title: The effect of a new topical local anaesthetic delivery system on forearm skin blood flow reactivity.
abstract: Different topical local anaesthetics have varying effects on skin blood flow and vascular reactivity. We compared the vasoactive properties of Rapydan, a new topical local anaesthetic, with those of Ametop and EMLA creams in 20 healthy volunteers. Blood flow and vascular reactivity in the forearm skin were assessed by laser Doppler flowmetry and the transient hyperaemic response ratio respectively, before and after the application of EMLA (for 60 min), Ametop (for 30 and 60 min) and Rapydan (for 30 min). Application of EMLA had no effect on skin blood flow (median (IQR [range]) change from baseline -0.9% (-63 to 414 [-38.5 to 51.3] %, p = 1.0)) or mean (SD) transient hyperaemic response ratio (from 2.86 (0.86) to 3.17 (1.3), p = 0.38). The application of Ametop for 60 min produced a greater median (IQR [range]) increase in blood flow from baseline (508 (-55 to 998 [148-649]) %) than Rapydan applied for 30 min 160 (-77 to 997 [45-301]) %, p = 0.001), and a similar decrease in mean (SD) transient hyperaemic response ratio (from 2.69 (1.16) to 1.08 (0.26) and from 2.83 (0.84) to 1.49 (0.93) respectively, p = 0.57).
authors.affiliation: University Department of Anaesthesia, University of Nottingham, Nottingham, UK. matt.wiles@nottingham.ac.uk
authors.forename: M D
authors.initials: MD
authors.lastname: Wiles
authors.forename: S A
authors.initials: SA
authors.lastname: Dobson
authors.forename: I K
authors.initials: IK
authors.lastname: Moppett
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000772:Anesthesia, Local / Q000379:methods; D019162:Anesthetics, Combined / Q000008:administration & dosage / Q000494:pharmacology; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000494:pharmacology; D001458:Bandages; D016503:Drug Delivery Systems; D005542:Forearm / Q000098:blood supply*; D006801:Humans; D006940:Hyperemia / Q000139:chemically induced / Q000503:physiopathology; D017078:Laser-Doppler Flowmetry / Q000379:methods; D008012:Lidocaine / Q000008:administration & dosage / Q000494:pharmacology; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D011318:Prilocaine / Q000008:administration & dosage / Q000494:pharmacology; D012039:Regional Blood Flow / Q000187:drug effects; D012867:Skin / Q000098:blood supply*; D013748:Tetracaine / Q000008:administration & dosage / Q000494:pharmacology; D055815:Young Adult
chemical_list: D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D000077442:Lidocaine, Prilocaine Drug Combination; D011318:Prilocaine; D013748:Tetracaine; D008012:Lidocaine