A chitosan thermogel for delivery of ropivacaine in regional musculoskeletal anesthesia

Abstract Postoperative pain within the first days following musculoskeletal surgeries is a significant problem for which appropriate management correlates to positive clinical outcomes. While a variety of pain management modalities are currently used for postoperative pain, an optimal strategy has yet to be identified. Utilizing local anesthetics to convey analgesia through neural blockade represents a promising approach to alleviate postoperative pain. Unfortunately, local anesthetics are often associated with short half-lives, local tissue site reactions, and systemic toxicity. Drug delivery systems such as liposomes, microparticles, and nanoparticles have been previously utilized to extend analgesia, but these systems can easily diffuse from the injection site. In order to overcome this limitation a combination of drug delivery technologies were utilized. Ropivacaine base nanoparticles were fabricated and entrapped with dexamethasone using a chitosan thermogel delivery system in order to enhance neural blockade. Using a rat sciatic neural blockade model, this system was able to limit sensory function and motor function for up to 48 h. This approach utilized a low solubility drug, a drug action enhancer, nanoparticles, and a thermogel matrix together to yield a multi-faceted delivery system capable of providing moderate-term pain management.