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Local anesthetic systemic toxicity

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https://www.readbyqxmd.com/read/29762181/intraneural-ultrasound-guided-sciatic-nerve-block-minimum-effective-volume-and-electrophysiologic-effects
#1
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
#2
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
#3
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/29678320/care-of-the-patient-with-a-peripheral-nerve-block
#4
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/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
#5
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
#6
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...
March 16, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29543642/perioperative-cardiac-arrest-focus-on-local-anesthetic-systemic-toxicity-last-erratum
#7
(no author information available yet)
No abstract text is available yet for this article.
May 2018: Anesthesia and Analgesia
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
#8
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/29519981/dentists-knowledge-of-lipid-treatment-of-local-anaesthetic-systemic-toxicity
#9
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/29505566/blood-concentration-of-bupivacaine-and-duration-of-sensory-and-motor-block-following-ultrasound-guided-femoral-and-sciatic-nerve-blocks-in-dogs
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/29461316/perioperative-cardiac-arrest-focus-on-local-anesthetic-systemic-toxicity-last
#13
(no author information available yet)
No abstract text is available yet for this article.
March 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29356775/the-american-society-of-regional-anesthesia-and-pain-medicine-checklist-for-managing-local-anesthetic-systemic-toxicity-2017-version
#14
Joseph M Neal, Crystal M Woodward, T Kyle Harrison
The American Society of Regional Anesthesia and Pain Medicine (ASRA) periodically revises and updates its checklist for the management of local anesthetic systemic toxicity. The 2017 update replaces the 2012 version and reflects new information contained in the third ASRA Practice Advisory on Local Anesthetic Systemic Toxicity. Electronic copies of the ASRA checklist can be downloaded from the ASRA Web site (www.asra.com) for inclusion in local anesthetic toxicity rescue kits or perioperative checklist repositories...
February 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29356773/the-third-american-society-of-regional-anesthesia-and-pain-medicine-practice-advisory-on-local-anesthetic-systemic-toxicity-executive-summary-2017
#15
Joseph M Neal, Michael J Barrington, Michael R Fettiplace, Marina Gitman, Stavros G Memtsoudis, Eva E Mörwald, Daniel S Rubin, Guy Weinberg
The American Society of Regional Anesthesia and Pain Medicine's Third Practice Advisory on local anesthetic systemic toxicity is an interim update from its 2010 advisory. The advisory focuses on new information regarding the mechanisms of lipid resuscitation, updated frequency estimates, the preventative role of ultrasound guidance, changes to case presentation patterns, and limited information related to local infiltration anesthesia and liposomal bupivacaine. In addition to emerging information, the advisory updates recommendations pertaining to prevention, recognition, and treatment of local anesthetic systemic toxicity...
February 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29303925/local-anesthetic-systemic-toxicity-a-review-of-recent-case-reports-and-registries
#16
Marina Gitman, Michael J Barrington
This review summarizes presenting features, management, and outcomes of local anesthetic systemic toxicity (LAST) from published cases and those submitted to online registries capturing use of intravenous lipid emulsion (ILE) therapy. The results of single-center and multicenter registries and epidemiologic studies complement this information. Between March 2014 and November 2016, 47 separate cases of LAST were described in 35 peer-reviewed articles. Local anesthetic systemic toxicity events occurred as a result of penile blocks (23%), local infiltration (17%), and upper/lower extremity, torso, and neuraxial blockade...
February 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29295799/profound-prolonged-bradycardia-and-hypotension-after-interscalene-brachial-plexus-block-with-bupivacaine
#17
Mathew Nelson, Alexandra Reens, Lara Reda, David Lee
BACKGROUND: Interscalene brachial plexus blocks have been a routinely performed method of anesthesia for shoulder surgery that decreases the need for general anesthesia, length of stay, and recovery time. We describe a case of bupivacaine toxicity after an interscalene block. CASE REPORT: The patient was a 66-year-old man who presented to our Emergency Department by emergency medical services from an ambulatory surgery center where he had undergone rotator cuff surgery, with bradycardia and hypotension...
March 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29284860/effect-of-locally-administered-dexmedetomidine-as-adjuvant-to-levobupivacaine-in-supraclavicular-brachial-plexus-block-double-blind-controlled-study
#18
Bikash Bisui, Swastika Samanta, Sumanta Ghoshmaulik, Amit Banerjee, Tirtha R Ghosh, Suman Sarkar
Context: Brachial plexus block is effective with good postoperative analgesia in upper limb surgery has gained importance as it safe, low cost, and maintains stable hemodynamics intraoperatively. To decrease the onset time and prolong the duration of nerve block bicarbonate, opioids (morphine, fentanyl, etc.), sympathomimetic agents (epinephrine, phenylephrine, etc.), α-2 agonists (clonidine and dexmedetomidine), calcium channel blocker (verapamil), magnesium sulfate, etc., were studied with local anesthetics and their isomers...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29280923/local-anesthetic-systemic-toxicity-in-total-joint-arthroplasty-incidence-and-risk-factors-in-the-united-states-from-the-national-inpatient-sample-1998-2013
#19
Daniel S Rubin, Monica M Matsumoto, Guy Weinberg, Steven Roth
BACKGROUND: Local anesthetic systemic toxicity (LAST) is a rare and potentially devastating complication of regional anesthesia. Single-institution registries have reported a decreasing incidence, but these results have limited broad applicability. A recent study using a US database found a relatively high incidence of LAST. We used the National Inpatient Sample, a US database of inpatient admissions, to identify the national incidence and associated risk factors for LAST in total joint arthroplasties...
February 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29239940/prolonged-duration-local-anesthesia-using-liposomal-bupivacaine-combined-with-liposomal-dexamethasone-and-dexmedetomidine
#20
Alina Y Rwei, Robert T Sherburne, David Zurakowski, Bruce Wang, Daniel S Kohane
BACKGROUND: The relatively short duration of effect of local anesthetics has been addressed by encapsulation in drug delivery systems. Codelivery with a single compound that produces an adjuvant effect on nerve block but without intrinsic local anesthetic properties can further prolong the nerve block effect. Here, we investigated whether codelivery of more than 1 encapsulated adjuvant compound can further enhance nerve blockade. METHODS: Liposomes loaded with bupivacaine (Bup), dexamethasone phosphate (DexP), or dexmedetomidine (DMED) were synthesized and its in vitro drug release profiles were determined...
April 2018: Anesthesia and Analgesia
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