Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
Reg Anesth Pain Med. 2022 Apr;47(4):234-241. doi: 10.1136/rapm-2021-102726. Epub 2022 Feb 15.
Ropivacaine hydrochloride is a commonly used local anesthetic in clinics. However, local injection or continuous infusion of ropivacaine has been associated with several disadvantages. Accordingly, it is important to develop a new controlled release system for local administration of ropivacaine to achieve a prolong anesthetic effect, improve efficacy, and minimize the side effects.
We developed injectable hydroxypropyl chitin thermo-sensitive hydrogel (HPCH) combined with hyaluronan (HA), which was used to synthesize a ropivacaine (R)-loaded controlled release system. We then conducted drug release test and cytotoxicity assay in vitro. Importantly, we examined the analgesic effects and biocompatibility of this system in vivo by injecting different concentrations of R-HPCH-HA (7.5, 15, 22.5 mg/mL), ropivacaine hydrochloride (R, 7.5 mg/mL), or saline (all in 0.5 mL) near the sciatic nerve in rats.
R-HPCH-HA induced concentration-dependent thermal-sensory blockade and motor blockade in vivo. In hot plate test, R-HPCH-HA (22.5 mg/mL) induced a significant longer thermal-sensory blockade (17.7±0.7 hours), as compared with R (7.5 mg/mL, 5.7±0.8 hours, n=6/group, p<0.05). It also produced a more prolonged motor blockade (6.8±0.8 hours) than R (3.5±0.8 hours, p<0.05). R-HPCH-HA caused less cytotoxicity than R, as indicated by the higher cell viability in vitro (n=8/group).
Our findings in a sciatic nerve block model demonstrated that the injectable, ropivacaine-loaded controlled release system effectively prolonged the local analgesic effect in rats without notable side effects.
盐酸罗哌卡因是临床常用的局部麻醉药。然而,局部注射或连续输注罗哌卡因与多种缺点有关。因此,开发一种新的局部给予罗哌卡因的控释系统以实现延长麻醉效果、提高疗效和最小化副作用非常重要。
我们开发了可注射的羟丙基壳聚糖温敏水凝胶(HPCH)与透明质酸(HA)结合,用于合成载罗哌卡因(R)的控释系统。然后,我们进行了体外药物释放试验和细胞毒性测定。重要的是,我们通过在大鼠坐骨神经附近注射不同浓度的 R-HPCH-HA(7.5、15、22.5mg/mL)、盐酸罗哌卡因(R,7.5mg/mL)或生理盐水(均为 0.5mL),在体内研究了该系统的镇痛效果和生物相容性。
R-HPCH-HA 在体内诱导浓度依赖性热感觉阻滞和运动阻滞。在热板试验中,与 R(7.5mg/mL,5.7±0.8 小时,n=6/组,p<0.05)相比,R-HPCH-HA(22.5mg/mL)诱导的热感觉阻滞时间显著延长(17.7±0.7 小时)。与 R(3.5±0.8 小时,p<0.05)相比,它还产生了更长的运动阻滞时间(6.8±0.8 小时)。体外细胞活力更高表明,R-HPCH-HA 的细胞毒性低于 R(n=8/组)。
在坐骨神经阻滞模型中,我们的研究结果表明,可注射的载罗哌卡因控释系统有效延长了大鼠的局部镇痛效果,且无明显副作用。