16, 2017; 5(8): 307-323
Published online Aug 16, 2017. doi: 10.12998/wjcc.v5.i8.307
Adjuvants to local anesthetics: Current understanding and future trends
Amlan Swain, Deb Sanjay Nag, Seelora Sahu, Devi Prasad Samaddar
Amlan Swain, Deb Sanjay Nag, Seelora Sahu, Devi Prasad Samaddar, Department of Anaesthesia and Critical Care, Tata Main Hospital, Jamshedpur 831001, India
Author contributions: All the authors contributed to the manuscript.
Conflict-of-interest statement: The authors declare no conflicts of interest regarding this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Deb Sanjay Nag, Department of Anaesthesia and Critical Care, Tata Main Hospital, C Road West, Northern Town, Bistupur, Jamshedpur 831001, India. ds.nag@tatasteel.com
Telephone: +91-943-1166582 Fax: +91-657-2224559
Received: February 5, 2017
Peer-review started: February 7, 2017
First decision: April 18, 2017
Revised: May 3, 2017
Accepted: May 18, 2017
Article in press: May 19, 2017
Published online: August 16, 2017
Processing time: 191 Days and 6.4 Hours
Core Tip

Core tip: The use of local anaesthetics in acute and chronic pain is limited by its duration of action and the dose dependent adverse effects. Adjuvants or additives are often used with local anaesthetics for its synergistic effect by prolonging the duration of sensory-motor block and limiting its cumulative dose requirement. Various drugs like opioids, epinephrine, alpha-2 adrenergic antagonists, steroids, anti-inflammatory drugs, midazolam, ketamine, magnesium sulfate and neostigmine have been used to potentiate the effect of local anesthetics. Due its potential adverse effects, current research is exploring newer drugs and delivery mechanisms to prolong the duration of action of local anesthetics.