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lidocaine + prilocaine + bupivacaine is a topical eutectic mixture of three local anesthetics being investigated for the management of postoperative pain, specifically following hemorrhoidectomy. Developed by researchers at the Federal University of São Paulo, this combination therapy leverages the different pharmacokinetic profiles of its components: lidocaine and prilocaine provide a rapid onset of action, while bupivacaine offers a more prolonged duration of analgesia. The mixture acts by binding to and blocking voltage-gated sodium channels on the internal surface of nerve cell membranes. This action prevents the influx of sodium ions, thereby inhibiting the depolarization of the neuronal membrane and the subsequent propagation of pain signals from the surgical site to the central nervous system.
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