Department of Chemistry, Hefei Cosource Pharmaceutical Co., Ltd, Hefei, Anhui, China.
Department of Orthopedics, First Affiliated Hospital of Anhui Medical University Department of Medical Oncology, Hefei, Anhui, China.
Reg Anesth Pain Med. 2020 May;45(5):367-372. doi: 10.1136/rapm-2019-100730. Epub 2020 Mar 12.
Effective postoperative pain management plays a key role in enhancing recovery of patients after surgery. Bupivacaine hydrochloride is one of the most commonly local anesthetics used for the postoperative pain control. However, the relatively short anesthesia duration of bupivacaine preparations limited their clinical application.
Both guinea pig pin-prick study and rat tail-flick test were performed to evaluate the local anesthesia efficacy of HYR-PB21-LA, a new microparticle suspension injection of bupivacaine pamoate.
In the pin-prick test, the complete cutaneous trunci muscle reflex inhibitions were observed at 30 min in all treatment groups containing bupivacaine. In comparison with 6.7 mg/mL HYR-PB21-LA, both 10 and 20 mg/mL HYR-PB21-LA groups had significantly higher area under effect time curve (AUEC) values (p<0.001 and p<0.0001) and slower offset time (p<0.0001). Significantly higher AUEC (p<0.0001) and slower offset time (p<0.0001) were also found in 10 mg/mL HYR-PB21-LA treatment group compared with bupivacaine liposome injectable suspension (liposomal bupivacaine). In the rat tail-flick test, significantly increased local anesthesia effect was lasted for 5 hours after 2.5 mg/mL HYR-PB21-LA administration, which was fivefold longer than bupivacaine hydrochloride. The longer lasted efficacy of significantly increased local anesthesia was also observed in 5 mg/mLHYR-PB21-LA than those in liposomal bupivacaine (8 hour vs 1 hour).
The results demonstrated that the HYR-PB21-LA produced longer local anesthesia effect than current clinical preparations of bupivacaine in two animal models. These findings raise the potential clinical value of HYR-PB21-LA as a long-lasting local anesthesia for controlling postsurgical pain in humans.
有效的术后疼痛管理在促进患者术后康复方面起着关键作用。盐酸布比卡因是最常用于术后疼痛控制的局部麻醉剂之一。然而,布比卡因制剂的相对较短麻醉持续时间限制了其临床应用。
采用豚鼠刺痛试验和大鼠甩尾试验评估布比卡因癸酸酯新微球混悬注射液 HYR-PB21-LA 的局部麻醉效果。
在刺痛试验中,所有含布比卡因的治疗组在 30 分钟时均观察到完整的皮内横肌反射抑制。与 6.7mg/ml HYR-PB21-LA 相比,10mg/ml 和 20mg/ml HYR-PB21-LA 组的效应时间曲线下面积(AUEC)值更高(p<0.001 和 p<0.0001),时滞更慢(p<0.0001)。与布比卡因脂质体注射液(脂质体布比卡因)相比,10mg/ml HYR-PB21-LA 组的 AUEC 值更高(p<0.0001),时滞更慢(p<0.0001)。在大鼠甩尾试验中,2.5mg/ml HYR-PB21-LA 给药后 5 小时局部麻醉效果显著增加,是盐酸布比卡因的五倍。在两种动物模型中,HYR-PB21-LA 产生的局部麻醉效果均明显长于当前临床用布比卡因制剂,这表明 5mg/ml HYR-PB21-LA 的持续时间也明显长于脂质体布比卡因(8 小时比 1 小时)。
这些结果表明,HYR-PB21-LA 在两种动物模型中产生的局部麻醉效果明显长于当前临床用布比卡因制剂。这些发现提高了 HYR-PB21-LA 作为长效局部麻醉药控制人类术后疼痛的潜在临床价值。