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Bupivacaine toxicity

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https://www.readbyqxmd.com/read/28208809/a-lipid-emulsion-reverses-toxic-dose-bupivacaine-induced-vasodilation-during-tyrosine-phosphorylation-evoked-contraction-in-isolated-rat-aortae
#1
Seong-Ho Ok, Soo Hee Lee, Seong-Chun Kwon, Mun Hwan Choi, Il-Woo Shin, Sebin Kang, Miyeong Park, Jeong-Min Hong, Ju-Tae Sohn
The goal of this in vitro study was to examine the effect of a lipid emulsion on toxic-dose bupivacaine-induced vasodilation in a model of tyrosine phosphatase inhibitor sodium orthovanadate-induced contraction in endothelium-denuded rat aortae and to elucidate the associated cellular mechanism. The effect of a lipid emulsion on vasodilation induced by a toxic dose of a local anesthetic during sodium orthovanadate-induced contraction was examined. In addition, the effects of various inhibitors, either bupivacaine alone or a lipid emulsion plus bupivacaine, on protein kinase phosphorylation induced by sodium orthovanadate in rat aortic vascular smooth muscle cells was examined...
February 13, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28208010/circulating-plasma-and-exosomal-micrornas-as-indicators-of-drug-induced-organ-injury-in-rodent-models
#2
Young-Eun Cho, Sang-Hyun Kim, Byung-Heon Lee, Moon-Chang Baek
This study was performed to evaluate whether microRNAs (miRNAs) in circulating exosomes may serve as biomarkers of drug-induced liver, kidney, or muscle-injury. Quantitative PCR analyses were performed to measure the amounts of liver-specific miRNAs (miR-122, miR-192, and miR-155), kidney-specific miR-146a, or muscle-specific miR-206 in plasma and exosomes from mice treated with liver, kidney or muscle toxicants. The levels of liver-specific miRNAs in circulating plasma and exosomes were elevated in acetaminophen-induced liver injury and returned to basal levels by treatment with antioxidant N-acetyl-cysteine...
February 17, 2017: Biomolecules & Therapeutics
https://www.readbyqxmd.com/read/28165812/the-protective-effect-of-lipid-emulsion-in-preventing-bupivacaine-induced-mitochondrial-injury-and-apoptosis-of-h9c2-cardiomyocytes
#3
Zhe Chen, Zhousheng Jin, Yun Xia, Shishi Zhao, Xuzhong Xu, Thomas J Papadimos, Quanguang Wang
Lipid emulsion (LE) has been shown to be effective in the resuscitation of bupivacaine-induced cardiac arrest, but the precise mechanism of this action has not been fully elucidated. Pursuant to this lack of information on the mechanism in which LE protects the myocardium during bupivacaine-induced toxicity, we explored mitochondrial function and cell apoptosis. H9C2 cardiomyocytes were used in study. Cells were randomly divided in different groups and were cultivated 6 h, 12 h, and 24 h. The mitochondria were extracted and mitochondrial ATP content was measured, as was mitochondrial membrane potential, the concentration of calcium ion (Ca2+), and the activity of Ca2+-ATP enzyme (Ca2+-ATPase)...
November 2017: Drug Delivery
https://www.readbyqxmd.com/read/28144162/thoracic-epidural-catheter-for-postoperative-pain-control-following-an-ineffective-transversus-abdominis-plane-block-using-liposome-bupivacaine
#4
Brian D Terrien, David Espinoza, Charles C Stehman, Gabriel A Rodriguez, Nicholas C Connolly
A 24-year-old female with a history of ulcerative colitis underwent colectomy. The patient received an ineffective transversus abdominis plane (TAP) block with liposome bupivacaine (Exparel) intraoperatively and was started on a hydromorphone patient-controlled analgesia 5 hours after the TAP block, which did not relieve her pain. A continuous thoracic epidural (CTE) was then placed after blood levels of bupivacaine were drawn, and the patient immediately experienced significant pain relief. The combined use of liposome bupivacaine and bupivacaine CTE infusion in the postoperative management of this patient demonstrated no safety concerns, provided excellent analgesia and plasma concentrations of bupivacaine remained far below toxic levels...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28120158/pharmacokinetic-profile-and-tolerability-of-liposomal-bupivacaine-following-a-repeated-dose-via-local-subcutaneous-infiltration-in-healthy-volunteers
#5
David Rice, Justin W Heil, Lukasz Biernat
BACKGROUND: Liposomal bupivacaine is indicated for administration into the surgical site to produce post-surgical analgesia. OBJECTIVES: The objectives of this study were to characterize the pharmacokinetic and safety profiles of liposomal bupivacaine following a repeated dose in healthy volunteers. METHODS: Healthy adults were assigned to receive liposomal bupivacaine via subcutaneous infiltration in a single 266 mg dose (cohort 1) or in two 266 mg doses, with the second dose given immediately, 24, 48, or 72 h after the first dose (cohorts 2-5)...
January 25, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28089496/cell-toxicity-in-fibroblasts-tenocytes-and-human-mesenchymal-stem-cells-a-comparison-of-necrosis-and-apoptosis-inducing-ability-in-ropivacaine-bupivacaine-and-triamcinolone
#6
Anja Z Zhang, Andreas Ficklscherer, Mehmet F Gülecyüz, Alexander C Paulus, Thomas R Niethammer, Volkmar Jansson, Peter E Müller
PURPOSE: To analyze the ability of ropivacaine, bupivacaine, and triamcinolone to induce apoptosis and necrosis in fibroblasts, tenocytes, and human mesenchymal stem cells. METHODS: Human dermal fibroblasts, adipose-derived human mesenchymal stem cells (hMSCs), and tenocytes gained from the rotator cuff tendon were seeded with a cell density of 0.5 × 10(4)/cm(2). One specimen of ropivacaine, bupivacaine, and triamcinolone was tested separately on the cells with separate concentrations of 0...
January 12, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/27872765/cardiac-arrest-after-local-anaesthetic-toxicity-in-a-paediatric-patient
#7
Liana Maria Torres de Araújo Azi, Diego Grimaldi Figueroa, Ana Amélia Souza Simas
We report a case of a paediatric patient undergoing urological procedure in which a possible inadvertent intravascular or intraosseous injection of bupivacaine with adrenaline in usual doses caused subsequent cardiac arrest, completely reversed after administration of 20% intravenous lipid emulsion. Early diagnosis of local anaesthetics toxicity and adequate cardiovascular resuscitation manoeuvres contribute to the favourable outcome.
2016: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/27833486/a-comparative-study-of-dexmedetomidine-and-fentanyl-as-adjuvants-to-levobupivacaine-for-caudal-analgesia-in-children-undergoing-lower-limb-orthopedic-surgery
#8
S M Elfawal, W A Abdelaal, M R Hosny
BACKGROUND: Levobupivacaine is an effective local anesthetic agent with less systemic toxicity than racemic bupivacaine, but it has short postoperative analgesic duration. Dexmedetomidine and fentanyl are promising adjuncts to provide excellent and prolonged postoperative caudal analgesia. This study compared the effects of caudal levobupivacaine plus dexmedetomidine and levobupivacaine plus fentanyl for postoperative analgesia and sedation in children undergoing lower limb orthopedic surgery...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27815173/stable-gastric-pentadecapeptide-bpc-157-and-bupivacaine
#9
Gordana Zivanovic-Posilovic, Diana Balenovic, Ivan Barisic, Dean Strinic, Vasilije Stambolija, Mario Udovicic, Sandra Uzun, Domagoj Drmic, Josipa Vlainic, Martina Lovric Bencic, Aleksandra Sindic, Sven Seiwerth, Predrag Sikiric
Bupivacaine toxicity following accidental overdose still lacks therapeutic solution. However, there are major arguments for testing BPC 157 against bupivacaine toxicity in vivo in rats, in particular, and then finally, in vitro. These are: the lack of any known BPC 157 toxicity, a lifesaving effect via the mitigation of arrhythmias in rats underwent hyperkalemia or digitalis toxicity, the elimination of hyperkalemia and arrhythmias in rats underwent succinylcholine toxicity and finally, the reduction of potassium-induced depolarization in vitro (in HEK293 cells) in severe hyperkalemia...
December 15, 2016: European Journal of Pharmacology
https://www.readbyqxmd.com/read/27790556/efficacy-of-sciatic-nerve-block-for-pain-management-in-below-knee-orthopaedic-surgery
#10
Subhadra Arun Sinha, Sandeep Champalal Mutha, Deepak Sadashiv Phalgune
INTRODUCTION: Perioperative pain management is an integral part of anaesthesia and patients are most satisfied if there is minimal or no pain after surgery. Sciatic nerve block provides postoperative pain relief after below knee surgery and knee surgery. Many studies with different approaches for sciatic nerve block have been conducted to demonstrate the efficacy of sciatic nerve block with different local anaesthetic drugs over the past decade. AIM: To study the efficacy of single-shot sciatic nerve block for postoperative pain management in below knee orthopaedic surgery...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27778324/intraneural-injection-of-a-test-dose-of-local-anesthetic-in-peripheral-nerves-does-it-induce-histological-changes-in-nerve-tissue
#11
T Wiesmann, T Steinfeldt, M Exner, W Nimphius, J De Andres, H Wulf, U Schwemmer
BACKGROUND & OBJECTIVES: Most anesthesiologists use the injection of a test dose of local anesthetic in order to evaluate the final needle tip position. Thus, the intraneural injection of a full dose can be avoided. The aim of this study was to analyze whether an intraneural injection of a test dose of bupivacaine could trigger histological changes. METHODS: Intraneural injections under direct vision were performed in 40 brachial plexus nerves in seven anesthetized pigs...
January 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27746542/a-randomized-controlled-study-between-fentanyl-and-butorphanol-with-low-dose-intrathecal-bupivacaine-to-facilitate-early-postoperative-ambulation-in-urological-procedures
#12
Arvind Kumar, Ritesh Kumar, Vinod Kumar Verma, Chandrakant Prasad, Rajesh Kumar, Shashi Kant, Gunjan Kumar, Neha Singh, Rupam Kumari
INTRODUCTION: Opioids are widely used in conjunction with local anesthetics as they permit the use of lower dose of local anesthetics while providing adequate anesthesia and analgesia. It both provides adequate anesthesia as well as lower drug toxicity neuraxial administration of opioids in conjunction with local anesthetics improves the quality of intraoperative analgesia and prolongs the duration of postoperative analgesia. Bupivacaine is the most commonly used drug for subarachnoid block due to its lesser side effects...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27738501/lipid-emulsion-inhibits-vasodilation-induced-by-a-toxic-dose-of-bupivacaine-by-suppressing-bupivacaine-induced-pkc-and-cpi-17-dephosphorylation-but-has-no-effect-on-vasodilation-induced-by-a-toxic-dose-of-mepivacaine
#13
Hyunhoo Cho, Seong Ho Ok, Seong Chun Kwon, Soo Hee Lee, Jiseok Baik, Sebin Kang, Jiah Oh, Ju-Tae Sohn
BACKGROUND: The goal of this in vitro study was to investigate the effect of lipid emulsion on vasodilation caused by toxic doses of bupivacaine and mepivacaine during contraction induced by a protein kinase C (PKC) activator, phorbol 12,13-dibutyrate (PDBu), in an isolated endothelium-denuded rat aorta. METHODS: The effects of lipid emulsion on the dose-response curves induced by bupivacaine or mepivacaine in an isolated aorta precontracted with PDBu were assessed...
October 2016: Korean Journal of Pain
https://www.readbyqxmd.com/read/27687316/-effect-of-equipotent-doses-of-bupivacaine-and-ropivacaine-in-high-fat-diet-fed-neonatal-rodent-model
#14
Ying-Dong Lian, Zong-Xiang Chen, Kang-Ru Zhu, Shu-Yin Sun, Li-Ping Zhu
OBJECTIVES: The increase in the prevalence of obesity presents a significant health and economic problem. Obesity has been reported to be a major contributor to variety of chronic diseases. Childhood obesity has been rising over the past decades leading to various complications in health. Millions of infants and children undergo surgery every year on various health grounds. The present investigation was undertaken to evaluate the effect of spinal anesthesia of equipotent doses of ropivacaine and bupivacaine on over-weight neonatal rats...
September 26, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27608281/evidence-based-recommendations-on-the-use-of-intravenous-lipid-emulsion-therapy-in-poisoning
#15
Sophie Gosselin, Lotte C G Hoegberg, Robert S Hoffman, Andis Graudins, Christine M Stork, Simon H L Thomas, Samuel J Stellpflug, Bryan D Hayes, Michael Levine, Martin Morris, Andrea Nesbitt-Miller, Alexis F Turgeon, Benoit Bailey, Diane P Calello, Ryan Chuang, Theodore C Bania, Bruno Mégarbane, Ashish Bhalla, Valéry Lavergne
BACKGROUND: Although intravenous lipid emulsion (ILE) was first used to treat life-threatening local anesthetic (LA) toxicity, its use has expanded to include both non-local anesthetic (non-LA) poisoning and less severe manifestations of toxicity. A collaborative workgroup appraised the literature and provides evidence-based recommendations for the use of ILE in poisoning. METHODS: Following a systematic review of the literature, data were summarized in four publications: LA and non-LA poisoning efficacy, adverse effects, and analytical interferences...
December 2016: Clinical Toxicology
https://www.readbyqxmd.com/read/27430990/absorption-of-bupivacaine-after-administration-of-a-lozenge-as-topical-treatment-for-pain-from-oral-mucositis
#16
COMPARATIVE STUDY
Stine Mogensen, Eva Sverrisdóttir, Kolbrún Sveinsdóttir, Charlotte Treldal, Kenneth Jensen, Anders Bonde Jensen, Claus Andrup Kristensen, Jette Jacobsen, Mads Kreilgaard, Janne Petersen, Ove Andersen
The aim was to investigate systemic exposure after administration of a novel bupivacaine lozenge in healthy individuals with normal mucosa and in head and neck cancer (HNC) patients with oral mucositis. A lozenge containing 5, 10, 25 and 50 mg bupivacaine, respectively, was administered as single dose to 10 healthy individuals, and a lozenge containing 25 mg bupivacaine was administered as single dose to 10 HNC patients with oral mucositis and as multiple doses to five patients with HNC. Blood samples were collected for 6 hr from the healthy individuals and 3 hr from the patients with HNC, respectively, after administration...
January 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/27347237/time-to-analgesia-onset-and-pharmacokinetics-after-separate-and-combined-administration-of-liposome-bupivacaine-and-bupivacaine-hcl-considerations-for-clinicians
#17
Jeffrey Gadsden, William J Long
BACKGROUND: Liposome bupivacaine is a prolonged-release bupivacaine formulation indicated for single-dose administration into the surgical site to produce postsurgical analgesia. METHODS: An overview of time to onset of analgesia observed with liposome bupivacaine in human studies is provided, as well as a summary of data from pharmacokinetic studies including those that assessed pharmacokinetics after separate versus coadministration of liposome bupivacaine and bupivacaine HCl...
2016: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/27342601/new-updates-pertaining-to-drug-delivery-of-local-anesthetics-in-particular-bupivacaine-using-lipid-nanoparticles
#18
REVIEW
Siavash Beiranvand, Ali Eatemadi, Arash Karimi
Lipid nanoparticles (liposomes) were first described in 1965, and several work have led to development of important technical advances like triggered release liposomes and drug-loaded liposomes. These advances have led to numerous clinical trials in such diverse areas such as the delivery of anti-cancer, antifungal, and antibiotic drugs; the delivery of gene medicines; and most importantly the delivery of anesthesia drugs. Quite a number of liposomes are on the market, and many more are still in developmental stage...
December 2016: Nanoscale Research Letters
https://www.readbyqxmd.com/read/27310901/institutional-policy-changes-to-prevent-cardiac-toxicity-associated-with-bupivacaine-penile-blockade-in-infants
#19
Richard N Yu, Constance S Houck, Alfonso Casta, Richard H Blum
Dorsal penile nerve block is a widely used method of analgesia for infants undergoing penile surgery. Because of its potency, extended duration of action, and lack of vasoconstriction, bupivacaine remains the most commonly used local anesthetic. Rapid systemic absorption of bupivacaine, however, has been associated with profound central nervous system and cardiovascular side effects, including cardiac arrest. As determined by retrospective medical record analysis, the incidence of complications associated with dorsal penile blockade in our institution was 0...
August 1, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27302637/lipid-rescue-for-treatment-of-delayed-systemic-ropivacaine-toxicity-from-a-continuous-thoracic-paravertebral-block
#20
Trylon Mathew Tsang, Alfin Taddeo Okullo, Jeremy Field, Patrick Mamo
A 66-year-old man underwent a left minithoracotomy for pleural biopsies and thoracentesis. A left T3 paravertebral catheter was placed prior to induction of general anaesthesia, and a total of 20 mL of bupivacaine 0.25% administered. Postoperatively, ropivacaine 0.2% infusion was commenced at 10 mL/hour. Thirty-seven hours after the initial block, the patient developed convulsions without loss of consciousness. The ropivacaine infusion rate was unchanged and no further boluses had been given. He reported of perioral tingling, a burning sensation in his legs and penis and agitation...
June 14, 2016: BMJ Case Reports
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