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Anesthetic toxicity

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https://www.readbyqxmd.com/read/29145932/lipid-emulsion-more-than-reversing-bupivacaine-cardiotoxicity-potential-organ-protection
#1
Negar Motayagheni, Sheshanna Phan, Ala Nozari, Anthony Atala
Efforts to develop a treatment for bupivacaine cardiotoxicity led to the discovery that Intralipid, a popular brand of intravenous lipid emulsion, could be used not only as an effective treatment for anesthetic-induced cardiac arrest, but also as a means of reversing many other toxicities. Contradictory data exist regarding the mechanism of action of lipid emulsion, a combination of fatty acids traditionally used in parenteral nutrition. Some researchers attribute the effects to lipophilicity and the individual characteristics of the lipids, while other data demonstrate a direct empowering mechanism through cellular upstream and downstream pathways...
2017: Journal of Pharmacy & Pharmaceutical Sciences: a Publication of the Canadian Society for Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29125113/ultrasound-guided-selective-cervical-nerve-root-block-plus-superficial-cervical-plexus-block-for-minimally-invasive-parathyroidectomy
#2
Xu Li, Min-Na Li, Xu-Lei Cui, Shu-Ai Tang, Ya Hu, Quan Liao, Yu-Guang Huang
Objective To explore the efficacy and safety of ultrasound-guided cervical root block (CRB) in patients undergoing minimally invasive parathyroidectomy (MIP).Methods We enrolled 35 patients with hyperparathyroidism undergoing MIP in Peking Union Medical College Hospital.C4-7 nerve roots were identified in ultrasound imaging by the shape of the transverse process.A 50 mm insulated needle was gently introduced by an in-plane approach toward the posterior edge of the nerve root located at the inside of the posterior tubercle...
October 30, 2017: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/29123854/local-anesthetic-toxicity-acute-and-chronic-management
#3
REVIEW
Kenichi Sekimoto, Masaru Tobe, Shigeru Saito
Local anesthetics are commonly used medicines in clinical settings. They are used for pain management during minor interventional treatments, and for postoperative care after major surgeries. Cocaine is the well-known origin of local anesthetics, and the drug and related derivatives have long history of clinical usage for more than several centuries. Although illegal use of cocaine and its abuse are social problem in some countries, other local anesthetics are safely and effectively used in clinics and hospitals all over the world...
April 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29115169/protective-effect-of-captopril-against-diazinon-induced-nephrotoxicity-and-neurotoxicity-via-inhibition-of-ros-no-pathway
#4
Milad Vahidirad, Milad Arab-Nozari, Hamidreza Mohammadi, Ehsan Zamani, Fatemeh Shaki
Diazinon (Dz) is a widely used insecticide. It can induce nephrotoxicity and neurotoxicity via oxidative stress. Captopril, an angiotensin-converting enzyme inhibitor, is known for its antioxidant properties. In this study, we used captopril for ameliorating of Dz-induced kidney and brain toxicity in rats. Animals were divided into five groups as follows: negative control (olive oil), Dz (150 mg kg(-1)), captopril (60 and 100 mg kg(-1)) and positive control (N-acetylcysteine 200 mg kg(-1)) were injected intraperitoneally 30 min before Dz...
November 8, 2017: Drug and Chemical Toxicology
https://www.readbyqxmd.com/read/29111148/effects-of-opioid-and-nonopioid-analgesics-on-canine-wheal-formation-and-cultured-human-mast-cell-degranulation
#5
Eric Schmidt-Rondon, Zhenping Wang, Shelle A Malkmus, Anna Di Nardo, Keith Hildebrand, Linda Page, Tony L Yaksh
Mast cell (MC) degranulation has been implicated in the side effect profile of a variety of clinically useful agents. Thus, after intrathecal delivery, formation of space-occupying, meningeally-derived masses may be related to local MC degranulation. We systematically characterized degranulating effects of opioid and nonopioid analgesics on cutaneous flares in the dog and in primary human MC (hMC) cultures. METHODS: Dogs were anesthetized with IV propofol and received intradermal (ID) injections (50μL)...
October 27, 2017: Toxicology and Applied Pharmacology
https://www.readbyqxmd.com/read/29107256/local-anesthetic-systemic-toxicity
#6
Diana L Wadlund
Local anesthetics are commonly used in the perioperative environment to facilitate surgical procedures or to provide postoperative pain management for patients. The use of local anesthetics, however, introduces the risk of complications resulting from local anesthetic systemic toxicity and the risks of increased morbidity and mortality for the surgical patient. Systemic toxicity from the injection or overdose of local anesthetics is a rare but potentially fatal complication that occurs in less than 1 in 1,000 patients...
November 2017: AORN Journal
https://www.readbyqxmd.com/read/29098494/toxicity-of-inhaled-agents-after-prolonged-administration
#7
Panumart Manatpon, W Andrew Kofke
Inhaled anesthetics have been utilized mostly for general anesthesia in the operating room and oftentimes for sedation and for treatment of refractory status epilepticus and status asthmaticus in the intensive care unit. These contexts in the ICU setting are related to potential for prolonged administration wherein potential organ toxicity is a concern. Over the last decade, several clinical and animal studies of neurotoxicity attributable to inhaled anesthetics have been emerging, particularly in extremes of age...
November 2, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29084192/transient-left-ventricular-dysfunction-due-to-coronary-spasm-after-spinal-anesthesia-with-bupivacaine-a-case-report
#8
Waldemar Elikowski, Małgorzata Małek-Elikowska, Marek Słomczyński, Karolina Horbacka, Jarosław Bartkowski, Bartosz Kalawski
Bupivacaine is a long-acting local anesthetic (LA) used for cutaneous infiltration, peripheral nerve blocks, epidural and spinal anesthesia. However, its application may result in cardiovascular complications such as: hypotension, bradycardia, cardiac arrest and toxic myocardial injury. The authors describe a 53-year-old male with a history of cigarette smoking, admitted for an elective inguinal hernia surgery. Before surgery, the patient received subarachnoid injection of bupivacaine (20 mg). After the operation, he developed transient hypotension...
October 23, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29081796/hepatocyte-cyp2b6-can-be-expressed-in-cell-culture-systems-by-exerting-physiological-levels-of-shear-implications-for-adme-testing
#9
REVIEW
Timothy G Hammond, Holly H Birdsall
Cytochrome 2B6 (CYP2B6) has substantial clinical effects on morbidity and mortality and its effects on drug metabolism should be part of hepatotoxicity screening. Examples of CYP2B6's impacts include its linkage to mortality during cyclophosphamide therapy and its role in determining hepatotoxicity and CNS toxicity during efavirenz therapy for HIV infection. CYP2B6 is key to metabolism of many common drugs from opioids to antidepressants, anesthetics, and anticonvulsants. But CYP2B6 has been extremely difficult to express in cell culture, and as a result, it has been largely deemphasized in preclinical toxicity studies...
2017: Journal of Toxicology
https://www.readbyqxmd.com/read/29055733/qx-oh-levobupivacaine-fixed-dose-combination-to-provide-a-long-acting-postoperative-pain-of-knee-surgery-in-rodents
#10
WenLing Zhao, Jun Yang, YuJun Zhang, Jin Liu, WenSheng Zhang
Although total knee arthroplasty (TKA) is a commonly performed procedure, anesthetic efficacy in post-surgical pain remains an issue. Exparel (45mM liposome bupivacaine), a relatively long-acting local anesthetic, has shown efficacy in blocking peripheral nerve or periarticular infiltration to achieve better post-TKA analgesia. In the present work, we tested whether a fixed-dose combination of QX-OH (35mM) and levobupivacaine (10mM) (QX-OH/LB) could confer longer-lasting pain relief and reduce periarticular tissue toxicity compared to liposome bupivacaine (45mM) after TKA operation...
October 18, 2017: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29042063/-pharmacokinetic-and-clinical-effects-of-two-bupivacaine-concentrations-on-axillary-brachial-plexus-block
#11
Leonardo H C Ferraro, Alexandre Takeda, Cleber N Barreto, Bernadete Faria, Nilson A Assunção
INTRODUCTION: The risk of systemic bupivacaine toxicity is a persistent problem, which makes its pharmacokinetic study fundamental for regional anesthesia safety. There is little evidence of its influence on plasma peak at different concentrations. The present study compares two bupivacaine concentrations to establish how the concentration affects this drug plasma peak in axillary brachial plexus block. Postoperative latency and analgesia were also compared. METHODS: 30 patients were randomized...
October 14, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29041921/perioperative-management-of-paraganglioma-and-catecholamine-induced-cardiomyopathy-in-child-a-case-report-and-review-of-the-literature
#12
Xixi Jia, Xiangyang Guo, Qing Zheng
BACKGROUND: Paragangliomas are catecholamine-secreting tumors of the paraganglia. Perioperative mortality of children with paraganglioma is high, but preoperative therapy and anesthetic management of paraganglioma resection are controversial in children. The literatures on catecholamine-induced cardiomyopathy are limited to several case reports,with few reports of studies on children. CASE PRESENTATION: Here we report the anesthetic management of a child with paraganglioma and catecholamine-induced cardiomyopathy, and the possible perioperative anesthesia problems of the paraganglioma resection are discussed...
October 17, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29033727/ultrasound-assessment-of-cranial-spread-during-caudal-blockade-in-children-effect-of-different-volumes-of-local-anesthetic
#13
Chandni Sinha, Amarjeet Kumar, Shalini Sharma, Akhilesh Kumar Singh, Somak Majumdar, Ajeet Kumar, Nishant Sahay, Bindey Kumar, U K Bhadani
BACKGROUND: Ultrasound-guided caudal block injection is a simple, safe, and effective method of anesthesia/analgesia in pediatric patients. The volume of caudal drug required has always been a matter of debate. MATERIALS AND METHODS: This present prospective, randomized, double-blinded study aimed to measure extent of the cranial spread of caudally administered levobupivacaine in Indian children by means of real-time ultrasonography. Ninety American Society of Anesthesiologists I/II children scheduled for urogenital surgeries were enrolled in this trial...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28982737/evaluation-of-a-splunc1-derived-peptide-for-the-treatment-of-cystic-fibrosis-lung-disease
#14
Shawn T Terryah, Robert C Fellner, Saira Ahmad, Patrick John Moore, Boris Reidel, Juliana I Sesma, Christine S Kim, Alaina L Garland, David W Scott, Juan R Sabater, Jerome Carpenter, Scott H Randell, Mehmet Kesimer, William M Abraham, William J Arendshorst, Robert Tarran
In cystic fibrosis (CF) lungs, epithelial Na+ channel (ENaC) hyperactivity causes a reduction in airway surface liquid (ASL) volume, leading to decreased mucocilliary clearance and lung damage. Inhibition of ENaC is an attractive therapeutic option. However, ENaC antagonists have failed clinically due to off-target renal effects. The S18 peptide is a naturally occurring short palate lung and nasal epithelial clone 1 (SPLUNC1)-derived ENaC antagonist that restores ASL height for up to 24 h in CF human bronchial epithelial cultures...
October 5, 2017: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/28982145/encapsulation-of-ropivacaine-in-a-combined-donor-acceptor-ionic-gradient-liposomal-system-promotes-extended-anesthesia-time
#15
Camila Morais Gonçalves da Silva, Michelle Franz-Montan, Cíntia Elisabeth Gomez Limia, Lígia Nunes de Morais Ribeiro, Mário Antônio Braga, Viviane Aparecida Guilherme, Camila Batista da Silva, Bruna Renata Casadei, Cíntia Maria Saia Cereda, Eneida de Paula
Ropivacaine is a local anesthetic with similar potency but lower systemic toxicity than bupivacaine, the most commonly used spinal anesthetic. The present study concerns the development of a combined drug delivery system for ropivacaine, comprised of two types of liposomes: donor multivesicular vesicles containing 250 mM (NH4)2SO4 plus the anesthetic, and acceptor large unilamellar vesicles with internal pH of 5.5. Both kinds of liposomes were composed of hydrogenated soy-phosphatidylcholine:cholesterol (2:1 mol%) and were prepared at pH 7...
2017: PloS One
https://www.readbyqxmd.com/read/28958878/a-new-class-of-cubic-spions-as-a-dual-mode-t1-and-t2-contrast-agent-for-mri
#16
Akbar Alipour, Zeliha Soran-Erdem, Mustafa Utkur, Vijay Kumar Shamra, Oktay Algin, Emine Ulku Saritas, Hilmi Volkan Demir
Superparamagnetic iron oxide nanoparticles (SPIONs) are widely used as a robust negative contrast agent on conventional MRI. In this study, we (a) synthesized a new class of cubic SPIONs as a dual-mode contrast agent in MRI and (b) showed the in-vivo feasibility of these nanaoparticles as a simultaneous positive and negative contrast agent. Relaxation properties and contrast enhancement analysis of the synthesized SPIONs with two different shapes (cubic vs. spherical) and three different sizes 7nm, 11nm, and 14nm were investigated to evaluate contrast enhancement in-vitro...
September 25, 2017: Magnetic Resonance Imaging
https://www.readbyqxmd.com/read/28953509/procaine-and-local-anesthetic-toxicity-a-collaboration-between-the-clinical-and-basic-sciences
#17
James Seth Jacob, Anthony L Kovac
In 1924, the Therapeutic Research Committee of the American Medical Association appointed a special committee to investigate deaths following the administration of local anesthetics. The Committee for the Study of Toxic Effects of Local Anesthetics found procaine, although a safer clinical alternative to cocaine, was capable of causing death when large doses were injected into tissues and advised that it should be used with caution. This article describes a collaboration beginning in 1928 between Dr John Lundy of the Mayo Clinic and Dr Robert Isenberger of the University of Kansas, which arose from a controversy surrounding systemic adverse reactions to procaine...
November 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28939237/brief-isoflurane-administration-as-a-post-exposure-treatment-for-organophosphate-poisoning
#18
Jishnu K S Krishnan, Taíza H Figueiredo, John R Moffett, Peethambaran Arun, Abhilash P Appu, Narayanan Puthillathu, Maria F Braga, Thomas Flagg, Aryan M Namboodiri
Organophosphate chemical threat agents (OP-CTA) exert toxic effects through cholinergic over-activation. However, after the initial cholinergic phase, the pathophysiology shifts to a non-cholinergic phase which leads to prolonged status epilepticus (SE), irreversible neuronal degeneration and long-term damage to the central nervous system. The efficacy of delayed treatments against OP-CTA is generally low due to the fact that most drugs fail to inhibit the later phase of non-cholinergic activation. Recently, we reported that intranasal brain delivery of obidoxime (OBD) provides complete neuroprotection against a lethal dose of paraoxon when administered 5min after intoxication...
September 20, 2017: Neurotoxicology
https://www.readbyqxmd.com/read/28919152/erector-spinae-plane-esp-block-in-the-management-of-post-thoracotomy-pain-syndrome-a-case-series
#19
Mauricio Forero, Manikandan Rajarathinam, Sanjib Adhikary, Ki Jinn Chin
BACKGROUND AND AIMS: Post thoracotomy pain syndrome (PTPS) remains a common complication of thoracic surgery with significant impact on patients' quality of life. Management usually involves a multidisciplinary approach that includes oral and topical analgesics, performing appropriate interventional techniques, and coordinating additional care such as physiotherapy, psychotherapy and rehabilitation. A variety of interventional procedures have been described to treat PTPS that is inadequately managed with systemic or topical analgesics...
September 11, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/28917718/olfactory-toxicity-in-rats-following-manganese-chloride-nasal-instillation-a-pilot-study
#20
Melanie L Foster, Deepa B Rao, Taylor Francher, Samantha Traver, David C Dorman
Following inhalation, manganese travels along the olfactory nerve from the olfactory epithelium (OE) to the olfactory bulb (OB). Occupational exposure to inhaled manganese is associated with changes in olfactory function. This pilot study evaluated two related hypotheses: (a) intranasal manganese administration increases OE and OB manganese concentrations; and (b) intranasal manganese exposure impairs performance of previously trained rats on a go-no-go olfactory discrimination (OD) task. Male Fischer 344 rats were trained to either lever press ("go") in response to a positive conditioned stimulus (CS+: vanillin) or to do nothing ("no go") when a negative conditioned stimulus (CS-: amyl acetate) was present...
September 13, 2017: Neurotoxicology
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