Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, Key Laboratory of Anesthesia and Perioperative Medicine of Anhui Higher Education Institutes, Anhui Medical University, Hefei, 230032, China; Department of Anesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230031, China.
Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230032, China.
Acta Biomater. 2024 Jun;181:1-18. doi: 10.1016/j.actbio.2024.04.034. Epub 2024 Apr 26.
Postoperative pain (POP) is a major clinical challenge. Local anesthetics (LAs), including amide-type LAs, ester-type LAs, and other potential ion-channel blockers, are emerging as drugs for POP management because of their effectiveness and affordability. However, LAs typically exhibit short durations of action and prolonging the duration by increasing their dosage or concentration may increase the risk of motor block or systemic local anesthetic toxicity. In addition, techniques using LAs, such as intrathecal infusion, require professional operation and are prone to catheter displacement, dislodgement, infection, and nerve damage. With the development of materials science and nanotechnology, various LAs delivery systems have been developed to compensate for these disadvantages. Numerous delivery systems have been designed to continuously release a safe dose in a single administration to ensure minimal systemic toxicity and prolong pain relief. LAs delivery systems can also be designed to control the duration and intensity of analgesia according to changes in the external trigger conditions, achieve on-demand analgesia, and significantly improve pain relief and patient satisfaction. In this review, we summarize POP pathways, animal models and methods for POP testing, and highlight LAs delivery systems for POP management. STATEMENT OF SIGNIFICANCE: Postoperative pain (POP) is a major clinical challenge. Local anesthetics (LAs) are emerging as drugs for POP management because of their effectiveness and affordability. However, they exhibit short durations and toxicity. Various LAs delivery systems have been developed to compensate for these disadvantages. They have been designed to continuously release a safe dose in a single administration to ensure minimal toxicity and prolong pain relief. LAs delivery systems can also be designed to control the duration and intensity of analgesia to achieve on-demand analgesia, and significantly improve pain relief and patient satisfaction. In this paper, we summarize POP pathways, animal models, and methods for POP testing and highlight LAs delivery systems for POP management.
术后疼痛（POP）是一个主要的临床挑战。局部麻醉剂（LAs），包括酰胺型 LAs、酯型 LAs 和其他潜在的离子通道阻滞剂，由于其有效性和可负担性，正在成为 POP 管理的药物。然而，LAs 通常表现出作用时间短，通过增加剂量或浓度来延长作用时间可能会增加运动阻滞或全身局部麻醉毒性的风险。此外，使用 LAs 的技术，如鞘内输注，需要专业操作，并且容易发生导管移位、脱落、感染和神经损伤。随着材料科学和纳米技术的发展，已经开发出各种 LAs 输送系统来弥补这些缺点。已经设计了许多输送系统，以在单次给药中持续释放安全剂量，以确保最小的全身毒性和延长疼痛缓解。LAs 输送系统还可以根据外部触发条件的变化来设计控制镇痛的持续时间和强度，实现按需镇痛，并显著改善疼痛缓解和患者满意度。在这篇综述中，我们总结了 POP 途径、POP 测试的动物模型和方法，并强调了用于 POP 管理的 LAs 输送系统。
意义陈述：术后疼痛（POP）是一个主要的临床挑战。局部麻醉剂（LAs）由于其有效性和可负担性，正在成为 POP 管理的药物。然而，它们表现出作用时间短和毒性的缺点。已经开发出各种 LAs 输送系统来弥补这些缺点。它们被设计成在单次给药中持续释放安全剂量，以确保最小的毒性和延长疼痛缓解。LAs 输送系统还可以设计成控制镇痛的持续时间和强度，以实现按需镇痛，并显著改善疼痛缓解和患者满意度。在本文中，我们总结了 POP 途径、动物模型和 POP 测试方法，并强调了用于 POP 管理的 LAs 输送系统。
