Stories about: Anesthesiology

Using ultrasound to trigger on-demand, site-specific pain relief

Ultrasound being applied to agitate injected liposomes, which then release nerve blocking medication that stops pain at the site
Ultrasound triggers the release of local anesthetics from injectable liposomes. Credit: Mary O’Reilly

According to the CDC, 91 people die from opioid overdoses every day in the U.S. Here in Massachusetts, the state has an opioid-related death rate that is more than twice the national average.

“Opioid abuse is a growing problem in healthcare,” says Daniel Kohane, MD, PhD, a senior associate in critical care medicine at Boston Children’s and professor of anesthesiology at Harvard Medical School.

Now, Kohane and other scientists who are developing triggerable drug delivery systems at Boston Children’s Hospital have found a new way to non-invasively relieve pain without opioids. Their novel system uses ultrasound to trigger the release of nerve-blocking agents — injected into specific sites of the body ahead of time — when and where pain relief is needed most. A paper describing the findings was published online today in Nature Biomedical Engineering.

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Science seen: Stealthy beta cell transplants for diabetes

diabetes encapsulated beta cells Daniel Anderson
Type 1 diabetes afflicts more than 300 million people worldwide. Researchers have long sought a way to replace the insulin-producing beta cells lost in the disease, but transplanted cells are susceptible to immune attack. In this image, beta cells generated from human embryonic stem cells are encapsulated in microspheres made from a material called alginate, which help cloak the cells from the immune system. However, the reddish, blue and green markers on the spheres’ surfaces indicate that immune cells have discovered spheres and their cargo, and begun to block them off from the rest of the body.

In simultaneous papers in Nature Medicine and Nature Biotechnology, Daniel Anderson, PhD — a professor of applied biology at MIT and a researcher in Boston Children’s Hospital’s Department of Anesthesia, Perioperative and Pain Medicine — and his collaborators reported on their search for effective cloaking materials They also announced that microsphere-encapsulated beta cells can reverse diabetes in a mouse model. With further work on the microspheres’ chemistry and geometry, the team hopes to improve their cloaking abilities and provide longer lasting protection for beta cells. (Image: Andrew Bader, Omid Veiseh, Arturo Vegas, Anderson/Langer Laboratory, Koch Institute at MIT)

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Lasers for on-demand local pain relief?

laser drug delivery pain relief
(Juergen Faelchle/Shutterstock)

Consider this scenario: A patient is home recovering from knee surgery to repair an ACL tear. Her pain medications are wearing off, and the surgical cuts are starting to throb. Reaching over to the table she picks up what’s essentially a souped-up laser pointer, points it at the surgical wound and turns it on. Within seconds, the pain starts to fade.

This picture isn’t as far-fetched as you might think. In a pair of simultaneous papers, Boston Children’s Hospital’s Daniel Kohane, MD, PhD, and his laboratory recently reported their efforts to create not one, but two methods for packaging long-lasting local anesthetics in microspheres that could be injected in advance by a surgeon or anesthesiologist and that would release the drugs when zapped with a laser. Both methods have one goal in common: to provide patients with durable, localized and personalized control of surgical, traumatic or chronic pain with minimal side effects.

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Safety trial of algal anesthetic kicks off

Green algae
Algae similar to these could be the source of a powerful local anesthetic. (Micropix/Wikimedia Commons)
Two years ago, we told the story of the quest of Charles Berde, MD, PhD, of Boston Children’s Division of Pain Medicine, to turn an algal toxin called neosaxitoxin into a long-lasting local anesthetic.

At that time, Berde—together with Alberto Rodríguez-Navarro, MD, from Padre Hurtado Hospital in Santiago, Chile, and a Chilean company called Proteus SA—already knew that neosaxitoxin, a site 1 sodium channel blocker which in nature is produced by algal blooms, could help patients who had undergone laproscopic surgery recover more quickly and experience less pain compared with the current state -of-the-art local anesthetic called bupivacaine.

The group has now taken a big leap forward. In May, they launched a Phase 1 clinical trial at Boston Children’s in healthy male patients, aimed at showing that neosaxitoxin produced by Proteus from bioreactor-grown algae is safe using clinically relevant doses.

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