Department of Anesthesiology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, Guangdong, 510060, China.
School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Guangming District, Shenzhen, Guangdong, 518107, China.
Adv Sci (Weinh). 2024 Jun;11(24):e2309482. doi: 10.1002/advs.202309482. Epub 2024 Mar 13.
Peripheral nerve block is performed for precise pain control and lesser side effects after surgery by reducing opioid consumption. Injectable hydrogel delivery systems with high biosafety and moisture content have good clinical application prospects for local anesthetic delivery. However, how to achieve high drug loading and long-term controlled release of water-soluble narcotic drugs remains a big challenge. In this study, heterogeneous microspheres and an injectable gel-matrix composite drug delivery system are designed in two steps. First, heterogeneous hydrogel microspheres loaded with ropivacaine (HMS-ROP) are prepared using a microfluidic chip and in situ alkalization. An injectable self-healing hydrogel matrix (Gel) is then prepared from modified carboxymethylcellulose (CMC-ADH) and oxidized hyaluronic acid (OHA). A local anesthetic delivery system, Gel/HMS-ROP/dexmedetomidine (DEX), with long-term retention and drug release in vivo is prepared by combining HMS-ROP and Gel/DEX. The drug loading of HMS-ROP reached 41.1%, with a drug release time of over 160 h in vitro, and sensory and motor blockade times in vivo of 48 and 36 h, respectively. In summary, the sequential release and synergistic analgesic effects of the two anesthetics are realized using core-shell microspheres, DEX, and an injectable gel, providing a promising strategy for long-acting postoperative pain management.
外周神经阻滞通过减少阿片类药物的使用来实现术后精确的疼痛控制和更少的副作用。具有高生物安全性和高含水量的可注射水凝胶输送系统对于局部麻醉剂的输送具有良好的临床应用前景。然而,如何实现水溶性麻醉药物的高载药量和长期控释仍然是一个巨大的挑战。在这项研究中,通过两步法设计了异质微球和可注射凝胶-基质复合药物输送系统。首先,使用微流控芯片和原位碱化法制备了载有罗哌卡因的异质水凝胶微球(HMS-ROP)。然后,从改性羧甲基纤维素(CMC-ADH)和氧化透明质酸(OHA)制备可注射自修复水凝胶基质(Gel)。通过将 HMS-ROP 与 Gel/DEX 结合,制备了具有体内长效保留和药物释放的局部麻醉剂输送系统 Gel/HMS-ROP/dexmedetomidine(DEX)。HMS-ROP 的载药量达到 41.1%,体外药物释放时间超过 160 小时,体内感觉和运动阻滞时间分别为 48 小时和 36 小时。总之,通过核壳微球、DEX 和可注射凝胶实现了两种麻醉剂的顺序释放和协同镇痛作用,为长效术后疼痛管理提供了一种有前途的策略。