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Neuraxial drug delivery in pain management: An overview of past, present, and future

Yaksh TL, dos Santo G, Lemes J, Malange K (2023) Neuraxial drug delivery in pain management: An overview of past, present, and future. Anaesthesiology 37(2):243-265. doi: 10.1016/j.bpa.2023.04.003 PMID: 37321769

Objective: Review of neuraxial therapeutic delivery platforms for pain management and the regulation caused by pharmacological targeting of dorsal root ganglion and dorsal horn systems.

Summary: Studies have shown modulation by spinal opiates, but subsequent work reveals the complexity of the neuraxial system. Various delivery platforms, such as viral transfection, antisense and targeted neurotoxins give evidence to approaches to selectively address the acute and chronic pain phenotype. Substance P-Saporin is discussed as a method to lesion NK1R-containing neurons for the treatment of chronic pain.

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