Bupivacaine

Background Despite the growing interest in dexmedetomidine as an adjunct to truncal blocks, little is known about the systemic absorption of dexmedetomidine after these blocks and its role in analgesia and in hemodynamics. Objective We investigated the pharmacokinetics and pharmacodynamics of dexmedetomidine as an adjunct to transversus abdominis plane (TAP) block in patients undergoing lower abdominal cancer surgery. Methods Twenty-four adult patients were randomized to receive a bilateral single-injection TAP block before surgery with 20 mL of bupivacaine 0.5% (TAP group, n = 12) or combined with 1 µg/kg dexmedetomidine (TAP-DEX group, n = 12) and diluted with saline to a volume of 40 mL (20 mL on each side). Plasma concentrations of dexmedetomidine and its pharmacokinetics were investigated using non-compartmental methods, postoperative analgesia, hemodynamics, and adverse events (nausea, vomiting, itching, hypotension, bradycardia, and respiratory depression). Results Dexmedetom...

The pharmacodynamics and pharmacokinetics of bupivacaine in solution and in liposome preparations following subcutaneous administration were studied in rats. Multilamellar vesicles entrapping bupivacaine solution were prepared. The local anaesthetic effect was estimated by the tail-flick test in Wistar rats treated with 1 mg bupivacaine in 0.2-ml. preparations. Plasma concentrations of bupivacaine were determined by high-performance liquid chromatography. The results showed that both bupivacaine solution and bupivacaine liposomes revealed local anaesthetic effects in the initial tail-flick test (15 min after injection). With bupivacaine liposomes, the duration of action was 5-fold (447 ± 28.9 vs 87 ± 6.7 min), the maximum possible effect was 2-fold (100 ± 0 vs 47.6 ± 13%), and the peak plasma concentration (Cmax) was less than one-fifth (0.12 ± 0.04 vs 0.65 ± 0.04 μg mL−1) that with bupivacaine solution. The sensory block effect of bupivacaine solution completely resolved at 90 min,...

BACKGROUND Caudal anesthesia is widely used as intraoperative and postoperative analgesia in children's subumbilical surgeries such as on the urogenital system, lower extremities and lower abdomen to reduce the stress response to surgery and to facilitate the general anesthesia. AIM The purpose of this study was to compare the effects of caudally administered bupivacaine and levobupivacaine of equal volume and concentration on motor block and postoperative pain in children undergoing circumcision surgery. PATIENTS AND METHODS The prospective, randomized, double-blind study included 60 patients with ages ranging from 1-10 years and ASA (American Society of Anesthesiologists) physical status of I-II who underwent elective circumcision surgery. The patients were divided into two groups: group B received 0.5 ml/kg of bupivacaine 0.25% caudally and group L received 0.5 ml/kg of levobupivacaine 0.25% caudally. Postoperative pain was assessed by children's and infant's postoper...

BACKGROUND AND PURPOSE: Oxygen-ozone therapy is a minimally invasive treatment for lumbar disk herniation that exploits the biochemical properties of a gas mixture of oxygen and ozone. We assessed the therapeutic outcome of oxygen-ozone therapy and compared the outcome of administering medical ozone alone with the outcome of medical ozone followed by injection of a corticosteroid and an anesthetic at

BACKGROUND: This study was designed to evaluate the maternal effects ofepidural analgesia by different local anesthetics and their impact on placental and fetal blood flow.METHODS: Depending on the type of local anesthetics used, sixty full-term parturients were randomly allocated into 3 equal groups in a randomized blind study; Group (1) received Bupivacaine (0.125%), Group (2) received Ropivacaine (0.2%) and, Group (3) received Levobupivacaine (0.125%). Epidural fentanyl (100 microg) was added to all groups. Safety was assessed by recording the mothers' characters and vital signs as well as the fetal Doppler indices while efficacy was assessed by measuring severity of pain, onset and duration of analgesia, and the motor blockade. Doppler velocimetry studies for fetus included monitoring of Umbilical Artery Pulsitility Indices (UAPI) and Middle Cerebral Artery Pulsitility Indices (MCAPI).RESULTS: Parturient in all groups were comparable. Pulse rate and arterial blood pressure were significantly decreased in all groups after analgesia, but remained within normal ranges. The pain score, had significant reduction in all groups with best results observed in Group 3. The onset of analgesia was relatively rapid in Group 2 followed by Group 3 then Group 1. The duration of analgesia was prolonged in Group 1 followed by Group 3 and then Group 2. There was no incidence of motor block except in 5 parturient (20%) in Group 1. UAPI was significantly decreased in the three studied groups after epidural analgesia. But, during uterine contraction, there was slight elevation in the UAPI in all groups. The best improvement in placental perfusion was observed in Group 3, then Group 1, and the least was Group 2. On the other hand, MCAPI was significantly increased in al groups after epidural analgesia. But, during uterine contraction, there was slight decrease in the MCAPI in the three groups. The best improvement in MCAPI was observed in Group 3, then Group 1, and the least was Group 2.CONCLUSION: All local anesthetics produced excellent analgesia during labor. The Doppler indices were improved in the three groups with the best results in levobupivacaine group.

Background: The aim of our study was to compare the effects of three techniques for preventing the hypertensive response to the insertion of Mayfield skull pins (MSP): group F (fentanyl), group B (bupivacaine) and FB (combined fentanylbupivacaine).

OBJECTIVE To compare the clinical characteristics of sensory and motor block as well as haemodynamic stability using plain and hyperbaric bupivacaine in spinal anaesthesia for caesarean section. METHODS Two equal groups were formed from a total of 60 patients who were enrolled in this prospective randomised double-blinded study that was done at tertiary care hospital in Karach, during 2005 to 2006. Equal volume of plain and hyperbaric bupivacaine 10 mg with 25 mcg of fentanyl was used for spinal anaesthesia in the two groups that were formed on the basis of random allocation. Characteristics of sensory and motor block, episodes of hypotension and bradycardia as well as use of ephedrine and atropine were recorded by blinded investigator. RESULTS There was no difference in the onset of block, time to achieve maximum level of block and haemodynamic parameters between the two groups. However, plain bupivacaine took more time for two dermatomes sensory level regression below T4, and resu...

The local anaesthetics used in day-case spinal anaesthesia should provide short recovery times. We aimed to compare hyperbaric prilocaine and bupivacaine in terms of sensory block resolution and time to home readiness in day-case spinal anaesthesia. MeTHODS: Fifty patients undergoing perianal surgery were randomized into two groups. The bupivacaine-fentanyl group (Group B) received 7.5 mg, 0.5% hyperbaric bupivacaine + 20 μg fentanyl in total 1.9 mL. The prilocaine-fentanyl group (Group P) received 30 mg, 0.5% hyperbaric prilocaine + 20 μg fentanyl in the same volume. Time to L1 block and maximum block was shorter in Group P than in Group B (Group P 4.6 ± 1.3 min versus Group B 5.9 ± 01.9 min, P = 0.017, and Group P 13.2 ± 7.5 min versus Group B 15.3 ± 6.6 min, P = 0.04). The time to L1 regression and S3 regression of the sensorial block was significantly shorter in Group P than in Group B (45.7 ± 21.9 min versus 59.7 ± 20.9 min, P = 0.024, and 133.8 ± 41.4 min versus 200.4 ± 64.8 m...

The present study defined the dose-response relationship of intrathecally injected bupivacaine in rats. The effect was a quantified drug-induced and graded reduction in the magnitude of the withdrawal reflexes elicited by transcutaneous electrical stimulation. Intrathecal epinephrine reduced the magnitude of the withdrawal reflexes. The combination of epinephrine and bupivacaine resulted in a dose-response relationship different from that of bupivacaine alone, and the combination was more effective than bupivacaine alone. The intrathecal combinations of bupivacaine and 25 micrograms of the alpha 2-adrenergic antagonist idazoxan had an effect not different from that of bupivacaine alone, but the duration of effect was shorter. The dose-response relationship of bupivacaine was not different whether the pH of the solution was 4.4 or 6.1. The results concerning the effect as a function of time confirm those of earlier studies: 1) the duration of effect depends on the dose of bupivacaine; 2) epinephrine protracts the duration of effect; 3) the pH is of no relevance. Thermal tests for nociception showed that antinociception outlasted motor symptoms. Epinephrine enhanced this effect of bupivacaine, but did not change the duration of motor impairment.

To compare combined spinal-epidural anaesthesia (CSE) VS spinal anaesthesia (SA) in caesarean section (CS) performed by Stark method. 200 women were prospectively studied before undergoing to a Stark CS in two groups: 95 patients were assigned to a local anaesthesia by SA (first group) and 105 women to CSE anaesthesia (second group). After a pre-load of 500 ml of plasma expander in both groups, SA was performed at the L1-L2 interspace with an injection of 5 ml of levobupivacaine 0.15%, with a 5 mcg of Sufentanil. The CSE was performed by a spinal-epidural injection at the L1-L2 interspace, primarily by 4 ml of levobupivacaine 0.125% and 5 mcg of Sufentanil, then by 3-7 mL of xilocaine carbonate 0.5% plus 1 mcg/ml of Sufentanil. Successively a CS by Stark method was performed in both groups. The recorded anaesthesiologic side effects in two groups were: motor block, intraoperative discomfort, vomiting, bradycardia and hypotension. Statistical evaluation was by Z-Test referred to the ...

Bupivacaine is a local anaesthetic prohibited in equine sports. It is highly metabolized in the horse but a thorough description of its metabolite profile is lacking. An administration study should find appropriate analytical targets for doping control. Furthermore, knowledge of an in vitro system for production of metabolites would be beneficial. Marcain® (bupivacaine hydrochloride) was administered subcutaneously to a horse and urine samples were collected. In vitro metabolic systems consisting of the fungi Cunninghamella elegans and Cunninghamella blakesleeana were incubated with bupivacaine and bupivacaine-d(9). Samples were analyzed directly after dilution or cleaned up using liquid-liquid extraction. Separation was achieved with liquid chromatography. Mass spectrometric analysis was performed using positive electrospray ionization with both a tandem quadrupole and an ion trap instrument using MS(n) and hydrogen/deuterium exchange. In horse urine, seven phase I metabolites were...

To compare pain sensation induced by phacoemulsification with topical anesthesia with that by peribulbar anesthesia, without sedation. Using a 10-level visual pain analogue scale, the pain induced by phacoemulsification with topical anesthesia (2% tetracaine drops) was measured in 20 patients. The same scale was used to measure the pain induced by peribulbar anesthesia (2% lidocaine and 0.5% bupivacaine) in 21 patients. The same surgeon performed peribulbar infiltrations and surgeries. The phacoemulsifications were done using clear corneal approach followed by in-the-bag intraocular lens implantation. Pain comparison between the two groups was performed by the non-parametrical U Mann-Whitney test. The distribution of the pain scores of the patients who underwent cataract extraction with topical anesthesia ranged from 0 to 5 (median value = 2). The scores of the patients who underwent peribulbar infiltration ranged from 0 to 7 (median value = 3). The mean rank of the group of patient...

Tandem pore domain K+ channels represent a new family of ion channels involved in the control of background membrane conductances. We report the structural and functional properties of a TWIK-related acid-sensitive K+ channel (rTASK), a new member of this family cloned from rat cerebellum. The salient features of the primary amino acid sequence include four putative transmembrane domains and, unlike other cloned tandem pore domain channels, a PDZ (postsynaptic density protein, disk-large, zo-1) binding sequence at the C terminal. rTASK has distant overall homology to a putative Caenorhabditis elegans K+ channel and to the mammalian clones TREK-1 and TWIK-1. rTASK expression is most abundant in rat heart, lung, and brain. When exogenously expressed in Xenopus oocytes, rTASK currents activate instantaneously, are noninactivating, and are not gated by voltage. Because rTASK currents satisfy the Goldman-Hodgkin-Katz current equation for an open channel, rTASK can be classified an open r...