A moldable sustained release bupivacaine formulation for tailored treatment of postoperative dental pain

Sci Rep. 2018 Aug 15;8(1):12172. doi: 10.1038/s41598-018-29696-w.

Abstract

A moldable and biodegradable dental material was designed for customized placement and sustained delivery of bupivacaine (BP) within an extraction cavity. Microparticles comprising poly(lactic-co-glycolic acid) (PLGA) containing BP were generated via solvent-evaporation and combined with absorbable hemostat Gelfoam®. Kinetics of drug release were evaluated by in vitro dialysis assays, showing higher release within the first 24 hours, with subsequent tapering of release kinetics. Formulations of Gelfoam® and BP-PLGA microparticles (GelBP), with three targeted dosing profiles (0.25, 0.5, and 1 mg/kg/day), were evaluated alongside acute subcutaneous BP injections (2 mg/kg) to determine analgesic efficacy in a rat model of tooth extraction pain. Molar extraction resulted in mechanical and thermal cold hyperalgesia in male and female rats. GelBP outperformed acute BP in blocking post-surgical dental pain, with the 0.25 mg/kg GelBP dose preventing hypersensitivity to mechanical (p < 0.01) and thermal cold stimuli (p = 0.05). Molar extraction also resulted in decreased food consumption and weight. Males receiving acute BP and 0.25 mg/kg GelBP maintained normal food consumption (p < 0.002) and weight (p < 0.0001) throughout 7 days. Females, receiving 0.25 mg/kg GelBP maintained weight on days 5-7 (p < 0.04). Customized, sustained release formulation of anesthetic within a tooth extraction cavity holds potential to eliminate post-operative dental pain over several days.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Analgesics
  • Anesthetics, Local / administration & dosage*
  • Animals
  • Bupivacaine / pharmacology*
  • Delayed-Action Preparations / pharmacology
  • Drug Compounding
  • Drug Delivery Systems / methods
  • Female
  • Hyperalgesia / prevention & control
  • Male
  • Microspheres
  • Pain, Postoperative / drug therapy*
  • Polyglycolic Acid / therapeutic use
  • Polylactic Acid-Polyglycolic Acid Copolymer
  • Rats
  • Tooth Extraction

Substances

  • Analgesics
  • Anesthetics, Local
  • Delayed-Action Preparations
  • Polylactic Acid-Polyglycolic Acid Copolymer
  • Polyglycolic Acid
  • Bupivacaine