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PubMedDate not supplied

Treatment of plantar fasciitis by iontophoresis of 0.4% dexamethasone. A randomized, double-blind, placebo-controlled study.

Plantar fasciitis is a common problem in running sports. This study was undertaken to determine whether iontophoresis of dexamethasone in conjunction with other traditional modalities provides more immediate pain relief than traditional modalities alone. Forty affected feet were randomly assigned to one of two groups. Group I feet were treated with traditional modalities and placebo iontophoresis. Group II feet received the traditional modalities plus iontophoresis of dexamethasone. Both groups were treated six times over 2 weeks. The subjects' clinical course was assessed using the Maryland Foot Score. At the conclusion of treatment, Group II patients had significantly greater improvement than Group I patients (increase on Maryland Foot Score of 6.8 +/- 5.6 for Group II and 3.1 +/- 4.1 for Group I). However, at followup 1 month after completion of treatment there was no significant difference between groups (increase of 5.6 +/- 8.0 for Group I and 7.4 +/- 6.3 for Group II). These results suggest that although traditional modalities alone are ultimately effective, iontophoresis in conjunction with traditional modalities provides immediate reduction in symptoms. Based on these results, iontophoresis of dexamethasone for plantar fasciitis should be considered when more immediate results are needed (i.e., performance athletes and active patients.

Adult↗

PubMed1998

The treatment of lateral epicondylitis by iontophoresis of sodium salicylate and sodium diclofenac.

OBJECTIVE: To investigate the effectiveness of sodium diclofenac and sodium salicylate applied by topical iontophoresis and to compare them in the treatment of lateral epicondylitis. SUBJECTS: Forty patients with lateral epicondylitis were randomized into two groups of 20 patients who were matched for age and sex. INTERVENTIONS: The patients in one group were treated by iontophoresis of sodium diclofenac and the other group were treated by iontophoresis of sodium salicylate. Then infrared treatment was applied to patients in both groups. MAIN OUTCOME MEASURES: Pain scores obtained before and after treatment were compared. RESULTS: Pain produced by pressure on the lateral epicondyle, on resisting wrist extension, during function and spontaneous pain at rest significantly decreased in both groups after treatment (p < 0.001). When pain scores obtained after treatment were compared, greater decrease was observed in the pain produced on resisting wrist extension (p < 0.01) and by pressure on the lateral epicondyle (p < 0.05) in the group treated with sodium diclofenac than in the group treated with sodium salicylate. CONCLUSIONS: The results suggest some benefits from the process of iontophoresis and the use of infrared in the treatment of lateral epicondylitis and indicate that iontophoresis of sodium diclofenac is more effective than that of sodium salicylate.

Adult↗

PubMed1993

In vivo iontophoresis of fentanyl and sufentanil in rats: pharmacokinetics and acute antinociceptive effects.

Iontophoresis is a process which enhances skin permeation of ionized species by using an electrical field as driving force. The aim of the present study was to investigate whether transdermal iontophoresis of fentanyl or sufentanil could induce therapeutic plasma levels and antinociceptive effect. Fentanyl and sufentanil were introduced in an acidic buffer (acetate buffer 0.01 M at pH 5) at 40 micrograms/mL. A platinum electrode was clamped in an hydrophilic foam soaked with the drug solution and linked to the anode. A cathodic foam reservoir was filled with saline solution. The device was applied on the abdominal skin of hairless rats and direct current (0.17 mA/cm2) was applied for 1 h. Opioid plasma concentrations were monitored. In the experimental conditions used, iontophoresis strongly increased transdermal permeation of the drugs as compared to diffusion. A 1.5 h Tmax was observed. The maximal plasma levels after 1.5 h were 29.3 +/- 14 ng/mL for fentanyl and 29.1 +/- 14 ng/mL for sufentanil. The plasma level of the narcotics decreased slowly after iontophoresis was terminated. Iontophoretic transdermal permeation of fentanyl and sufentanil in rats induced analgesic effects as measured by the tail-flick test. These effects lasted for about 4 h. Thus, transdermal iontophoresis with a miniaturized device is effective for the controlled and pulsatile or sustained delivery of synthetic opiates for pain management in humans. As compared to classical patches, it could reduce the lag time before reaching steady state and allow variable drug release rate.

Administration, Cutaneous↗

PubMed1987

HSV-induced reactivation: contribution of epinephrine after corneal iontophoresis.

A modified, bilateral iontophoresis technique was used to evaluate herpes simplex virus (HSV) reactivation and epinephrine distribution and concentration in full-thickness corneas and in trigeminal ganglia of rabbits. Infectious virus was recovered from 58% of epinephrine-induced eyes 24-96 hours after iontophoresis. A histochemical adrenochrome oxidation method localized epinephrine exclusively in the corneal epithelium and anterior stromal lamellae after iontophoresis. Epinephrine introduced iontophoretically into the corneal epithelium and stroma did not reach the ganglion level as detected by the assay. Radiometric-enzymatic assay of corneal and ganglionic tissues demonstrated a transient increase in total corneal catecholamine levels from an average of 417 micrograms to an average of 778 micrograms ; concentrations returned to approximate control values 24 hours after iontophoresis. Ganglion total catecholamine levels increased from an average of 606 micrograms to an average of 1211 micrograms for a 12-hour period and remained elevated at 24 hours after iontophoresis. Epinephrine acting directly on the corneal epithelium and epinephrine metabolites at the ganglion level could act synergistically to induce ocular and ganglionic HSV reactivation.

Animals↗

PubMed1999

Management of heel pain syndrome with acetic acid iontophoresis.

This study was undertaken to determine the effectiveness of acetic acid iontophoresis in the treatment of heel pain. Thirty-five patients with chronic heel pain were treated with acetic acid iontophoresis over a 4-year period. Ninety-four percent of patients had complete or substantial relief of heel pain after an average of 5.7 sessions of acetic acid iontophoresis over an average period of 2.8 weeks. Heel pain levels were rated from 0 to 10, with 10 representing the most severe pain. Heel pain prior to iontophoresis treatment received an average rating of 7.5; by the end of therapy, the average rating had decreased to 1.8. At an average follow-up time of 27 months, heel pain levels averaged 0.64, indicating continued reduction in heel pain. Ninety-four percent of participants said that they would recommend acetic acid iontophoresis to someone with similar heel pain.

Acetic Acid↗

PubMed1999

[Induction of genes into the rabbit eye by iontophoresis].

PURPOSE: After inducing 6-carboxyfluorescein (6-FAM)-labeled phosphorothioate oligonucleotides (S-ODNs) noninvasively into albino rabbit eyes by iontophoresis, we assessed the transfer of S-ODNs into the ocular tissues, their stability, and the possible presence of injury to the ocular tissues. METHODS: The iontophoresis group consisted of 12 eyes of 6 rabbits and the control group consisted of 4 eyes of 2 rabbits given eye drops containing S-ODNs. Aqueous humor and vitreous humor were collected after iontophoresis, subjected to electrophoresis with a fluorescent DNA sequencer and analyzed by the Gene Scan program. Frozen sections at 10 microns were prepared for observations under a fluorescent microscope. A plasmid 4.7 kbp in size that expresses green fluorescent protein (GFP) was induced into 18 eyes of 9 rabbits by the same procedure. RESULTS: In the iontophoresis group, S-ODNs were detected in the anterior chamber 5 minutes after electrophoresis and in the vitreous 10 minutes after. These S-ODNs maintained the same length as at the initial synthesis. S-ODNs could also be detected in the posterior retina 20 minutes after electrophoresis. No evidence of degeneration or inflammation due to the above procedure was found in the ocular tissues. Fluorescence showing GFP gene expressions were found in the cornea, the anterior chamber angle, and the ciliary subepithelial tissues. CONCLUSIONS: These findings show that iontophoresis is an effective method to induce gene into rabbit eyes.

Animals↗

PubMed2000

Iontophoresis for treatment of Peyronie's disease.

PURPOSE: We evaluate the efficacy of iontophoresis of dexamethasone, lidocaine and verapamil to treat Peyronie's disease. MATERIALS AND METHODS: In an uncontrolled prospective study 100 unselected patients with Peyronie's disease were treated with 3 weekly courses of iontophoresis. The drug mixture was administered by an electrical current of 5 mA. and a self-adhesive receptacle fixed to the penile skin overlying the plaque. RESULTS: Resolution of pain was observed in 96% of patients, plaque diminution in 53% and improvement of penile deviation in 37%. Impaired sexual function was improved in 19 of 43 patients (44%). The benefit of iontophoresis therapy was more pronounced in patients with a short history of disease. Because of lack of side effects and painless administration iontophoresis was well tolerated and accepted by all patients. CONCLUSIONS: Iontophoresis of dexamethasone, lidocaine and verapamil may be regarded as first line nonsurgical treatment for Peyronie's disease.

Adult↗

PubMed2000

Improvement of transdermal permeation of captopril by iontophoresis.

AIM: The feasibility of iontophoresis on the transdermal delivery of captopril was studied. METHODS: Iontophoresis was employed for enhancing transdermal transport of captopril through rat skin in vitro and in vivo. RESULTS: It was demonstrated that the iontophoresis-induced flux of captopril was affected by various factors such as pH, ionic concentration, and the concentration of captopril in donor compartments as well as the applied electric current intensity. Electric current could induce several-fold increase in captopril flux with hydrogel. Skin permeation study in vivo in rats demonstrated that iontophoresis could effectively promote the transdermal transport of captopril without significant skin irritation. Captopril concentration in plasma reached plateau (approximately 0.9 microgram/mL) at 1 h after current application and was maintained at the same level during the experiment. On the contrary, captopril could not be detected in plasma when the current was not applied. No obvious skin irritation was observed after 9-h continuous iontophoresis. CONCLUSION: Transdermal delivery of captopril can be effectively improved by iontopophoresis.

Angiotensin-Converting Enzyme Inhibitors↗

PubMed2002

[The enhancing effect of electroporation and iontophoresis on the permeation of insulin through human skin].

AIM: To study the enhancing effect of electroporation and iontophoresis on the permeation of insulin through human cadaver skin in vitro. METHODS: Using side by side two-chamber diffusion cells, the flux of insulin achieved with iontophoresis and electrophoration were compared. RESULTS: The application of high-voltage pulse combined with iontophoresis resulted in higher flux transdermal permeation of insulin than either one technique alone (P < 0.05). Pulsing at a higher voltage increased the flux of insulin more dramatically than pulsing at a lower voltage (P < 0.01). The transdermal transport of insulin by 90 pulse of 500 V (exponential pulse generater, pulse time: 20-24 ms, pulse frequency: 3 pulse.min-1) followed by iontophoresis led to a quick input and a high steady flux. CONCLUSION: Electroporation combined with iontophoresis can enhance the permeation of insulin significantly.

Electroporation↗

PubMed2004

[Iontophoresis with traditional Chinese herbal medicine accelerates the healing of bone fracture].

OBJECTIVE: To observe the effect of iontophoresis with traditional Chinese herbal medicine on the healing of bone fracture. METHODS: Twelve New Zealand rabbits with tibial fracture were treated by iontophoresis with traditional Chinese herbal medicine. A retrospective study of 52 clinical cases of tibial fracture treated with the iontophoresis was also performed in comparison with 50 control cases. RESULTS: The total effective rate was 100% and in the clinical cases, treatment with the iontophoresis resulted in accelerated healing of the tibial fracture, which took place 10 d earlier than that in the control cases. The follow-up of the patients lasting for 4 to 12 months found satisfactory healing of the fractures with functional recoveries. CONCLUSION: Iontophoresis with traditional Chinese herbal medicine promotes blood circulation and accelerates the growth of bony callus, and provides a new therapeutic approach for promoting the healing of bone fractures.

Adolescent↗

PubMed2004

Spectral analysis of skin laser Doppler blood perfusion signal during cutaneous hyperemia in response to acetylcholine iontophoresis and ischemia in normal subjects.

Spectral analysis of skin laser Doppler (LD) signal was performed using Fourier transformation in twelve healthy subjects in order to compare post-ischemic hyperemia and acetylcholine (ACh) iontophoresis tests for the exploration of cutaneous microcirculatory endothelial function. Within the frequency range studied of 0.009-1.6 Hz, five different frequency intervals were considered, arising from local (endothelial and myogenic) and central (neural, respiratory and cardiac) regulatory mechanisms. The power density (PD) for each of the five frequency intervals considered was measured in perfusion units (PU)/Hz, in each subject, before and in response to ischemia and to ACh iontophoresis, using a dedicated software. The relative contribution of each frequency interval was calculated as per cent rate between each PD and the sum of the PD of the five frequency interval considered. PD of LD signals in response to ischemia and Ach iontophoresis significantly increased for all the five frequency intervals considered. A significant increase (from 25.0+/-6.3 to 48.3+/-17.8; p<0.01) in the relative contribution of 0.009-0.02 frequency interval, referred to endothelium activity, was observed only in response to ACh iontophoresis. No significant increase in the relative power contribution was observed in response to ischemia for any of the five frequency intervals considered. These data suggest that ACh iontophoresis test is more adequate than post-ischemic hyperemia test in exploring the skin microcirculatory endothelial function in normal subjects.

Acetylcholine↗

PubMed1990

Iontophoresis for eyelid anesthesia.

Local anesthesia is appropriate for eyelid surgery, but patients fear the pain of injections. We evaluated iontophoresis of lidocaine for eyelid skin anesthesia to pinprick pain sensation in normal subjects, and prior to regional infiltration of the anesthetic agent in patients undergoing eyelid surgery. After iontophoresis of lidocaine hydrochloride 4% solution to one randomly chosen eyelid, pinprick skin sensation was tested in a double-masked manner. Subjective pain scores of 10 subjects were significantly less (P less than .008) on the iontophoresis treated eyelids (0.25) than on the untreated eyelids (2.55). Nine patients undergoing bilateral upper eyelid surgery had iontophoresis applied to one randomly chosen eyelid prior to the usual anesthetic injections. In this double-masked evaluation, patients reported significantly less pain (P less than .02) on the treated eyelids (1.4) than on the untreated eyelids (4.7). We conclude that iontophoresis is effective for achieving short-term, superficial anesthesia of eyelid skin.

Anesthesia, Local↗

PubMed1990

Clinical management of dentin hypersensitivity using cathode and anode iontophoresis.

A clinical study was undertaken to study the desensitising effect of Anode and Cathode iontophoresis using solutions and gels. A total number of sixty patients were selected, divided into four groups and subjected to the following methods of treatment. a) Anode Iontophoresis using strontium Chloride Solution (9%) b) Anode Iontophoresis using Strontium Chloride gel (9%) c) Cathode Iontophoresis using Sodium Fluoride solution (2%) d) Cathode Iontophoresis using Sodium Fluoride gel (2%) Distilled water was used as the control Sensitivity was evaluated objectively with the help of specially designed apparatus which delivered measurable electrical stimuli. The results showed a statistically significant difference in the reduction of tooth sensitivity using Strontium Chloride (9%) both as a gel and solution as compared to Sodium Fluoride (2%) gel and solution.

Adult↗

PubMed1990

Reactivation of HSV-1 in primates by transcorneal iontophoresis of adrenergic agents.

Transcorneal iontophoresis of adrenergic agents has been shown to reactivate latent herpes simplex virus type 1 (HSV-1) and to produce viral shedding in the tear film in rabbits and mice, but not, to date, in nonhuman primates. In this study, we demonstrated induced reactivation of latent HSV-1, viral shedding, and production of ocular lesions in nine squirrel monkeys (Saimiri sciureus) by iontophoresis of 6-hydroxydopamine (6-HD) with topical instillation of epinephrine or with iontophoresis of timolol. Monkey corneas were scarified and inoculated with McKrae strain HSV-1 on three separate occasions. All monkeys received daily intramuscular prednisolone for 39 or 46 days prior to ionotophoresis. Once latency was established, a single ionotphoresis of 6-HD was performed on both eyes in five of the monkeys, followed by 1% epinephrine given topically four times daily for 5 days. Iontophoresis of timolol was performed on both eyes in the other four monkeys once per day on 3 consecutive days. Eight of the ten eyes receiving 6-HD and epinephrine shed HSV-1; seven eyes developed deep punctate, dendritic, or geographic corneal lesions. Seven of the eight eyes receiving timolol shed HSV-1; six of the eyes developed lesions suggestive of HSV-1 specific corneal lesions. The methods used in this report were slightly different from those used to reactivate HSV-1 in rabbits, in that repeated inoculations with HSV-1 and repeated intramuscular injections with prednisolone were required; however, these results demonstrate that iontophoresis of adrenergic agents can produce shedding and recurrent epithelial lesions in the nonhuman primate.

Animals↗

PubMed1985

Iontophoresis of epinephrine isomers to rabbit eyes induced HSV-1 ocular shedding.

Iontophoresis of 0.01% levo(-) epinephrine for 8 min at 0.8 mAmp once daily for 3 consecutive days induces ocular shedding of herpes simplex virus type 1 (HSV-1) in latently infected rabbits. In the present experiment, we tested dextro(+) and levo(-) epinephrine for their comparative effects on induced HSV-1 ocular shedding. One hundred percent of the eyes shed virus after either 0.01% dextro(+) or levo(-) epinephrine iontophoresis (8 min, 0.8 mAmp). However, the shedding frequency caused by 0.005% levo(-) epinephrine was significantly higher (P less than 0.05) than that by 0.005% dextro(+) epinephrine when the iontophoresis was conducted at 0.4 mAmp for 4 min. Iontophoresis of 0.001% levo(-) epinephrine for 8 min at 0.8 mAmp once daily for 3 consecutive days and iontophoresis of 0.001% dextro(+) epinephrine for 8 min at 0.8 mAmp once daily for 3 consecutive days did not induce HSV-1 ocular shedding in latently infected rabbits. The data suggest that the mechanism of induction of HSV-1 ocular shedding by epinephrine is correlated to the receptor potency of levo(-) epinephrine.

Animals↗

PubMed1995

The effect of iontophoresis on bacterial growth in urine.

PURPOSE: To determine the effect of iontophoresis (electrical current for therapeutic purposes) on the growth of pathogenic bacteria in human urine. MATERIALS AND METHODS: Pathogenic bacteria were isolated and inoculated into a dynamic in vitro artificial bladder model. Pooled sterile human urine was regulated through the artificial bladder by intravenous tubing and pumps to simulate filling and emptying of the human bladder. The effect of electrical current on bacterial growth in the system was then studied. RESULTS: When iontophoresis is applied at low bacterial concentrations ( < 10(8) colony forming units [CFU]/l.), inhibition of bacterial growth occurs. However, when iontophoresis is applied after fulminant growth of bacteria ( > 10(8) CFU/l.), no inhibition of bacterial growth occurs. Iontophoresis was not found to enhance the antibacterial action of gentamicin to resistant Pseudomonas aeruginosa. CONCLUSIONS: Iontophoresis inhibits bacterial growth at low bacterial concentrations. It does not inhibit bacterial growth after infectious levels have been attained, and it does not potentiate the action of gentamicin on resistant Pseudomonas aeruginosa.

Equipment Design↗

PubMed1993

Diffusion versus iontophoresis in the transport of gentamicin in the burned rabbit ear model.

This experimental study demonstrates that iontophoresis can be used to transport biologically active gentamicin into auricular cartilage. Fifty female New Zealand White rabbits were divided into three groups: live controls with unburned ears, live animals with burn-injured ears (deep or partial-thickness), and euthanized animals with unburned ears. Each group was then divided into subgroups that received gentamicin transported by iontophoresis or diffusion. In ears subjected to iontophoresis, adequate gentamicin activity could be demonstrated only in the cartilage of euthanized animals with unburned ears and live animals with full-thickness burned ears. Diffusion did not transport a detectable level of gentamicin in any instance. Diffusion is ineffective in the transport of gentamicin and should not be used as a primary method of treatment for ear chondritis. Iontophoresis did not transport active gentamicin across partial-thickness burns, presumably because the migrating antibiotic molecules were dispersed throughout the body by the circulation. However, if the circulation is destroyed, as in a full-thickness burn, iontophoresis can move the biologically active gentamicin into the cartilage.

Animals↗

PubMed1995

The effects of imipramine, amitriptyline and clonidine administered by iontophoresis on the pain threshold.

We performed iontophoresis of aqueous solution of imipramine and amitriptyline, tricyclic antidepressant, and clonidine, an alpha 2 agonist, in a total of 30 healthy adult volunteers. Analgesic effects were compared among the 3 drugs by measurement of the pain threshold using a thermopainmeter. No significant changes in the pain threshold were observed with imipramine or amitriptyline. On the other hand, clonidine significantly increased the pain threshold, compared with the control value before iontophoresis. Although the effects of iontophoresis of clonidine were smaller than the previously reported effects of iontophoresis with other drugs, these effects seemed to be due to the action of clonidine itself not associated with electric stimulation. More marked effects may be obtained with changes in the conditions of iontophoresis.

Adrenergic alpha-Agonists↗