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Bupivacaine toxicity

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https://www.readbyqxmd.com/read/28751934/activation-of-p47phox-as-a-mechanism-of-bupivacaine-induced-burst-production-of-reactive-oxygen-species-and-neural-toxicity
#1
Yu-Jie Li, Wei Zhao, Xu-Jiao Yu, Feng-Xian Li, Zi-Ting Liu, Le Li, Shi-Yuan Xu
Bupivacaine has been shown to induce neurotoxicity through inducing excessive reactive oxygen species (ROS), but the underlying mechanism remains unclear. NOX2 is one of the most important sources of ROS in the nervous system, and its activation requires the membrane translocation of subunit p47phox. However, the role of p47phox in bupivacaine-induced neurotoxicity has not been explored. In our in vitro study, cultured human SH-SY5Y neuroblastoma cells were treated with 1.5 mM bupivacaine to induce neurotoxicity...
2017: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/28745230/bupivacaine-s75-r25-loaded-in-nanostructured-lipid-carriers-factorial-design-hplc-quantification-method-and-physicochemical-stability-study
#2
Gustavo Henrique Rodrigues Da Silva, Ligia Nunes de Moraes Ribeiro, Viviane Guilherme, Simone Ramos de Castro, Márcia Cristina Breitkreitz, Eneida de Paula
Bupivacaine is the most used local anesthetic in surgical procedures, producing prolonged anesthesia. The major limiting factor for the clinical use of bupivacaine comes from its systemic toxicity. Nanostructured lipid carriers (NLC) are vehicles for sustained drug delivery that are able to minimize the toxicity and to increase the action time of lipophilic drugs. This work reports a 22 factorial design, which elucidate the role of the lipids mixture in the NLC, towards an optimized formulation. It also provides a new method for Bupivacaine S75:R25 (BVCS75) quantification in NLC...
July 26, 2017: Current Drug Delivery
https://www.readbyqxmd.com/read/28727583/serum-bupivacaine-concentration-after-periarticular-injection-with-a-mixture-of-liposomal-bupivacaine-and-bupivacaine-hcl-during-total-knee-arthroplasty
#3
Michael J Buys, Marian F Murphy, Christine M Warrick, Nathan L Pace, Jeremy M Gililland, Christopher E Pelt, Byron R Bankhead, John L Patzkowsky, Ken B Johnson
BACKGROUND AND OBJECTIVES: A relatively new technique to reduce postoperative pain for total knee arthroplasty is to inject a mixture of 266 mg of liposomal bupivacaine and 125 mg of 0.25% bupivacaine HCl with epinephrine 1:300,000 around the knee joint at the time of surgery. Currently, no publications report serum bupivacaine concentrations over time after periarticular injection of liposomal mixed with free bupivacaine. This information is important to ensure safe serum bupivacaine concentrations are maintained especially when considering supplemental or rescue peripheral nerve blocks...
September 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28692439/lipid-emulsion-in-local-anesthetic-toxicity
#4
Martyn Harvey, Grant Cave
PURPOSE OF REVIEW: Enthusiasm for regional anesthesia has been driven by multimodal benefits to patient outcomes. Despite widespread awareness and improved techniques (including the increasing use of ultrasound guidance for block placement), intravascular sequestration and the attendant risk of local anesthetic systemic toxicity (LAST) remains. Intravenous lipid emulsion (ILE) for the treatment of LAST has been endorsed by anesthetic regulatory societies on the basis of animal study and human case report data...
July 7, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28663643/comparison-between-conventional-and-ultrasound-guided-supraclavicular-brachial-plexus-block-in-upper-limb-surgeries
#5
Kiran Abhayakumar Honnannavar, Mahantesh Shivangouda Mudakanagoudar
INTRODUCTION: Brachial plexus blockade is a time-tested technique for upper limb surgeries. The classical approach using paresthesia technique is a blind technique and may be associated with a higher failure rate and injury to the nerves and surrounding structures. To avoid some of these problems, use of peripheral nerve stimulator and ultrasound techniques were started which allowed better localization of the nerve/plexus. Ultrasound for supraclavicular brachial plexus block has improved the success rate of the block with excellent localization as well as improved safety margin...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28655546/optimised-nlc-a-nanotechnological-approach-to-improve-the-anaesthetic-effect-of-bupivacaine
#6
Gustavo H Rodrigues da Silva, Lígia N M Ribeiro, Hery Mitsutake, Viviane A Guilherme, Simone R Castro, Ronei J Poppi, Márcia C Breitkreitz, Eneida de Paula
The short time of action and systemic toxicity of local anaesthetics limit their clinical application. Bupivacaine is the most frequently used local anaesthetic in surgical procedures worldwide. The discovery that its S(-) enantiomeric form is less toxic than the R(+) form led to the introduction of products with enantiomeric excess (S75:R25 bupivacaine) in the market. Nevertheless, the time of action of bupivacaine is still short; to overcome that, bupivacaine S75:R25 (BVCS75) was encapsulated in nanostructured lipid carriers (NLC)...
June 24, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28614364/serum-levels-of-bupivacaine-after-pre-peritoneal-bolus-vs-epidural-bolus-injection-for-analgesia-in-abdominal-surgery-a-safety-study-within-a-randomized-controlled-trial
#7
Timothy H Mungroop, Ganapathy van Samkar, Bart F Geerts, Susan van Dieren, Marc G Besselink, Denise P Veelo, Philipp Lirk
BACKGROUND: Continuous wound infiltration (CWI) has become increasingly popular in recent years as an alternative to epidural analgesia. As catheters are not placed until the end of surgery, more intraoperative opioid analgesics might be needed. We, therefore, added a single pre-peritoneal bolus of bupivacaine at the start of laparotomy, similar to the bolus given with epidural analgesia. METHODS: This was a comparative study within a randomized controlled trial (NTR4948)...
2017: PloS One
https://www.readbyqxmd.com/read/28599806/pharmacokinetics-of-bupivacaine-after-bilateral-ultrasound-guided-transversus-abdominis-plane-block-following-cesarean-delivery-under-spinal-anesthesia
#8
B Trabelsi, R Charfi, L Bennasr, S Ben Marzouk, H Eljebari, N Jebabli, M Ben Sassi, S Trabelsi, H Maghrebi
BACKGROUND: Transversus abdominis plane block is an effective method of post-cesarean analgesia. There are no data available about plasma bupivacaine levels after this block in adults. This study aimed to assess bupivacaine pharmacokinetic parameters after ultrasound-guided transversus abdominis plane blocks following cesarean delivery under spinal anesthesia. METHODS: A prospective observational study in parturients undergoing elective cesarean delivery under hyperbaric bupivacaine spinal anesthesia was conducted...
April 22, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28562387/lipid-resuscitation-in-acute-poisoning-after-a-decade-of-publications-what-have-we-really-learned
#9
Lotte C G Hoegberg, Sophie Gosselin
PURPOSE OF REVIEW: The decision to provide intravenous lipid emulsion (ILE) therapy as a treatment modality for the reversal of various drug toxicity was discovered in the last decade. Numerous publications, in both humans and animals attest to its clinical use, but current supporting evidence is inconsistent. RECENT FINDINGS: A recent systematic review reported evidence for benefit of ILE in bupivacaine toxicity. Human randomized trials, large observational studies as well as animal models of orogastric poisoning failed to report a clear benefit of ILE for nonlocal anesthetics poisoning...
August 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28550928/effectiveness-of-continuous-wound-infusion-of-local-anesthetics-after-abdominal-surgeries
#10
Baskaran Dhanapal, Sarath Chandra Sistla, Ashok Shankar Badhe, Sheikh Manwar Ali, Niranjan T Ravichandran, Indira Galidevara
BACKGROUND: To assess the effectiveness of continuous preperitoneal wound infusion of local anesthetic drug bupivacaine in providing pain relief, reducing opioid consumption, and enhancing postoperative recovery. METHODS: Eligible patients were randomly allocated to two groups (study group: bupivacaine and control group: normal saline). There were 47 patients in each group. The patients received continuous infusion of either 0.25% bupivacaine or 0.9% normal saline at 6 mL/h, for 48 h, based on their group allocation, through a multiholed wound infiltration catheter placed preperitoneally...
May 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28540470/effects-of-remifentanil-pretreatment-on-bupivacaine-cardiotoxicity-in-rats
#11
Özcan Pişkin, Hilal Ayoğlu
Unintentional intravascular administration of bupivacaine may cause local anesthetic systemic toxicity (LAST). Although many systems are affected in LAST, the cardiovascular effects can be life-threatening. Remifentanil is a selective, ultra-short-acting, µ-opioid receptor agonist opioid. This study assessed the effects of combined pretreatment with intravenous lipid emulsion (ILE) and remifentanil on the cardiotoxicity caused by bupivacaine in an experimental model of anesthetized rats. The rats were divided into three groups...
May 24, 2017: Cardiovascular Toxicology
https://www.readbyqxmd.com/read/28538107/local-anesthetics-systemic-toxicity-association-with-exparel-bupivacaine-liposome-a-pharmacovigilance-evaluation
#12
Nitish Aggarwal
BACKGROUND: Local anesthetic systemic toxicity (last) is a rare life threatening complication usually from intra-arterial or intravenous injection leading to systemic absorption of regional anesthesia drug. the objective of this research was to statistically quantify the association between exparel (bupivacaine liposome) injectable suspension and last. METHODS: Adverse Event Reporting System database of FDA, which houses public and industry submitted adverse event case reports, was queried and analyzed to quantify the passive pharmacovigilance signal for Local Anesthetic Systemic Toxicity as associated with use of bupivacaine Liposome...
June 5, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28529036/qx-oh-a-qx-314-derivative-agent-produces-long-acting-local-anesthesia-in-rats
#13
YuJun Zhang, Jun Yang, QinQin Yin, LingHui Yang, Jin Liu, WenSheng Zhang
QX-314 has been shown to produce long-acting local anesthesia in vivo in animals; however, translation to humans has been impeded by concerns about toxicity. We investigated whether the newly emerged QX-OH molecule could confer long-lasting anesthesia with a low local toxicity in rats. In rat sciatic nerve block model, QX-OH 25mM produced a longer sensory block than QX-314 25mM (median [25th, 75th percentiles], 5.5 [4.25, 6] h vs. 3 [3, 4] h; P=0.03). QX-OH 35mM produced a longer sensory block than QX-314 35mM (8 [6, 12] h vs...
May 18, 2017: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28467482/correction-the-quaternary-lidocaine-derivative-qx-314-in-combination-with-bupivacaine-for-long-lasting-nerve-block-efficacy-toxicity-and-the-optimal-formulation-in-rats
#14
Qinqin Yin, Jun Li, Qingshan Zheng, Xiaolin Yang, Rong Lv, Longxiang Ma, Jin Liu, Tao Zhu, Wensheng Zhang
[This corrects the article DOI: 10.1371/journal.pone.0174421.].
2017: PloS One
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
#15
COMPARATIVE STUDY
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/28408853/tumescent-mastectomy-the-current-indications-and-operative-tips-and-tricks
#16
Ashraf Khater, Alaa Mazy, Mona Gad, Ola Taha Abd Eldayem, Mohamed Hegazy
BACKGROUND: Tumescent mastectomy refers to usage of a mixture of lidocaine and epinephrine in a diluting saline solution that makes flaps firm and tense, thus minimizing systemic drugs toxicity and making surgery possible with minimal bleeding. This technique is very useful in elder women and those with American Society of Anesthesiologists; score III and IV. The objective was to establish an alternative safe technique to general anesthesia in some selected mastectomy patients. PATIENTS AND METHODS: Twenty candidate women for total mastectomy and axillary dissection were enrolled and consented to participate...
2017: Breast Cancer: Targets and Therapy
https://www.readbyqxmd.com/read/28346007/lipid-emulsion-improves-survival-in-animal-models-of-local-anesthetic-toxicity-a-meta-analysis
#17
REVIEW
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...
August 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28334014/the-quaternary-lidocaine-derivative-qx-314-in-combination-with-bupivacaine-for-long-lasting-nerve-block-efficacy-toxicity-and-the-optimal-formulation-in-rats
#18
Qinqin Yin, Jun Li, Qingshan Zheng, Xiaolin Yang, Rong Lv, Longxiang Ma, Jin Liu, Tao Zhu, Wensheng Zhang
OBJECTIVE: The quaternary lidocaine derivative (QX-314) in combination with bupivacaine can produce long-lasting nerve blocks in vivo, indicating potential clinical application. The aim of the study was to investigate the efficacy, safety, and the optimal formulation of this combination. METHODS: QX-314 and bupivacaine at different concentration ratios were injected in the vicinity of the sciatic nerve in rats; bupivacaine and saline served as controls (n = 6~10)...
2017: PloS One
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
#19
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/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
#20
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
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