# Prolonged duration and triggered local anesthesia

> **NIH NIH R35** · BOSTON CHILDREN'S HOSPITAL · 2024 · $651,622

## Abstract

Pain is a very common clinical problem, causing suffering in millions. Treatment of pain that lasts longer
than a brief procedure can be difficult and can entail the use of opioids, with their side effects and potential for
addiction and diversion. In this research we seek to develop injectable drug delivery systems (DDS) using
sustained release technology to provide continuous prolonged local anesthesia (PLA) lasting many hours to
days for perioperative pain, or even weeks for chronic pain. In addition, will develop DDS where the patient
could determine when they receive local anesthesia, how intense the anesthesia is, and how long it lasts.
Those on-demand DDS (termed triggered local anesthetics, TLA) are controlled by external energy sources
such as near-infrared light and ultrasound. Both the continuous and triggered DDS have the potential to
revolutionize pain management and advance the science of drug delivery. These PLA and TLA systems could
mitigate or obviate opioid use.
 All the DDS should ideally: be delivered by a single injection; be easy to administer; not require general
anesthesia or surgery to initiate; last days to weeks; cause minimal local inflammation and no local neuro- or
myotoxicity, or systemic toxicity; be fully biodegradable and reversible. Triggerable systems should be easy to
use with a safe and convenient device.
 Our strategy has been to develop novel sustained release vehicles to extend the release of local
anesthetics, thus prolonging duration of effect and reducing systemic toxicity. To minimize local (tissue) toxicity
we have used site 1 sodium channel blockers (S1SCBs) such as saxitoxin and tetrodotoxin, and taken
advantage of interactions with compounds that are known to enhance their duration of nerve blockade, such as
conventional local anesthetics and steroids.
 In PLA, we have greatly extended the duration of effect of our previous designs and reduced their toxicity,
such that 3-4 days of nerve block can be achieved without using drug synergy, and at least a week with. In
TLA, we have used photo-labile linkages to produce formulations that only release drugs upon photo-triggering
(i.e. do not cause nerve block unless the site of injection is irradiated), and where nerve block can be safely
and repeatedly re-induced by irradiating the injection site with near-infrared light or ultrasound. This work has
produced 17 papers in the past 4 years (actually 3 years if accounting for the lab shutdown due to COVID-19),
many in prominent journals (5 in Nature communications, 1 in Nature Biomedical Engineering, 2 in Nano
Letters).
 In PLA, we propose a spectrum of approaches to produce yet longer blocks while improving safety. In TLA,
we propose means to extend the number of triggerable events, and extend the time frame over which they can
be triggered – allowing use in prolonged perioperative and chronic pain.
 Addressing these challenges will entail overcoming challenges in biomaterials / drug delivery /
nanoscience...

## Key facts

- **NIH application ID:** 10841831
- **Project number:** 2R35GM131728-06
- **Recipient organization:** BOSTON CHILDREN'S HOSPITAL
- **Principal Investigator:** Daniel S Kohane
- **Activity code:** R35 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $651,622
- **Award type:** 2
- **Project period:** 2019-05-01 → 2029-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10841831

## Citation

> US National Institutes of Health, RePORTER application 10841831, Prolonged duration and triggered local anesthesia (2R35GM131728-06). Retrieved via AI Analytics 2026-06-02 from https://api.ai-analytics.org/grant/nih/10841831. Licensed CC0.

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