1
|
Overstreet DJ, Zdrale G, McLaren AC. Extended Release of Bupivacaine from Temperature-Responsive PNDJ Hydrogels Improves Postoperative Weight-Bearing in Rabbits Following Knee Surgery. Pharmaceuticals (Basel) 2024; 17:879. [PMID: 39065729 PMCID: PMC11280370 DOI: 10.3390/ph17070879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 06/21/2024] [Accepted: 07/02/2024] [Indexed: 07/28/2024] Open
Abstract
Effective treatment of postoperative pain lasting for multiple days without opioids is an important clinical need. We previously reported analgesia lasting up to 96 h in a porcine soft tissue model of postoperative pain using SBG004, an extended-release formulation of bupivacaine based on the temperature-responsive polymer poly(N-isopropylacrylamide-co-dimethylbutyrolactone acrylamide-co-Jeffamine M-1000 acrylamide) [PNDJ]. Orthopaedic surgical sites such as the knee can involve complex sensory innervation which presents a distinct challenge to local anesthetic delivery. The purpose of this work was to evaluate the pharmacokinetics and efficacy of SBG004 in an orthopaedic surgical model in comparison to currently available local anesthetics. Pharmacokinetics following periarticular (PA) or intraarticular (IA) injection of SBG004 were compared against liposomal bupivacaine (Lip-Bupi) PA in New Zealand White rabbits (all doses 14.5 mg/kg). Analgesic efficacy of SBG004 (IA, PA, or IA + PA), three active comparators, and saline was evaluated following knee surgery in New Zealand White rabbits. Analgesia was assessed via weight-bearing on the operated limb during spontaneous large steps in video recordings. Systemic bupivacaine exposure lasted at least 7 days for SBG004 PA, 4 days for SBG004 IA, and 2 days for Lip-Bupi PA. In the analgesia study, weight-bearing in all active groups except SBG004 IA was more frequent versus saline through 8 h postoperatively (p < 0.05). Only SBG004 IA + PA resulted in a higher proportion of weight-bearing rabbits at 24 h versus saline (6/7 versus 2/10, p = 0.015). Analysis of pooled data from 24-72 h showed significantly greater frequency of weight-bearing in rabbits receiving SBG004 IA + PA (71%) versus saline (37%), ropivacaine cocktail (41%), and Lip-Bupi PA (36%). The results indicate that the release profile from SBG004 PA or IA coincides reasonably with the time course of postoperative pain, and SBG004 may produce longer duration of analgesia than local anesthetics currently used in knee surgery, including during the period of 24-72 h recognized as a target for extended-release local anesthetics.
Collapse
Affiliation(s)
- Derek J. Overstreet
- School of Biological & Health Systems Engineering, Arizona State University, Tempe, AZ 85287, USA
- Sonoran Biosciences, Tempe, AZ 85284, USA
| | | | - Alex C. McLaren
- School of Biological & Health Systems Engineering, Arizona State University, Tempe, AZ 85287, USA
- Sonoran Biosciences, Tempe, AZ 85284, USA
- Department of Orthopaedic Surgery, University of Arizona College of Medicine, Phoenix, AZ 85004, USA
| |
Collapse
|
2
|
Qiao B, Song X, Zhang W, Xu M, Zhuang B, Li W, Guo H, Wu W, Huang G, Zhang M, Xie X, Zhang N, Luan Y, Zhang C. Intensity-adjustable pain management with prolonged duration based on phase-transitional nanoparticles-assisted ultrasound imaging-guided nerve blockade. J Nanobiotechnology 2022; 20:498. [PMID: 36424657 PMCID: PMC9694595 DOI: 10.1186/s12951-022-01707-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 11/11/2022] [Indexed: 11/27/2022] Open
Abstract
Background The lack of a satisfactory strategy for postoperative pain management significantly impairs the quality of life for many patients. However, existing nanoplatforms cannot provide a longer duration of nerve blockage with intensity-adjustable characteristics under imaging guidance for clinical applications. Results To overcome this challenge, we proposed a biocompatible nanoplatform that enables high-definition ultrasound imaging-guided, intensity-adjustable, and long-lasting analgesia in a postoperative pain management model in awake mice. The nanoplatform was constructed by incorporating perfluoropentane and levobupivacaine with red blood cell membranes decorated liposomes. The fabricated nanoplatform can achieve gas-producing and can finely escape from immune surveillance in vivo to maximize the anesthetic effect. The analgesia effect was assessed from both motor reactions and pain-related histological markers. The findings demonstrated that the duration of intensity-adjustable analgesia in our platform is more than 20 times longer than free levobupivacaine injection with pain relief for around 3 days straight. Moreover, the pain relief was strengthened by repeatable ultrasound irradiation to effectively manage postoperative pain in an intensity-adjustable manner. No apparent systemic and local tissue injury was detected under different treatments. Conclusion Our results suggest that nanoplatform can provide an effective strategy for ultrasound imaging-guided intensity-adjustable pain management with prolonged analgesia duration and show considerable transformation prospects. Supplementary Information The online version contains supplementary material available at 10.1186/s12951-022-01707-z.
Collapse
Affiliation(s)
- Bin Qiao
- grid.412615.50000 0004 1803 6239Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080 People’s Republic of China
| | - Xinye Song
- grid.452435.10000 0004 1798 9070Department of Anesthesiology, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011 People’s Republic of China
| | - Weiyi Zhang
- grid.452435.10000 0004 1798 9070Department of Anesthesiology, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011 People’s Republic of China
| | - Ming Xu
- grid.412615.50000 0004 1803 6239Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080 People’s Republic of China
| | - Bowen Zhuang
- grid.412615.50000 0004 1803 6239Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080 People’s Republic of China
| | - Wei Li
- grid.412615.50000 0004 1803 6239Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080 People’s Republic of China
| | - Huanling Guo
- grid.412615.50000 0004 1803 6239Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080 People’s Republic of China
| | - Wenxin Wu
- grid.412615.50000 0004 1803 6239Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080 People’s Republic of China
| | - Guangliang Huang
- grid.412615.50000 0004 1803 6239Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080 People’s Republic of China
| | - Minru Zhang
- grid.412615.50000 0004 1803 6239Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080 People’s Republic of China
| | - Xiaoyan Xie
- grid.412615.50000 0004 1803 6239Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080 People’s Republic of China
| | - Nan Zhang
- grid.412615.50000 0004 1803 6239Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080 People’s Republic of China
| | - Yong Luan
- grid.452435.10000 0004 1798 9070Department of Anesthesiology, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011 People’s Republic of China
| | - Chunyang Zhang
- grid.412615.50000 0004 1803 6239Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080 People’s Republic of China
| |
Collapse
|