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Anesthetic toxicity

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https://www.readbyqxmd.com/read/28445208/toxic-keratoconjunctivitis
#1
Grace L Paley, Anthony J Lubniewski, James J Reidy, Asim V Farooq
Toxic keratoconjunctivitis (TK) is an underrecognized complication of ophthalmic drug use and various environmental or occupational exposures. A detailed history and clinical examination are important to identify the offending agent(s). Common drug-related causes of TK include preservatives in ophthalmic medications, topical antimicrobials, and topical anesthetics. Alternatives to benzalkonium chloride as well as preservative-free formulations should be considered in patients requiring long-term topical medication...
April 25, 2017: Eye & Contact Lens
https://www.readbyqxmd.com/read/28431423/blood-bupivacaine-concentrations-after-a-combined-single-shot-sciatic-block-and-a-continuous-femoral-nerve-block-in-pediatric-patients-a-prospective-observational-study
#2
Santhanam Suresh, Gildasio S De Oliveira
We evaluated blood bupivacaine concentrations in children having a single-shot sciatic and continuous femoral blocks after anterior cruciate ligament repair. Dried blood spot samples were analyzed for bupivacaine levels at 0, 5, 15, 30, 60, and 120 minutes and 4, 24, and 48 hours. The highest 99% upper confidence interval limit was 135 ng/mL at the 4-hour evaluation point. The 99% upper confidence interval was below potentially toxic levels (1500 ng/mL) across all sampling times. The risk of local anesthetic toxicity in pediatric patients receiving single-shot sciatic and continuous femoral nerve blocks is very low...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28390026/fabrication-of-highly-effective-mosquito-nanolarvicides-using-an-asian-plant-of-ethno-pharmacological-interest-priyangu-aglaia-elaeagnoidea-toxicity-on-non-target-mosquito-natural-enemies
#3
Giovanni Benelli, Marimuthu Govindarajan, Sengamalai Senthilmurugan, Periasamy Vijayan, Shine Kadaikunnan, Naiyf S Alharbi, Jamal M Khaled
Mosquitoes threaten the lives of humans, livestock, pets and wildlife around the globe, due to their ability to vector devastating diseases. Aglaia elaeagnoidea, commonly known as Priyangu, is widely employed in Asian traditional medicine and pest control. Medicinal activities include anti-inflammatory, analgesic, anticancer, and anesthetic actions. Flavaglines, six cyclopenta[b]benzofurans, a cyclopenta[bc]benzopyran, a benzo[b]oxepine, and an aromatic butyrolactone showed antifungal properties, and aglaroxin A and rocaglamide were effective to control moth pests...
April 8, 2017: Environmental Science and Pollution Research International
https://www.readbyqxmd.com/read/28374060/possible-utility-of-contrast-enhanced-ultrasonography-for-detecting-spread-of-local-anesthetic-in-nerve-block
#4
Hideaki Sasaki, Masanori Yamauchi, Takafumi Ninomiya, Haruyuki Tatsumi, Michiaki Yamakage
PURPOSE: This study demonstrated the effects of perfluorobutane (Sonazoid(®)) with contrast-enhanced ultrasonography (CEUS) to identify the spread of local anesthetics in ultrasound-guided nerve block. METHODS: This study consists of simulation, cadaveric, and animal studies. In a simulation study, 1% lidocaine with 10- to 1000-fold diluted Sonazoid(®), a US-specific contrast agent to diagnose hepatic and breast cancers (0.5 mL), was injected into a resin-based phantom to determine the optimal concentration for ultrasound-guided peripheral nerve block...
April 3, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28358639/review-of-hazards-to-female-reproductive-health-in-veterinary-practice
#5
Joni M Scheftel, Brigid L Elchos, Carol S Rubin, John A Decker
OBJECTIVE To review publications that address female reproductive health hazards in veterinary practice, summarize best practices to mitigate reproductive risks, and identify current knowledge gaps. DESIGN Systematized review. SAMPLE English-language articles describing chemical, biological, and physical hazards present in the veterinary workplace and associations with adverse reproductive outcomes or recommendations for minimizing risks to female reproductive health. PROCEDURES Searches of the CAB abstracts database were performed in July 2012 and in May 2015 with the following search terms: veterinarians AND occupational hazards and vets...
April 15, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/28356688/comparing-hemodynamic-and-glycemic-response-to-local-anesthesia-with-epinephrine-and-without-epinephrine-in-patients-undergoing-tooth-extractions
#6
Paramjot Kaur, Rashi Bahl, Sameer Kaura, Sumit Bansal
INTRODUCTION: Lignocaine with epinephrine as local anesthetic (LA) provides hemostasis and decreases the risk of systemic toxicity. The purpose of the present study was to investigate and compare the response of lignocaine with and without epinephrine to evaluate hemodynamic and metabolic response in normotensive and type II controlled diabetic patients. MATERIAL AND METHODS: A total of 50 patients (25 healthy and 25 controlled type II diabetics) undergoing multiple tooth extractions (age group of 20-80 years) were included in this prospective, randomised, clinical study...
July 2016: National Journal of Maxillofacial Surgery
https://www.readbyqxmd.com/read/28346007/lipid-emulsion-improves-survival-in-animal-models-of-local-anesthetic-toxicity-a-meta-analysis
#7
Michael R Fettiplace, Daniel J McCabe
INTRODUCTION: The Lipid Emulsion Therapy workgroup, organized by the American Academy of Clinical Toxicology, recently conducted a systematic review, which subjectively evaluated lipid emulsion as a treatment for local anesthetic toxicity. We re-extracted data and conducted a meta-analysis of survival in animal models. METHODS: We extracted survival data from 26 publications and conducted a random-effect meta-analysis based on odds ratio weighted by inverse variance...
February 17, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28345549/sub-anesthesia-dose-of-isoflurane-in-60-oxygen-reduces-inflammatory-responses-in-experimental-sepsis-models
#8
Yi Huang, Xiao-Xia Wang, Dong-Dong Sun, Ze-Xin Zhang, Wan-Wan Yang, Tian Shao, Han Han, Er-Fei Zhang, Zhong-Shu Pu, Zuo-Xu Hou, Hai-Long Dong, Li-Ze Xiong, Li-Chao Hou
BACKGROUND: Sepsis is a major cause of mortality in Intensive Care Units. Anesthetic dose isoflurane and 100% oxygen were proved to be beneficial in sepsis; however, their application in septic patients is limited because long-term hyperoxia may induce oxygen toxicity and anesthetic dose isoflurane has potential adverse consequences. This study was scheduled to find the optimal combination of isoflurane and oxygen in protecting experimental sepsis and its mechanisms. METHODS: The effects of combined therapy with isoflurane and oxygen on lung injury and sepsis were determined in animal models of sepsis induced by cecal ligation and puncture (CLP) or intraperitoneal injection of lipopolysaccharide (LPS) or zymosan...
April 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28337880/effects-of-anesthesia-using-propofol-and-etomidate-on-t-lymphocyte-subpopulation-of-infectious-shock-patients-in-perioperative-period
#9
Y Wang, J Zhang, S J Zhang
Infectious or septic shock is induced when a toxic microorganism invades blood circulation in the human body. Emergency operation is an effective method for treating infectious shock in the early stages although the use of anesthesia is more complex due to the internal disorders caused by the disease. This study explored the effects of propofol and etomidate anesthesia on the cellular immune function (T lymphocyte subpopulation) of infectious shock patients, aiming to provide a basis for the selection of the proper anesthetic method...
January 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28321983/chloroprocaine-for-epidural-anesthesia-in-infants-and-children
#10
REVIEW
Giorgio Veneziano, Joseph D Tobias
Continuous epidural infusions are an effective and safe method of providing anesthesia and postoperative analgesia in infants and children with multiple advantages over systemic medications, including earlier tracheal extubation, decreased perioperative stress response, earlier return of bowel function, and decreased exposure to volatile anesthetic agents with uncertain long-term neurocognitive effects. Despite these benefits, local anesthetic toxicity remains a concern in neonates and infants because of their decreased metabolic capacity for amide local anesthetics...
March 21, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28298772/effect-of-dexmedetomidine-as-an-adjuvant-to-0-75-ropivacaine-in-interscalene-brachial-plexus-block-using-nerve-stimulator-a-prospective-randomized-double-blind-study
#11
H D Rashmi, H K Komala
BACKGROUND: Ropivacaine, a newer local anesthetic (LA), has been increasingly used nowadays in different concentrations for peripheral nerve blocks. It has lesser cardiac toxicity and higher safety margin when compared to bupivacaine. Dexmedetomidine, a novel α2 agonist, is widely used as adjuvant to LA in peripheral nerve blocks to decrease the time of onset and increase the duration of the block. In this study, we evaluated the effect of dexmedetomidine as an adjuvant with 0.75% ropivacaine for interscalene brachial plexus block using nerve stimulator...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298749/perioperative-considerations-and-management-of-patients-receiving-anticoagulants
#12
REVIEW
Safiya Imtiaz Shaikh, R Vasantha Kumari, Ganapati Hegade, M Marutheesh
Anticoagulants remain the primary strategy for the prevention and treatment of thrombosis. Unfractionated heparin, low molecular weight heparin (LMWH), fondaparinux, and warfarin have been studied and employed extensively with direct thrombin inhibitors typically reserved for patients with complications or those requiring interventions. Novel oral anticoagulants have emerged from clinical development and are expected to replace older agents with their ease to use and more favorable pharmacodynamic profiles...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28291734/safety-assessment-of-the-aqueous-extract-of-the-flowers-of-nymphaea-lotus-linn-nymphaeaceae-acute-neuro-and-subchronic-oral-toxicity-studies-in-albinos-wistar-rats
#13
Mireille Kameni Poumeni, Danielle Claude Bilanda, Paul Désiré Dzeufiet Djomeni, Yolande Sandrine Mengue Ngadena, Marguerite Francine Mballa, Madeleine Chantal Ngoungoure, Agnès Carolle Ouafo, Théophile Dimo, Pierre Kamtchouing
BACKGROUND: Nymphaea lotus Linn (N. lotus) is a medicinal plant widely used in Cameroon popular medicine, to treat neuropsychiatric conditions, male sexual disorders or as food supplement. However, scientific data on the pharmacotoxic profile of this plant are not available. The safety of N. lotus was assessed in acute, neuro- and subchronic toxicity studies by following the OECD guidelines. Effectively, no data have been published until now in regard to its safety on the nervous system...
March 14, 2017: Journal of Complementary & Integrative Medicine
https://www.readbyqxmd.com/read/28291185/efficacy-of-surgical-site-multimodal-drug-injection-following-operative-management-of-femoral-fractures-a-randomized-controlled-trial
#14
RANDOMIZED CONTROLLED TRIAL
Daniel Koehler, J Lawrence Marsh, Matthew Karam, Catherine Fruehling, Michael Willey
BACKGROUND: Multimodal analgesia inclusive of periarticular injection with a local anesthetic agent has been rapidly assimilated, with demonstrated safety and efficacy, into the care of patients undergoing elective lower-extremity arthroplasty. The present study was performed to evaluate the efficacy and safety of a surgical-site, multimodal drug injection for postoperative pain control following operative management of femoral fractures. METHODS: There were 102 patients undergoing operative intervention (plate fixation, intramedullary device, or arthroplasty) for a broad range of femoral fracture patterns who were prospectively randomized either to receive an intraoperative, surgical-site injection into the superficial and deep tissues containing ropivacaine, epinephrine, and morphine or to receive no injection...
March 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28289821/single-dose-local-anesthetics-exhibit-a-type-dose-and-time-dependent-chondrotoxic-effect-on-chondrocytes-and-cartilage-a-systematic-review-of-the-current-literature
#15
REVIEW
Peter Cornelius Kreuz, Matthias Steinwachs, Peter Angele
PURPOSE: Many studies have shown that local anesthetics may impede chondrocyte metabolism. However, the influence of a single-dose local anesthetics is controversial. The aim of this metaanalysis was to review the literature for studies investigating the cytotoxic effects of single-dose local anesthetics on chondrocytes and cartilage. METHODS: A comprehensive literature search was performed using established search engines (Medline, Embase) to identify studies, investigating the influence of single-dose local anesthetics on cartilage...
March 13, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28276857/safety-considerations-of-anesthetic-drugs-in-children
#16
REVIEW
Raeford E Brown
Great strides have been made in the last twenty years in providing safe anesthesia care for infants and children. Despite a historical record of safety, recent findings have called to question the toxicities of many anesthetic agents. Observations concerning the inherent safety of these agents, their appropriate management in infants, and new findings which suggest overlooked toxicities will be discussed. Areas covered: A literature search using Pub Med identified journal articles relating to the safety of anesthetic agents in infants and children...
April 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28267672/local-anesthetic-effects-of-bupivacaine-loaded-lipid-polymer-hybrid-nanoparticles-in-vitro-and-in-vivo-evaluation
#17
Pengju Ma, Ting Li, Huaixin Xing, Suzhen Wang, Yingui Sun, Xiugui Sheng, Kaiguo Wang
PURPOSE: There is a compelling need for prolonged local anesthetic that would be used for analgesia with a single administration. However, due to the low molecular weight of local anesthetics (LA) (lidocaine, bupivacaine, procaine, dibucaine, etc), they present fast systemic absorption. METHODS: The aim of the present study was to develop and evaluate bupivacaine lipid-polymer hybrid nanoparticles (BVC LPNs), and compared with BVC loaded PLGA nanoparticles (BVC NPs)...
May 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28265069/clinical-concentrations-of-chemically-diverse-general-anesthetics-minimally-affect-lipid-bilayer-properties
#18
Karl F Herold, R Lea Sanford, William Lee, Olaf S Andersen, Hugh C Hemmings
General anesthetics have revolutionized medicine by facilitating invasive procedures, and have thus become essential drugs. However, detailed understanding of their molecular mechanisms remains elusive. A mechanism proposed over a century ago involving unspecified interactions with the lipid bilayer known as the unitary lipid-based hypothesis of anesthetic action, has been challenged by evidence for direct anesthetic interactions with a range of proteins, including transmembrane ion channels. Anesthetic concentrations in the membrane are high (10-100 mM), however, and there is no experimental evidence ruling out a role for the lipid bilayer in their ion channel effects...
March 21, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28259274/use-and-effectiveness-of-ethyl-chloride-for-hand-injections
#19
Orrin I Franko, Peter J Stern
PURPOSE: Limited literature supports using ethyl chloride topical spray as an anesthetic for hand injections whereas documented risks include frostbite, skin irritation, and inhalation toxicity. We hypothesize that ethyl chloride spray imparts no benefit to patients' perception of pain or anxiety for routine hand injections. METHODS: We first surveyed all members of the American Society for Surgery of the Hand to discern the prevalence of ethyl chloride use during routine injections...
March 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28251021/prevention-of-intraabdominal-adhesions-an-experimental-study-using-mitomycin-c-and-4-icodextrin
#20
Murat Urkan, İsmail Hakkı Özerhan, Aytekin Ünlü, Mehmet Fatih Can, Erkan Öztürk, Armağan Günal, Gökhan Yağcı
BACKGROUND: Intraabdominal adhesions remain a significant cause of morbidity and mortality. Moreover, intraabdominal adhesions can develop in more than 50% of abdominal operations. AIMS: We compared the anti-adhesive effects of two different agents on postoperative adhesion formation in a cecal abrasion model. STUDY DESIGN: Experimental animal study. METHODS: Forty Wistar albino type female rats were anesthetized and underwent laparotomy...
January 2017: Balkan Medical Journal
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