Local anesthetics are commonly used in different dermatologic procedures. A group of doctors led by Hyun Jung Kwon presented a case wherein brimonidine, an α-2 agonist known to cause vasoconstriction, prolonged the duration of action of local anesthesia.
Local anesthetics are commonly used in different dermatologic procedures due to their efficacy and minimal side effects. Clinicians are currently finding different ways to prolong the duration of these anesthetics.
In an article published in the Journal of the European Academy of Dermatology and Venereology, a group of doctors led by Hyun Jung Kwon presented a case wherein Brimonidine, a α-2 agonist which causes vasoconstriction, was used as an additive to a local anesthetic. A 45-year-old man who came in with a chief complaint of lentigines on his cheeks underwent intense pulse light therapy. Prior to the procedure, a thin layer of brimonidine was applied on one side of the cheek. Local anesthetic was then applied to the whole face 5 minutes after application of brimonidine. The patient then reported the degree of pain sensation from 0 to 4 (0 = no pain, 4= maximal pain).
The results of the study showed that the patient had a later onset of pain on the cheek treated with brimonidine (within 90 minutes after onset of procedure vs. 60 minutes in the local anesthetics only group). In addition to this, there was less skin redness observed post-procedure in the cheek treated with brimonidine. This goes to show that vasoconstrictive agents like brimonidine may play a role in extending the duration of action of local anesthetics.
Written by Karla Sevilla
Hyun, J.K., et al. (2017). Topical brimonidine gel for extended-duration local anesthesia. Journal of the European Academy of Dermatology and Venereology. doi:10.1111/jdv.14448