Fundamental advancements in our field do not occur every day, so it is particularly exciting when early reports of innovative new treatments are published. In this issue of Anesthesiology, Shafer et al. describe the results of a phase 2 clinical trial in which vocacapsaicin, a soluble prodrug of capsaicin, was administered to patients undergoing bunionectomy with the hope of providing long-lasting analgesia. Capsaicin, it should be recalled, works as a potent agonist of the TRPV1 receptor, initially causing pain and hyperalgesia but over time providing desensitization of primary afferent sensory neurons. Past studies demonstrated that local infiltration of tissues around an incision with capsaicin reduces hyperalgesia and pain-related behaviors in laboratory animals. In the current study, participants reported 33% less pain when calculated using area under the numerical rating scale curve through 96 postoperative hours (AUC0-96h) and consumed 50% less oxycodone during the same...

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