Nano-enabled delivery of anesthetics: mechanistic insights, technological advances and translational challenges

The application of anesthetics constitutes a cornerstone of modern medicine, yet conventional agents are plagued by suboptimal pharmacokinetics and potential toxicity. Nanotechnology has emerged as a transformative paradigm, facilitating the design of sophisticated carriers that enable unprecedented precision in anesthetic delivery. This narrative review provides a critical synthesis of the field, advancing beyond conventional material cataloguing to deliver a comprehensive "bench-to-bedside" analysis. We systematically elucidate how the fundamental physicochemical properties of lipid-based, polymeric, and inorganic nanomaterials can be engineered to develop smart stimuli-responsive systems capable of on-demand analgesia and targeted central nervous system delivery. More importantly, this review rigorously examines three pivotal translational challenges, including long-term toxicology, immunogenicity modulation, and the navigation of complex regulatory pathways, that must be overcome. By translating clinical needs into well-defined material design criteria, this work establishes a multidisciplinary roadmap for researchers, encompassing materials chemists, pharmacologists, and clinicians, to collaboratively develop the next generation of nano-anesthetics with enhanced safety profiles and therapeutic efficacy.