Ropivacaine magnetic nanoparticles: An efficient local anesthetic nerve conduction blocker

Ropivacaine (Rop) is one of the commonly used local nerve blocks in clinical anesthesia and postoperative analgesia and it inhibits the stimulation of peripheral nociceptive pain. However, Rop alone is not effective enough to exert a controllable anesthetic effect in patients with peripheral nociceptive pain. Therefore, there is an urgent need to improve the targeting of the local anesthetic effect of Rop and reduce its potential chronic or acute toxicity. In this study, a novel Rop nanocomposite hydrogel drug, N-isopropylacrylamide-methacrylic acid/ropivacaine magnetic nanoparticles (NIP-MAA/Rop MNPs), was constructed on magnetic iron oxide. The unique pH and temperature response of NIP-MAA can effectively retain magnetic properties, improve the stability and targeting controllability of magnetic nanoparticles, and avoid excessive drug diffusion. Therefore, the NIP-MAA/Rop MNPs is expected to open a new field of vision for the research of clinical anesthesia and postoperative analgesia.

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Effect of magnetic nanoparticles containing ropivacaine on ankle nerve block in rats

Materials Express ◽

10.1166/mex.2021.2056 ◽

2021 ◽

Vol 11 (9) ◽

pp. 1483-1490

Author(s):

Ronghua Li ◽

Yongbo Li ◽

Xiucai Hu ◽

Shiqiang Shan ◽

Lingling Liu ◽

...

Keyword(s):

Iron Oxide ◽

Magnetic Nanoparticles ◽

Pain Management ◽

Management Strategy ◽

Magnetic Iron Oxide ◽

Pain Stimulation ◽

The Central Nervous System ◽

Clinical Anesthesia ◽

The Stability ◽

Pain Management Strategy

Ropivacaine (RVC), a common pain management drug used for clinical anesthesia and postoperative analgesia, inhibits peripheral nociceptive pain stimulation. However, the potential neurological damage resulting from RVC use must be considered. Developing a strategy to enhance the local anesthetic effect of RVC while reducing its potential acute toxicity to the central nervous system is urgently needed. In this study, a novel RVC nanocomposite drug, magnetic iron oxide/polyethylene glycol-carboxymethyl chitosan/ropivacaine nanoparticle (mCMCS-PEG/RVC NPs), was synthesized with magnetic iron oxide. The inherent shell–core structure of mCMCS-PEG retained core magnetic properties, improved the stability and biocompatibility of magnetic nanoparticles, and avoided excessive degradation. Thus, mCMCS-PEG/RVC NPs are expected to provide a new pain management strategy for perioperative patients.

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Peripheral nerve blocks for postoperative analgesia: From traditional unencapsulated local anesthetic to liposomes, cryoneurolysis and peripheral nerve stimulation

Best Practice & Research Clinical Anaesthesiology ◽

10.1016/j.bpa.2019.06.002 ◽

2019 ◽

Vol 33 (3) ◽

pp. 293-302

Author(s):

Rodney A. Gabriel ◽

Brian M. Ilfeld

Keyword(s):

Peripheral Nerve ◽

Postoperative Analgesia ◽

Local Anesthetic ◽

Nerve Stimulation ◽

Peripheral Nerve Stimulation ◽

Nerve Blocks ◽

Peripheral Nerve Blocks

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Ilioinguinal and Iliohypogastric Nerve Blocks

Ultrasound Guided Procedures and Radiologic Imaging for Pediatric Anesthesiologists ◽

10.1093/med/9780190081416.003.0008 ◽

2021 ◽

pp. 71-80

Author(s):

Ann Lawrence ◽

Corey Sheahan

Keyword(s):

Small Bowel ◽

Failure Rate ◽

Postoperative Analgesia ◽

Local Anesthetic ◽

Transversus Abdominis ◽

Lower Abdomen ◽

Middle Portion ◽

Spinal Root ◽

Nerve Blocks ◽

Internal Oblique

Chapter 8 covers ilioinguinal and iliohypogastric nerve blocks. These techniques involve the injection of local anesthetic into the facial layer between the internal oblique and transversus abdominis muscles, with the goal of anesthetizing the nerves that originate from the L1 spinal root. This block provides analgesia to the skin over the lower abdomen where it joins with the upper pelvis, to the upper pelvis, and along the middle portion of the thigh. Historically, a blind technique was utilized, during which the needle was inserted until a palpable “fascial click” was felt. This approach had an estimated 20 to 30% failure rate as well as a higher risk for iatrogenic small bowel and colonic puncture. An ultrasound guided approach reduces the risk for complications and has been shown to be successful, reducing postoperative analgesia requirements as well as reducing the volume of local anesthetic required.

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Faculty Opinions recommendation of Incidence of local anesthetic systemic toxicity and postoperative neurologic symptoms associated with 12,668 ultrasound-guided nerve blocks: an analysis from a prospective clinical registry.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717956479.793461186 ◽

2012 ◽

Author(s):

Joseph Szokol

Keyword(s):

Local Anesthetic ◽

Systemic Toxicity ◽

Ultrasound Guided ◽

Clinical Registry ◽

Nerve Blocks ◽

Neurologic Symptoms ◽

Local Anesthetic Systemic Toxicity

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Faculty Opinions recommendation of Ultrasound-guided continuous interscalene block: the influence of local anesthetic background delivery method on postoperative analgesia after shoulder surgery: a randomized trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718457672.793500369 ◽

2014 ◽

Author(s):

Philip Popham ◽

Awini Gunasekera

Keyword(s):

Randomized Trial ◽

Postoperative Analgesia ◽

Local Anesthetic ◽

Shoulder Surgery ◽

Interscalene Block ◽

Delivery Method ◽

Ultrasound Guided ◽

Continuous Interscalene

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Benzocaine loaded solid lipid nanoparticles: Formulation design, in vitro and in vivo evaluation of local anesthetic effect

Current Drug Delivery ◽

10.2174/1567201812666150703115126 ◽

2015 ◽

Vol 12 (6) ◽

pp. 680-692 ◽

Cited By ~ 15

Author(s):

Mona Basha ◽

Sameh Abd El-Alim ◽

Ahmed Kassem ◽

Sally El Awdan ◽

Gamal Awad

Keyword(s):

Local Anesthetic ◽

Solid Lipid Nanoparticles ◽

Lipid Nanoparticles ◽

In Vivo Evaluation ◽

Formulation Design ◽

Solid Lipid ◽

Anesthetic Effect

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CLytA-DAAO Chimeric Enzyme Bound to Magnetic Nanoparticles. A New Therapeutical Approach for Cancer Patients?

International Journal of Molecular Sciences ◽

10.3390/ijms22031477 ◽

2021 ◽

Vol 22 (3) ◽

pp. 1477

Author(s):

María Fuentes-Baile ◽

Elizabeth Pérez-Valenciano ◽

Pilar García-Morales ◽

Camino de Juan Romero ◽

Daniel Bello-Gil ◽

...

Keyword(s):

Magnetic Nanoparticles ◽

Colorectal Carcinoma ◽

Acid Oxidase ◽

Oxygen Species ◽

Cell Models ◽

Amino Acid Oxidase ◽

Direct Addition ◽

Alginate Capsules ◽

Anti Cancer ◽

The Stability

D-amino acid oxidase (DAAO) is an enzyme that catalyzes the oxidation of D-amino acids generating H2O2. The enzymatic chimera formed by DAAO bound to the choline-binding domain of N-acetylmuramoyl-L-alanine amidase (CLytA) induces cytotoxicity in several pancreatic and colorectal carcinoma and glioblastoma cell models. In the current work, we determined whether the effect of CLytA-DAAO immobilized in magnetic nanoparticles, gold nanoparticles, and alginate capsules offered some advantages as compared to the free CLytA-DAAO. Results indicate that the immobilization of CLytA-DAAO in magnetic nanoparticles increases the stability of the enzyme, extending its time of action. Besides, we compared the effect induced by CLytA-DAAO with the direct addition of hydrogen peroxide, demonstrating that the progressive generation of reactive oxygen species by CLytA-DAAO is more effective in inducing cytotoxicity than the direct addition of H2O2. Furthermore, a pilot study has been initiated in biopsies obtained from pancreatic and colorectal carcinoma and glioblastoma patients to evaluate the expression of the main genes involved in resistance to CLytA-DAAO cytotoxicity. Based on our findings, we propose that CLytA-DAAO immobilized in magnetic nanoparticles could be effective in a high percentage of patients and, therefore, be used as an anti-cancer therapy for pancreatic and colorectal carcinoma and glioblastoma.

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Continuous bilateral subomohyoid suprascapular nerve blocks for postoperative analgesia for bilateral rotator cuff repair: a case report

Canadian Journal of Anesthesia/Journal canadien d anesthésie ◽

10.1007/s12630-021-02050-x ◽

2021 ◽

Author(s):

Shalini Dhir ◽

MarieEve LeBel ◽

Rosemary Ann Craen

Keyword(s):

Case Report ◽

Rotator Cuff ◽

Postoperative Analgesia ◽

Rotator Cuff Repair ◽

Suprascapular Nerve ◽

Nerve Blocks ◽

Cuff Repair

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Subparaneural injection in popliteal sciatic nerve blocks evaluated by MRI

Open Medicine ◽

10.1515/med-2019-0034 ◽

2019 ◽

Vol 14 (1) ◽

pp. 346-353

Author(s):

Benedikt Büttner ◽

Alexander Schwarz ◽

Caspar Mewes ◽

Katalin Kristof ◽

José Hinz ◽

...

Keyword(s):

Sciatic Nerve ◽

Local Anesthetic ◽

Ultrasound Guidance ◽

Resonance Imaging ◽

Nerve Blocks ◽

Cross Sectional ◽

Neurological Sequelae ◽

Patient Reported ◽

Study Population ◽

Intraneural Injection

AbstractIntraneural injection of a local anesthetic can damage the nerve, yet it occurs frequently during distal sciatic block with no neurological sequelae. This has led to a controversy about the optimal needle tip placement that results from the particular anatomy of the sciatic nerve with its paraneural sheath.The study population included patients undergoing lower extremity surgery under popliteal sciatic nerve block. Ultrasound-guidance was used to position the needle tip subparaneurally and to monitor the injection of the local anesthetic. Sonography and magnetic resonance imaging were used to assess the extent of the subparaneural injection.Twenty-two patients participated. The median sciatic cross-sectional area increased from 57.8 mm2 pre-block to 110.8 mm2 immediately post-block. An intraneural injection according to the current definition was seen in 21 patients. Two patients had sonographic evidence of an intrafascicular injection, which was confirmed by MRI in one patient (the other patient refused further examinations). No patient reported any neurological symptoms.A subparaneural injection in the popliteal segment of the distal sciatic nerve is actually rarely intraneural, i.e. intrafascicular. This may explain the discrepancy between the conventional sonographic evidence of an intraneural injection and the lack of neurological sequelae.

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