title: Controlled release drug delivery systems to improve post-operative pharmacotherapy.
abstract: Over 230 million surgical procedures are conducted worldwide each year with numbers increasing. Pain, undesirable inflammation and infection are common complications experienced by patients following surgery. Opioids, non-steroidal anti-inflammatory drugs (NSAIDs), local anaesthetics (LAs) and antibiotics are the commonly administered drugs peri-operatively to manage these complications. Post-operative pharmacotherapy is typically achieved using immediate-release dosage forms of drugs, which lead to issues around fluctuating plasma concentrations, systemic adverse effects and poor patient adherence. Controlled release (CR) systems for certain medicines including opioids, NSAIDs and antibiotics have demonstrably enhanced treatment efficacy in the post-surgical setting. However, challenges remain to ensure patient safety while achieving individual therapeutic needs. Newer CR systems in the research and development pipeline have a high level of control over medicine release, which can be initiated, tuned or stopped on-demand. Future systems will self-regulate drug release in response to biological markers providing precise individualized therapy. In this review, we cover currently adopted CR systems in post-operative pharmacotherapy, including drug eluting medical devices, and highlight a series of examples of novel CR technologies that have the potential for translation into post-surgical settings to improve medication efficacy and enhance post-surgical recovery.
authors.affiliation: School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
authors.forename: Prabhat
authors.initials: P
authors.lastname: Bhusal
authors.affiliation: School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
authors.forename: Jeff
authors.initials: J
authors.lastname: Harrison
authors.affiliation: School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
authors.forename: Manisha
authors.initials: M
authors.lastname: Sharma
authors.affiliation: School of Pharmacy, Medical and Biological Centre, Queen's University Belfast, Belfast, UK.
authors.forename: David S
authors.initials: DS
authors.lastname: Jones
authors.affiliation: Department of Surgery, South Auckland Clinical Campus, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 93311, Otahuhu, Auckland, 1640, New Zealand.
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Hill
authors.affiliation: School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand. d.svirskis@auckland.ac.nz.
authors.forename: Darren
authors.identifier: 0000-0001-9435-1773
authors.initials: D
authors.lastname: Svirskis
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D003692:Delayed-Action Preparations / Q000627:therapeutic use*; D016503:Drug Delivery Systems / Q000379:methods*; D006801:Humans; D011183:Postoperative Complications / Q000188:drug therapy*
chemical_list: D000701:Analgesics, Opioid; D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D003692:Delayed-Action Preparations
keywords: Controlled release systems; Pharmacotherapy; Post-operative management; Surgery; Surgical recovery