Al Malyan M, Becchi C, Boncinelli S, Ashammakhi N
Unit of Anaesthesia and Intensive Care, Department of Medical and Surgical Critical Care, Florence University, Florence, Italy.
Minerva Anestesiol. 2007 Mar;73(3):173-9. Epub 2006 Dec 12.
Pain is an unpleasant sensory experience resulting from damage to bodily tissues. It is considered a significant public health problem because it affects 1/5 of the world population and causes loss of great amounts of money. Pain reflects a mixture of pathological, psychological and genetic conditions that need deep understanding to be efficiently treated. If under-treated, pain results in serious immune and metabolic problems. Pain management faces many problems that limit its control. For instance, efficiency of pain killers is limited, pain killers give rise to serious side effects and inability of drug administration methods to help in pain control. Technology can overcome some of these problems and the introduction of implantable controlled drug delivery systems (CDDS), manufactured from biodegradable materials, offers a solution. Implantable CDDS provide good level of pain control, as they continuously provide drug, reduce side effects and improve patients' compliance. Biodegradable type of implantable CDDS are polymer based devices that are fabricated to locally deliver drugs in a pre-designed manner. They are currently a focus of research in the field of pain therapy in order to explore their chance to offer an alternative to the conventional methods for drug delivery. This paper aims to highlight the dimensions of pain issue and to overview the basics of drug release from polymers used for CDDS in pain management. In addition, it discusses the recent advances in the technologically designed drug delivery systems in the field of pain medicine and their clinical applications. Future perspectives are also presented.
疼痛是身体组织受损产生的一种不愉快的感觉体验。它被视为一个重大的公共卫生问题,因为它影响着世界五分之一的人口,并造成大量金钱损失。疼痛反映了病理、心理和遗传状况的综合,需要深入了解才能得到有效治疗。如果治疗不足,疼痛会导致严重的免疫和代谢问题。疼痛管理面临许多限制其控制效果的问题。例如,止痛药的效果有限,止痛药会产生严重的副作用,而且给药方法无法有效帮助控制疼痛。技术可以克服其中一些问题,由可生物降解材料制成的植入式控释给药系统(CDDS)的引入提供了一种解决方案。植入式CDDS能提供良好的疼痛控制水平,因为它们能持续给药,减少副作用并提高患者的依从性。可生物降解型植入式CDDS是基于聚合物的装置,其制造目的是以预先设计的方式局部给药。它们目前是疼痛治疗领域的研究重点,以便探索它们为传统给药方法提供替代方案的可能性。本文旨在突出疼痛问题的各个方面,并概述用于疼痛管理的CDDS中聚合物药物释放的基本原理。此外,还讨论了疼痛医学领域中技术设计的给药系统的最新进展及其临床应用。同时也提出了未来展望。