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Local anesthetics toxicity

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https://www.readbyqxmd.com/read/29785585/poisoning-associated-with-inappropriate-use-of-a-eutectic-mixture-of-lidocaine-and-prilocaine-before-laser-assisted-hair-removal-about-3-cases
#1
Weniko Caré, Islam-Amine Larabi, Jérôme Langrand, Chantal Medernach, Jean-Claude Alvarez, Antoine Villa
BACKGROUND: Eutectic mixtures of lidocaine and prilocaine are used during painful dermatological procedures. Poisoning is rarely reported in adults. MATERIAL AND METHOD: We report three cases of women who experienced lidocaine and prilocaine poisoning after laser-assisted hair removal. Plasma levels of local anesthetics were assayed by a fully validated liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) method. CASE REPORTS: The rules of application of the anesthetic cream were observed apart from the maximum dose and/or maximum surface area...
May 21, 2018: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/29762181/intraneural-ultrasound-guided-sciatic-nerve-block-minimum-effective-volume-and-electrophysiologic-effects
#2
Gianluca Cappelleri, Andrea Luigi Ambrosoli, Marco Gemma, Valeria Libera Eva Cedrati, Federico Bizzarri, Giorgio Francesco Danelli
BACKGROUND: Both extra- and intraneural sciatic injection resulted in significant axonal nerve damage. This study aimed to establish the minimum effective volume of intraneural ropivacaine 1% for complete sensory-motor sciatic nerve block in 90% of patients, and related electrophysiologic variations. METHODS: Forty-seven consecutive American Society of Anesthesiologists physical status I-II patients received an ultrasound-guided popliteal intraneural nerve block following the up-and-down biased coin design...
May 15, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29757886/perioperative-lidocaine-infusions-for-the-prevention-of-chronic-post-surgical-pain-a-systematic-review-and-meta-analysis-of-efficacy-and-safety
#3
Martin Bailey, Tomas Corcoran, Stephan Schug, Andrew Toner
Chronic post-surgical pain (CPSP) occurs in 12% of surgical populations and is a high priority for perioperative research. Systemic lidocaine may modulate several of the pathophysiological processes linked to CPSP. This systematic review aims to identify and synthesize the evidence linking lidocaine infusions and CPSP.The authors conducted a systematic literature search of the major medical databases from inception until October 2017. Trials that randomized adults without baseline pain to perioperative lidocaine infusion or placebo were included if they reported on CPSP...
May 11, 2018: Pain
https://www.readbyqxmd.com/read/29745266/a-comparison-of-approaches-to-identify-possible-cases-of-local-anesthetic-systemic-toxicity-in-the-fda-adverse-event-reporting-system-faers-database
#4
Simon Dagenais, Richard Scranton, Andrew R Joyce, Catherine C Vick
BACKGROUND: Local anesthetic systemic toxicity (LAST) is a rare but potentially serious adverse event . METHODS: Data from the US Food and Drug Administration Adverse Event Reporting System were examined for liposomal bupivacaine (LB), bupivacaine, or other injectable local anesthetics. Possible LAST cases were identified based on MedDRA system organ classes (Approach 1), a recent publication (Approach 2), and a novel approach based on LAST literature (Approach 3)...
May 10, 2018: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/29742927/tetracaine-induces-apoptosis-through-a-mitochondrion-dependent-pathway-in-human-corneal-stromal-cells-in-vitro
#5
Zhan Song, Ting-Jun Fan
PURPOSE: Tetracaine is a local anesthetic widely used in ocular diagnosis and ophthalmic surgery and may lead to some adverse effects and complications at a clinical dose. To assess the cytotoxicity and molecular toxicity mechanisms of tetracaine, we used human corneal stromal (HCS) cells as an in vitro model to study the effects of tetracaine on HCS cells. MATERIALS AND METHODS: The cytotoxicity of tetracaine on HCS cells was investigated by examining the changes of cell growth, morphology, viability and cell cycle progressing when HCS cells were treated with tetracaine at concentrations from 10 g/L to 0...
May 9, 2018: Cutaneous and Ocular Toxicology
https://www.readbyqxmd.com/read/29703617/hazards-of-improper-dispensary-literature-review-and-report-of-an-accidental-chloroform-injection
#6
Prashant Verma, Patricia Tordik, Ali Nosrat
Several clear, transparent solutions are used in endodontics. Inappropriate dispensing methods can lead to accidental injection or accidental irrigation. These accidents can cause permanent tissue damage including damage to the bone, periodontium, nerves, and vasculature. This article reports on the consequences of an accidental chloroform injection. Nonsurgical retreatment of tooth #8 was planned as part of a restorative treatment plan in a 69-year-old woman. The dentist accidentally injected chloroform instead of local anesthesia because chloroform was loaded into the anesthetic syringe...
April 24, 2018: Journal of Endodontics
https://www.readbyqxmd.com/read/29678320/care-of-the-patient-with-a-peripheral-nerve-block
#7
Oluwatobi O Hunter, T Edward Kim, Edward R Mariano, T Kyle Harrison
Long-acting peripheral nerve blocks provide effective postoperative pain management, but there are risks associated with rendering an extremity insensate. Perianesthesia nurses play a major role in anticipating and mitigating risks and carefully monitoring patients for potential complications. This article presents uncommon but important considerations related to the care of patients with a peripheral nerve block. These include compartment syndrome, local anesthetic systemic toxicity, thermal injuries, falls, and fractures as well as their management and prevention...
April 17, 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29671656/interferon-beta-injection-site-reactions-in-patients-with-multiple-sclerosis
#8
Martina Maurelli, Roberto Bergamaschi, Ambra Antonini, Maria Concetta Fargnoli, Elisa Puma, Giulia Mallucci, Rocco Totaro, Giampiero Girolomoni
Interferon-beta (IFNβ) are effective treatments for relapsing multiple sclerosis. IFNβ treatment includes subcutaneous (sc) IFNβ-1b, intramuscular and sc IFNβ-1a, and sc pegylated IFNβ-1a (PEG-IFNβ-1a). PEG-IFNβ-1a offers the advantage of a prolonged duration of action with a less frequent administration (every 2 weeks) and a higher patient adherence. However, the use of subcutaneous interferons could be characterized by potential skin toxicity. Injection site reactions (ISRs), featured by erythema, edema, pain and pruritus, are the most common adverse reactions...
April 19, 2018: Journal of Dermatological Treatment
https://www.readbyqxmd.com/read/29670395/bupivacaine-in-alginate-and-chitosan-nanoparticles-an-in-vivo-evaluation-of-efficacy-pharmacokinetics-and-local-toxicity
#9
Cíntia Maria Saia Cereda, Daniel Sebbe Mecatti, Juliana Zampoli Boava Papini, Diego Valério Bueno, Michelle Franz-Montan, Thalita Rocha, José Pedrazzoli Júnior, Eneida de Paula, Daniele Ribeiro de Araújo, Renato Grillo, Leonardo Fernandes Fraceto, Silvana Aparecida Calafatti, Giovana Radomille Tofoli
Objective: This study reports a preclinical evaluation of an alginate/chitosan nanoparticle formulation containing NovaBupi®, a racemic bupivacaine (BVC) containing 25% dextrobupivacaine and 75% levobupivacaine. Methods: New Zealand White rabbits (n=6) received intraoral or intrathecal injections of BVC 0.5% or BVC 0.5%-loaded alginate-chitosan nanoparticles (BVCALG ). BVC plasma levels and pharmacokinetic parameters were determined in blood samples of these rabbits...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29574861/updated-retrospective-single-center-comparative-analysis-of-peripheral-nerve-block-complications-using-landmark-peripheral-nerve-stimulation-versus-ultrasound-guidance-as-a-primary-means-of-nerve-localization
#10
Vladyslav Melnyk, James W Ibinson, Michael L Kentor, Steven L Orebaugh
OBJECTIVES: The purpose of this study was to perform an updated analysis of complications associated with upper and lower extremity peripheral nerve blocks (PNBs) performed with ultrasound (US) guidance versus the landmark approach. METHODS: We conducted a single-center retrospective cohort analysis to compare the incidence of PNB complications between the techniques. The primary outcome was local anesthetic systemic toxicity (LAST), whereas the secondary outcomes included short- and long-term nerve injuries...
March 25, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29547406/in-vitro-negative-inotropic-effect-of-low-concentrations-of-bupivacaine-relates-to-diminished-ca2-sensitivity-but-not-to-ca2-handling-or-%C3%AE-adrenoceptor-signaling
#11
Frederik Flenner, Nicole Arlt, Mahtab Nasib, Sophie Schobesberger, Thea Koch, Ursula Ravens, Felix Friedrich, Viacheslav Nikolaev, Torsten Christ, Sebastian N Stehr
BACKGROUND: Systemic toxicity of local anesthetics is predominantly complicated by their myocardial toxicity. Especially long-acting local anesthetics exert a negative inotropic effect that has been described at lower concentrations than defined for blockade of myocardial ion channels. We evaluated the negative inotropic effect of bupivacaine at a concentration described for clinical toxicity testing the hypothesis that negative inotropy is a result of reduced Ca sensitivity rather than blockade of ion channels...
June 2018: Anesthesiology
https://www.readbyqxmd.com/read/29543642/perioperative-cardiac-arrest-focus-on-local-anesthetic-systemic-toxicity-last-erratum
#12
(no author information available yet)
No abstract text is available yet for this article.
May 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29529915/combining-ultrasound-guided-vascular-access-with-ultrasound-guided-analgesia-for-single-skin-and-vessel-puncture
#13
Timothy E Murray, Damien C O'Neill, Michael J Lee
PURPOSE: To describe a single skin puncture technique combining subcutaneous injection of anesthetic to the depth of the vessel wall with venipuncture in the same movement. TECHNIQUE: Using ultrasound guidance, controlled anesthetic instillation along the needle tract and outer vessel wall with a 21-G vascular access needle can be combined with vessel puncture. This technique reduces the number of skin punctures and ensures accurate anesthetic instillation. The maximum inadvertent intravascular dose of commercial local anesthetic preparations that can be delivered with a small syringe is far below toxicity thresholds...
March 1, 2018: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29525187/local-anesthetic-systemic-toxicity-induced-cardiac-arrest-after-topicalization-for-transesophageal-echocardiography-and-subsequent-treatment-with-extracorporeal-cardiopulmonary-resuscitation
#14
Brandon Bacon, Natalie Silverton, Micah Katz, Elise Heath, David A Bull, Jason Harig, Joseph E Tonna
No abstract text is available yet for this article.
January 31, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29524770/following-up-skin-penetration-of-lidocaine-from-different-vehicles-by-raman-spectroscopic-mapping
#15
Mónika Bakonyi, Attila Gácsi, Anita Kovács, Mária-Budai Szűcs, Szilvia Berkó, Erzsébet Csányi
The application of local anesthetics, usually administered by subcutaneous injection, is common in the course of diagnostic, therapeutic, and cosmetic dermatology procedures. The effective dermal delivery of lidocaine could offer a solution to many adverse effects caused by needle insertion, such as pain, local reactions or toxicity, and additionally, it avoids the disruption of anatomical landmarks. Therefore, novel dermal formulations of local anesthetics are needed to overcome the barrier function of the skin and provide sufficient and prolonged anesthesia...
May 30, 2018: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/29519981/dentists-knowledge-of-lipid-treatment-of-local-anaesthetic-systemic-toxicity
#16
G Oksuz, A Urfalioglu, T Sekmen, N Akkececi, N Alpay, B Bilal
Context: : Local anesthetics (LAs) are in widespread use by dental practitioners, and erroneous administration, such as intravenously or exceeding the maximum dose, can cause the life-threatening condition of local anesthetic systemic toxicity (LAST). Aims: The objective of the present study was evaluate the ability of dentists to recognize signs of LAST and quantify how often they have used lipids to treat LAST in dentistry patients. Materials and Methods: The study administered 600 questionnaires that asked about the frequency with which dentists encountered LAST and the symptoms of LAST and its treatment, especially with lipids...
March 2018: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29505959/wrong-site-nerve-blocks-a-systematic-literature-review-to-guide-principles-for-prevention
#17
REVIEW
Ellen S Deutsch, Robert A Yonash, Donald E Martin, Joshua H Atkins, Theresa V Arnold, Christina M Hunt
STUDY OBJECTIVE: Wrong-site nerve blocks (WSBs) are a significant, though rare, source of perioperative morbidity. WSBs constitute the most common type of perioperative wrong-site procedure reported to the Pennsylvania Patient Safety Authority. This systematic literature review aggregates information about the incidence, patient consequences, and conditions that contribute to WSBs, as well as evidence-based methods to prevent them. DESIGN: A systematic search of English-language publications was performed, using the PRISMA process...
May 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29505566/blood-concentration-of-bupivacaine-and-duration-of-sensory-and-motor-block-following-ultrasound-guided-femoral-and-sciatic-nerve-blocks-in-dogs
#18
Michéal O Cathasaigh, Matt R Read, Aylin Atilla, Teresa Schiller, Grace P S Kwong
Peripheral nerve blocks are becoming increasingly popular for perioperative use as anesthetics and analgesics in small animals. This prospective study was performed to investigate the duration of motor and sensory blockade following use of bupivacaine for ultrasound-guided femoral and sciatic nerve blocks in dogs and to measure the plasma concentrations of bupivacaine that result from these procedures. Six dogs were anesthetized twice using a randomized cross-over design. At the first anesthetic, dogs were assigned to receive either an ultrasound-guided femoral nerve block or sciatic nerve block with 0...
2018: PloS One
https://www.readbyqxmd.com/read/29502993/intraperitoneal-chloroprocaine-is-a-useful-adjunct-to-neuraxial-block-during-cesarean-delivery-a-case-series
#19
M Werntz, R Burwick, B Togioka
BACKGROUND: Use of intraperitoneal local anesthetic to treat intraoperative pain during cesarean delivery has not been described previously. The aim of this study was to determine if intraperitoneal chloroprocaine may be useful as an adjunct to neuraxial block in reducing the proportion of patients with severe intraoperative pain that requires conversion to general anesthesia. Intraperitoneal chloroprocaine was administered during cesarean delivery as a potential alternative, when the anesthesiologist considered performing a general anesthetic due to severe intraoperative pain...
March 1, 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29487769/local-anesthetic-systemic-toxicity-complicating-thyroid-biopsy
#20
Jean Liew, James Lundblad, Adam Obley
The overdiagnosis of thyroid malignancies may be contributing to the increased incidence of these cancers with a relatively stable mortality rate. We present the case of a man with known malignancies, who underwent biopsy of a suspicious thyroid nodule. This procedure was complicated by local anesthetic systemic toxicity (LAST). It is important to address goals of diagnostic testing and treatment with patients, particularly if further evaluation is unlikely to change management or outcomes.
December 16, 2017: Curēus
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