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Anesthetic 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/29755192/efficacy-and-pharmacokinetics-of-bupivacaine-with-epinephrine-or-dexmedetomidine-after-intraperitoneal-administration-in-cats-undergoing-ovariohysterectomy
#3
Javier Benito, Beatriz Monteiro, Francis Beaudry, Paulo Steagall
The aim of this study was to determine the efficacy and pharmacokinetics of bupivacaine in combination with epinephrine or dexmedetomidine after intraperitoneal administration in cats undergoing ovariohysterectomy. Sixteen healthy adult cats (3.3 ± 0.6 kg) were included in a prospective, randomized, masked clinical trial after obtaining owners' consent. Anesthetic protocol included buprenorphine-propofol-isoflurane. Meloxicam [0.2 mg/kg body weight (BW)] was administered subcutaneously before surgery. Cats were randomly divided into 2 groups to receive 1 of 2 treatments...
April 2018: Canadian Journal of Veterinary Research, Revue Canadienne de Recherche Vétérinaire
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/29734272/general-anesthetic-use-in-fragile-x-spectrum-disorders
#6
Andrew Ligsay, Marwa El-Deeb, Maria J Salcedo-Arellano, Nina Schloemerkemper, Jeremy S Grayson, Randi Hagerman
The fragile X premutation is characterized by a repeat expansion mutation (between 55 to 200 CGG repeats) in the fragile X mental retardation 1 (FMR1) gene, which leads to RNA toxicity at the cellular level. This may cause patients with the premutation to be particularly susceptible to environmental toxins, which could manifest clinically as new or worsening ataxia and memory loss. Multiple published case reports have also suggested general anesthetics as a potential toxin leading to negative side effects when used in patients with fragile X- associated disorders...
May 4, 2018: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29719742/toxic-myelitis-and-arachnoiditis-after-intrathecal-delivery-of-bupivacaine-via-an-implanted-drug-delivery-system-case-report-and-review-of-the-literature
#7
Meng Huang, Brian Dalm, Richard K Simpson
The off-label usage of amino-amide anesthetics in intrathecal drug delivery systems (IDDS) for the treatment of chronic non-malignant and malignant pain is supported in the polyanalgesic consensus guidelines as a second-line adjunctive therapy. Although strong evidence for its clinical efficacy is lacking, its clinical safety profile has been well established within established dosing parameters. Despite the rarity of neurological adverse reactions to intrathecal bupivacaine, whether given as regional anesthesia or intrathecal therapy, neurologic morbidity associated with its administration is well documented...
February 27, 2018: Curēus
https://www.readbyqxmd.com/read/29703617/hazards-of-improper-dispensary-literature-review-and-report-of-an-accidental-chloroform-injection
#8
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
#9
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
#10
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
#11
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/29648463/protective-effect-of-thymoquinone-the-main-component-of-nigella-sativa-against-diazinon-cardio-toxicity-in-rats
#12
Gholam Hassan Danaei, Bahram Memar, Ramin Ataee, Mohammad Karami
Several studies have shown that oxidative stress and cell damage can occur at very early stages of diazinon (DZN) exposure. The present study was designed to determine the beneficial effect of thymoquinone (Thy), the main component of Nigella sativa (black seed or black cumin), against DZN cardio-toxicity in rats. In the present experimental study, 48 male Wistar rats were randomly divided into six groups: control (corn oil gavages), DZN gavages (20 mg/kg/day), Thy gavages (10 mg/kg/day) and Thy + DVN gavages (2...
April 12, 2018: Drug and Chemical Toxicology
https://www.readbyqxmd.com/read/29644580/on-the-efficacy-of-cardio-pulmonary-resuscitation-and-epinephrine-following-cyanide-and-h-2-s-intoxication-induced-cardiac-asystole
#13
Annick Judenherc-HaouzI, Takashi Sonobe, Vikhyat S Bebarta, Philippe Haouzi
This study was aimed at determining the efficacy of epinephrine, followed by chest compressions, in producing a return of spontaneous circulation (ROSC) during cyanide (CN)- or hydrogen sulfide (H2 S)-induced toxic cardiac pulseless electrical activity (PEA) in the rat. Thirty-nine anesthetized rats were exposed to either intravenous KCN (n = 27) or H2 S solutions (n = 12), at a rate that led to a PEA within less than 10 min. In the group intoxicated by CN, 20 rats were mechanically ventilated and received either epinephrine (0...
April 11, 2018: Cardiovascular Toxicology
https://www.readbyqxmd.com/read/29605588/genotoxic-effect-of-lippia-alba-mill-n-e-brown-essential-oil-on-fish-oreochromis-niloticus-and-mammal-mus-musculus
#14
Edgar Hell Kampke, Maria Eduarda de Souza Barroso, Franciane Martins Marques, Marcio Fronza, Rodrigo Scherer, Mayara Fumiere Lemos, Bianca Prandi Campagnaro, Levy Carvalho Gomes
"Erva cidreira" (Lippia alba (Mill.) N. E. Brown) is popular for its therapeutic properties, especially its sedative properties. Such properties led to the discovery of the anesthetic action of Lippia alba essential oil in fish culture. The objective of this study was to evaluate the genotoxic effect of Lippia alba essential oil in fish and mammals. The oil was extracted by hydrodistillation with a Clevenger apparatus and analyzed by gas chromatography coupled to mass spectrometry (GC-MS), where the compounds linalool, eucalyptol, γ-muurolene, and caryophyllene were identified as the most abundant compounds...
March 26, 2018: Environmental Toxicology and Pharmacology
https://www.readbyqxmd.com/read/29588038/electrophysiological-analysis-of-voltage-gated-ion-channel-modulation-by-general-anesthetics
#15
Elaine Yang, Lianteng Zhi, Qiansheng Liang, Manuel Covarrubias
Voltage-gated ion channels (VGICs) of excitable tissues are emerging as targets likely involved in both the therapeutic and toxic effects of inhaled and intravenous general anesthetics. Whereas sevoflurane and propofol inhibit voltage-gated Na+ channels (Navs), sevoflurane potentiates certain voltage-gated K+ channels (Kvs). The combination of these effects would dampen neural excitability and, therefore, might contribute to the clinical endpoints of general anesthesia. As the body of work regarding the interaction of general anesthetics with VGICs continues to grow, a multidisciplinary approach involving functional, biochemical, structural, and computational techniques, many of which are detailed in other chapters, has increasingly become necessary to solve the molecular mechanism of general anesthetic action on VGICs...
2018: Methods in Enzymology
https://www.readbyqxmd.com/read/29579407/modulatory-effect-of-curcumin-on-ketamine-induced-toxicity-in-rat-thymocytes-involvement-of-reactive-oxygen-species-ros-and-the-phosphoinositide-3-kinase-pi3k-protein-kinase-b-akt-pathway
#16
Svetlana Pavlovic, Zorica Jovic, Radmila Karan, Dane Krtinic, Gorana Rankovic, Mladjan Golubovic, Jelena Lilic, Voja Pavlovic
Ketamine is a widely used anesthetic in pediatric clinical practice. Previous studies have demonstrated that ketamine induces neurotoxicity and has a modulatory effect on the cells of the immune system. Here, we evaluated the potential protective effect and underlying mechanisms of natural phenolic compound curcumin against ketamine-induced toxicity in rat thymocytes. Rat thymocytes were exposed to 100 µM ketamine alone or combined with increasing concentrations of curcumin (0.3, 1, and 3 μM) for 24 hours...
March 21, 2018: Bosnian Journal of Basic Medical Sciences
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
#17
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/29565700/90-day-oral-toxicity-assessment-of-tropaeolum-majus-l-in-rodents-and-lagomorphs
#18
Valdinei de Oliveira Araújo, Carlos Eduardo Linhares Andreotti, Michelle de Paula Reis, Daniely Alves de Lima, Karoline Bach Pauli, Bruna Caroline Nunes, Caroline Gomes, Ricardo de Melo Germano, Euclides Lara Cardozo Junior, Arquimedes Gasparotto Junior, Emerson Luiz Botelho Lourenço
Tropaeolum majus L., popularly known as nasturtium, is a species widely used in the form of infusions and salads. In the last years, the antihypertensive, diuretic, and calcium and potassium sparing activities of T. majus preparations were shown. Moreover, no preclinical 90-day oral toxicity studies were conducted. Thus, this study evaluated the toxicity of the hydroethanolic extract obtained from T. majus (HETM) leaves in female and male mice, rats, and rabbits. Swiss mice and Wistar rats were treated with HETM (75, 375, and 750 mg/kg)...
March 22, 2018: Journal of Medicinal Food
https://www.readbyqxmd.com/read/29550808/phosphodiesterase-4-inhibitor-roflumilast-protects-rat-hippocampal-neurons-from-sevoflurane-induced-injury-via-modulation-of-mek-erk-signaling-pathway
#19
Sheng Peng, Hong-Zhu Yan, Pei-Rong Liu, Xiao-Wei Shi, Chun-Liang Liu, Qi Liu, Yu Zhang
BACKGROUND/AIMS: Sevoflurane, a commonly used volatile anesthetic, recently has been found has neurotoxicity in the central nervous system of neonatal rodents. This study aimed to reveal whether phosphodiesterase 4 (PDE-4) inhibitor roflumilast has protective functions in sevoflurane-induced nerve damage. METHODS: Hippocampal neurons were isolated from juvenile rats, and were exposed to sevoflurane with or without roflumilast treatment. Cell viability and apoptosis were respectively assessed by CCK-8 and flow cytometry...
March 13, 2018: Cellular Physiology and Biochemistry
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
#20
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
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