Bupivacaine: A widely used local anesthetic agent.Anesthetics, Local: Drugs that block nerve conduction when applied locally to nerve tissue in appropriate concentrations. They act on any part of the nervous system and on every type of nerve fiber. In contact with a nerve trunk, these anesthetics can cause both sensory and motor paralysis in the innervated area. Their action is completely reversible. (From Gilman AG, et. al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed) Nearly all local anesthetics act by reducing the tendency of voltage-dependent sodium channels to activate.Anesthesia, Spinal: Procedure in which an anesthetic is injected directly into the spinal cord.Analgesia, Epidural: The relief of pain without loss of consciousness through the introduction of an analgesic agent into the epidural space of the vertebral canal. It is differentiated from ANESTHESIA, EPIDURAL which refers to the state of insensitivity to sensation.Amides: Organic compounds containing the -CO-NH2 radical. Amides are derived from acids by replacement of -OH by -NH2 or from ammonia by the replacement of H by an acyl group. (From Grant & Hackh's Chemical Dictionary, 5th ed)Analgesia, Obstetrical: The elimination of PAIN, without the loss of CONSCIOUSNESS, during OBSTETRIC LABOR; OBSTETRIC DELIVERY; or the POSTPARTUM PERIOD, usually through the administration of ANALGESICS.Anesthesia, Epidural: Procedure in which an anesthetic is injected into the epidural space.Anesthesia, Obstetrical: A variety of anesthetic methods such as EPIDURAL ANESTHESIA used to control the pain of childbirth.Nerve Block: Interruption of NEURAL CONDUCTION in peripheral nerves or nerve trunks by the injection of a local anesthetic agent (e.g., LIDOCAINE; PHENOL; BOTULINUM TOXINS) to manage or treat pain.Lidocaine: A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of PROCAINE but its duration of action is shorter than that of BUPIVACAINE or PRILOCAINE.Pain, Postoperative: Pain during the period after surgery.Anesthesia, Caudal: Epidural anesthesia administered via the sacral canal.Etidocaine: A local anesthetic with rapid onset and long action, similar to BUPIVACAINE.Anesthesia, Local: A blocking of nerve conduction to a specific area by an injection of an anesthetic agent.Sufentanil: An opioid analgesic that is used as an adjunct in anesthesia, in balanced anesthesia, and as a primary anesthetic agent.Fentanyl: A potent narcotic analgesic, abuse of which leads to habituation or addiction. It is primarily a mu-opioid agonist. Fentanyl is also used as an adjunct to general anesthetics, and as an anesthetic for induction and maintenance. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1078)Anesthetics, Combined: The use of two or more chemicals simultaneously or sequentially to induce anesthesia. The drugs need not be in the same dosage form.Double-Blind Method: A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment.Adjuvants, Anesthesia: Agents that are administered in association with anesthetics to increase effectiveness, improve delivery, or decrease required dosage.Mepivacaine: A local anesthetic that is chemically related to BUPIVACAINE but pharmacologically related to LIDOCAINE. It is indicated for infiltration, nerve block, and epidural anesthesia. Mepivacaine is effective topically only in large doses and therefore should not be used by this route. (From AMA Drug Evaluations, 1994, p168)Injections, Spinal: Introduction of therapeutic agents into the spinal region using a needle and syringe.Cesarean Section: Extraction of the FETUS by means of abdominal HYSTEROTOMY.Carticaine: A thiophene-containing local anesthetic pharmacologically similar to MEPIVACAINE.Analgesics, Opioid: Compounds with activity like OPIATE ALKALOIDS, acting at OPIOID RECEPTORS. Properties include induction of ANALGESIA or NARCOSIS.Pain Measurement: Scales, questionnaires, tests, and other methods used to assess pain severity and duration in patients or experimental animals to aid in diagnosis, therapy, and physiological studies.Analgesia: Methods of PAIN relief that may be used with or in place of ANALGESICS.Stereoisomerism: The phenomenon whereby compounds whose molecules have the same number and kind of atoms and the same atomic arrangement, but differ in their spatial relationships. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 5th ed)Sensation: The process in which specialized SENSORY RECEPTOR CELLS transduce peripheral stimuli (physical or chemical) into NERVE IMPULSES which are then transmitted to the various sensory centers in the CENTRAL NERVOUS SYSTEM.Subarachnoid Space: The space between the arachnoid membrane and PIA MATER, filled with CEREBROSPINAL FLUID. It contains large blood vessels that supply the BRAIN and SPINAL CORD.Analgesia, Patient-Controlled: Relief of PAIN, without loss of CONSCIOUSNESS, through ANALGESIC AGENTS administered by the patients. It has been used successfully to control POSTOPERATIVE PAIN, during OBSTETRIC LABOR, after BURNS, and in TERMINAL CARE. The choice of agent, dose, and lockout interval greatly influence effectiveness. The potential for overdose can be minimized by combining small bolus doses with a mandatory interval between successive doses (lockout interval).Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle.Brachial Plexus: The large network of nerve fibers which distributes the innervation of the upper extremity. The brachial plexus extends from the neck into the axilla. In humans, the nerves of the plexus usually originate from the lower cervical and the first thoracic spinal cord segments (C5-C8 and T1), but variations are not uncommon.Labor, Obstetric: The repetitive uterine contraction during childbirth which is associated with the progressive dilation of the uterine cervix (CERVIX UTERI). Successful labor results in the expulsion of the FETUS and PLACENTA. Obstetric labor can be spontaneous or induced (LABOR, INDUCED).Dose-Response Relationship, Drug: The relationship between the dose of an administered drug and the response of the organism to the drug.Procaine: A local anesthetic of the ester type that has a slow onset and a short duration of action. It is mainly used for infiltration anesthesia, peripheral nerve block, and spinal block. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1016).Injections, Epidural: The injection of drugs, most often analgesics, into the spinal canal without puncturing the dura mater.Ambulatory Surgical Procedures: Surgery performed on an outpatient basis. It may be hospital-based or performed in an office or surgicenter.Pregnancy: The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.Prilocaine: A local anesthetic that is similar pharmacologically to LIDOCAINE. Currently, it is used most often for infiltration anesthesia in dentistry.Epinephrine: The active sympathomimetic hormone from the ADRENAL MEDULLA. It stimulates both the alpha- and beta- adrenergic systems, causes systemic VASOCONSTRICTION and gastrointestinal relaxation, stimulates the HEART, and dilates BRONCHI and cerebral vessels. It is used in ASTHMA and CARDIAC FAILURE and to delay absorption of local ANESTHETICS.Specific Gravity: The ratio of the density of a material to the density of some standard material, such as water or air, at a specified temperature.Sciatic Nerve: A nerve which originates in the lumbar and sacral spinal cord (L4 to S3) and supplies motor and sensory innervation to the lower extremity. The sciatic nerve, which is the main continuation of the sacral plexus, is the largest nerve in the body. It has two major branches, the TIBIAL NERVE and the PERONEAL NERVE.Thoracotomy: Surgical incision into the chest wall.Hernia, Inguinal: An abdominal hernia with an external bulge in the GROIN region. It can be classified by the location of herniation. Indirect inguinal hernias occur through the internal inguinal ring. Direct inguinal hernias occur through defects in the ABDOMINAL WALL (transversalis fascia) in Hesselbach's triangle. The former type is commonly seen in children and young adults; the latter in adults.Hydromorphone: An opioid analgesic made from MORPHINE and used mainly as an analgesic. It has a shorter duration of action than morphine.Hydrocodone: Narcotic analgesic related to CODEINE, but more potent and more addicting by weight. It is used also as cough suppressant.Albuterol: A short-acting beta-2 adrenergic agonist that is primarily used as a bronchodilator agent to treat ASTHMA. Albuterol is prepared as a racemic mixture of R(-) and S(+) stereoisomers. The stereospecific preparation of R(-) isomer of albuterol is referred to as levalbuterol.Oxymorphone: An opioid analgesic with actions and uses similar to those of MORPHINE, apart from an absence of cough suppressant activity. It is used in the treatment of moderate to severe pain, including pain in obstetrics. It may also be used as an adjunct to anesthesia. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1092)Androstadienes: Derivatives of the steroid androstane having two double bonds at any site in any of the rings.Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug.Anaphylaxis: An acute hypersensitivity reaction due to exposure to a previously encountered ANTIGEN. The reaction may include rapidly progressing URTICARIA, respiratory distress, vascular collapse, systemic SHOCK, and death.Speech Disorders: Acquired or developmental conditions marked by an impaired ability to comprehend or generate spoken forms of language.Postural Orthostatic Tachycardia Syndrome: A syndrome of ORTHOSTATIC INTOLERANCE combined with excessive upright TACHYCARDIA, and usually without associated ORTHOSTATIC HYPOTENSION. All variants have in common an excessively reduced venous return to the heart (central HYPOVOLEMIA) while upright.Dizziness: An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness.Nanospheres: Spherical particles of nanometer dimensions.Tremor: Cyclical movement of a body part that can represent either a physiologic process or a manifestation of disease. Intention or action tremor, a common manifestation of CEREBELLAR DISEASES, is aggravated by movement. In contrast, resting tremor is maximal when there is no attempt at voluntary movement, and occurs as a relatively frequent manifestation of PARKINSON DISEASE.

Dose-response effects of spinal neostigmine added to bupivacaine spinal anesthesia in volunteers. (1/1144)

BACKGROUND: Intrathecal adjuncts often are used to enhance small-dose spinal bupivacaine for ambulatory anesthesia. Neostigmine is a novel spinal analgesic that could be a useful adjunct, but no data exist to assess the effects of neostigmine on small-dose bupivacaine spinal anesthesia. METHODS: Eighteen volunteers received two bupivacaine spinal anesthetics (7.5 mg) in a randomized, double-blinded, crossover design. Dextrose, 5% (1 ml), was added to one spinal infusion and 6.25, 12.5, or 50 microg neostigmine in dextrose, 5%, was added to the other spinal. Sensory block was assessed with pinprick; by the duration of tolerance to electric stimulation equivalent to surgical incision at the pubis, knee, and ankle; and by the duration of tolerance to thigh tourniquet. Motor block at the quadriceps was assessed with surface electromyography. Side effects (nausea, vomiting, pruritus, and sedation) were noted. Hemodynamic and respiratory parameters were recorded every 5 min. Dose-response relations were assessed with analysis of variance, paired t tests, or Spearman rank correlation. RESULTS: The addition of 50 microg neostigmine significantly increased the duration of sensory and motor block and the time until discharge criteria were achieved. The addition of neostigmine produced dose-dependent nausea (33-67%) and vomiting (17-50%). Neostigmine at these doses had no effect on hemodynamic or respiratory parameters. CONCLUSIONS: The addition of 50 microg neostigmine prolonged the duration of sensory and motor block. However, high incidences of side effects and delayed recovery from anesthesia with the addition of 6.25 to 50 microg neostigmine may limit the clinical use of these doses for outpatient spinal anesthesia.  (+info)

A double-blind comparison of 0.125% ropivacaine with sufentanil and 0.125% bupivacaine with sufentanil for epidural labor analgesia. (2/1144)

BACKGROUND: This study intends to evaluate the benefits of the administration of intermittent bolus doses of ropivacaine (0.125%) compared with bupivacaine (0.125%) after addition of sufentanil for analgesia during labor. METHODS: One hundred thirty American Society of Anesthesiologists physical status 1 or 2 parturients were studied. The 90 initial patients were assigned randomly to receive 10 ml bupivacaine, 0.125%, plus 7.5 microg sufentanil (initial bupivacaine 0.125% group) or ropivacaine, 0.125%, plus 7.5 microg sufentanil (ropivacaine 0.125% group). Forty additional patients were recruited and received 0.125% bupivacaine plus 7.5 microg sufentanil (additional bupivacaine 0.125% group) or 0.100% bupivacaine plus 7.5 microg sufentanil (additional bupivacaine 0.100% group). The duration of analgesia, visual analogue scores for pain, motor blockade (using a six-point modified Bromage scale), patient satisfaction scores, nausea, pruritus, heart rate, and blood pressure were recorded. RESULTS: Bupivacaine 0.125% and ropivacaine 0.125% coadministered with sufentanil provided rapid and complete analgesia. Onset of analgesia occurred after +/-15 min and lasted +/-90 min. After the third epidural injection, patients in the ropivacaine group experienced significantly less severe motor blockade than patients in the initial bupivacaine 0.125% group. At this point, 93% of the patients in the ropivacaine group were free from motor impairment versus 66% in the bupivacaine group (P<0.05). Comparable levels of motor blockade were obtained in both additional groups. Patients' evaluation of their analgesia was worst in the bupivacaine 0.100% group. CONCLUSIONS: Ropivacaine 0.125% with sufentanil affords reliable analgesia with minimal motor blockade.  (+info)

Interaction of bupivacaine and tetracaine with the sarcoplasmic reticulum Ca2+ release channel of skeletal and cardiac muscles. (3/1144)

BACKGROUND: Although various local anesthetics can cause histologic damage to skeletal muscle when injected intramuscularly, bupivacaine appears to have an exceptionally high rate of myotoxicity. Research has suggested that an effect of bupivacaine on sarcoplasmic reticulum Ca2+ release is involved in its myotoxicity, but direct evidence is lacking. Furthermore, it is not known whether the toxicity depends on the unique chemical characteristics of bupivacaine and whether the toxicity is found only in skeletal muscle. METHODS: The authors studied the effects of bupivacaine and the similarly lipid-soluble local anesthetic, tetracaine, on the Ca2+ release channel-ryanodine receptor of sarcoplasmic reticulum in swine skeletal and cardiac muscle. [3H]Ryanodine binding was used to measure the activity of the Ca2+ release channel-ryanodine receptors in microsomes of both muscles. RESULTS: Bupivacaine enhanced (by two times at 5 mM) and inhibited (66% inhibition at 10 mM) [3H]ryanodine binding to skeletal muscle microsomes. In contrast, only inhibitory effects were observed with cardiac microsomes (about 3 mM for half-maximal inhibition). Tetracaine, which inhibits [3H]ryanodine binding to skeletal muscle microsomes, also inhibited [3H]ryanodine binding to cardiac muscle microsomes (half-maximal inhibition at 99 microM). CONCLUSIONS: Bupivacaine's ability to enhance Ca2+ release channel-ryanodine receptor activity of skeletal muscle sarcoplasmic reticulum most likely contributes to the myotoxicity of this local anesthetic. Thus, the pronounced myotoxicity of bupivacaine may be the result of this specific effect on Ca2+ release channel-ryanodine receptor superimposed on a nonspecific action on lipid bilayers to increase the Ca2+ permeability of sarcoplasmic reticulum membranes, an effect shared by all local anesthetics. The specific action of tetracaine to inhibit Ca2+ release channel-ryanodine receptor activity may in part counterbalance the nonspecific action, resulting in moderate myotoxicity.  (+info)

Effect of i.v. ketamine in combination with epidural bupivacaine or epidural morphine on postoperative pain and wound tenderness after renal surgery. (4/1144)

We studied 60 patients undergoing operation on the kidney with combined general and epidural anaesthesia, in a double-blind, randomized, controlled study. Patients were allocated to receive a preoperative bolus dose of ketamine 10 mg i.v., followed by an i.v. infusion of ketamine 10 mg h-1 for 48 h after operation, or placebo. During the first 24 h after surgery, all patients received 4 ml h-1 of epidural bupivacaine 2.5 mg ml-1. From 24 to 48 h after operation, patients received epidural morphine 0.2 mg h-1 preceded by a bolus dose of 2 mg. In addition, patient-controlled analgesia (PCA) with i.v. morphine (2.5 mg, lockout time 15 min) was offered from 0 to 48 h after operation. Patients who received ketamine felt significantly more sedated at 0-24 h, but not at 24-48 h after operation, compared with patients who received placebo (P = 0.002 and P = 0.127, respectively). There were no significant differences in pain (VAS) at rest, during mobilization or cough, PCA morphine consumption, sensory block to pinprick, pressure pain detection threshold assessed with an algometer, touch and pain detection thresholds assessed with von Frey hairs, peak flow or side effects other than sedation. The power of detecting a reduction in VAS scores of 20 mm in our study was 80% at the 5% significance level. We conclude that we were unable to demonstrate an (additive) analgesic or opioid sparing effect of ketamine 10 mg h-1 i.v. combined with epidural bupivacaine at 0-24 h, or epidural morphine at 24-48 h after renal surgery.  (+info)

Neonatal outcome and mode of delivery after epidural analgesia for labour with ropivacaine and bupivacaine: a prospective meta-analysis. (5/1144)

In this prospective meta-analysis, we have evaluated the effect of epidural analgesia with ropivacaine for pain in labour on neonatal outcome and mode of delivery compared with bupivacaine. In six randomized, double-blind studies, 403 labouring women, primigravidae and multiparae, received epidural analgesia with ropivacaine or bupivacaine 2.5 mg ml-1. The drugs were administered as intermittent boluses in four studies and by continuous infusion in two. Apgar scores, neurological and adaptive capacity scores (NACS), degree of motor block and mode of delivery were recorded. The studies were designed prospectively to fit meta-analysis of the pooled results. Results showed similar pain relief and consumption of the two drugs. In the vaginally delivered neonates, NACS scores were approximately equal for both groups at 2 h, but at 24 h there were fewer infants with NACS less than 35 in the ropivacaine compared with the bupivacaine group (2.8% vs 7.6%; P < 0.05). Spontaneous vaginal deliveries occurred more frequently overall with ropivacaine than with bupivacaine (58% vs 49%; P < 0.05) and instrumental deliveries (forceps and vacuum extraction) less frequently (27% vs 40%; P < 0.01), while the frequency of Caesarean section was similar between groups. The intensity of motor block was lower with ropivacaine. There were no significant differences in adverse events.  (+info)

Incidence of bradycardia during recovery from spinal anaesthesia: influence of patient position. (6/1144)

We administered 0.5% plain bupivacaine 4 ml intrathecally (L2-3 or L3-4) in three groups of 20 patients, according to the position in which they were nursed in the post-anaesthesia care unit (PACU): supine horizontal, 30 degrees Trendelenburg or hammock position (trunk and legs 30 degrees elevated). Patients were observed until anaesthesia descended to less than S1. The incidence of severe bradycardia (heart rate < 50 beat min-1) in the PACU was significantly higher in patients in the Trendelenburg position (60%) than in the horizontal (20%, P < 0.01) or hammock (10%, P < 0.005) position. After 90 min, following admission to the PACU, only patients in the hammock position did not have severe bradycardia. In this late phase, the incidence of severe bradycardia in the Trendelenburg group was 35% (P < 0.005) and 10% in patients in the supine horizontal position. In four patients, severe bradycardia first occurred later than 90 min after admission to the PACU. The latest occurrence of severe bradycardia was recorded 320 min after admission to the PACU. We conclude that for recovery from spinal anaesthesia, the Trendelenburg position should not be used and the hammock position is preferred.  (+info)

Balanced pre-emptive analgesia: does it work? A double-blind, controlled study in bilaterally symmetrical oral surgery. (7/1144)

We studied 32 patients undergoing bilateral symmetrical lower third molar surgery under general anaesthesia to determine if the combined effects of pre-emptive local anaesthetic block using 0.5% bupivacaine, together with i.v. tenoxicam and alfentanil had any benefits over postoperative administration. Patients acted as their own controls and were allocated randomly to have surgery start on one side, the second side always being the pre-emptive side. Difference in pain intensity between the two sides was determined using visual analogue scales completed by each individual at 6 h, and at 1, 3 and 6 days after operation. A long-form McGill pain questionnaire was also used to assess difference in pain intensity between the two sides on the morning after surgery. There was no significant difference in pain intensity at any time after surgery. Our findings indicate that the combined use of pre-emptive analgesia from 0.5% bupivacaine, tenoxicam and alfentanil did not reduce postoperative pain intensity in patients undergoing molar exodontia.  (+info)

Relative analgesic potencies of ropivacaine and bupivacaine for epidural analgesia in labor: implications for therapeutic indexes. (8/1144)

BACKGROUND: The minimum local analgesic concentration (MLAC) has been defined as the median effective local analgesic concentration in a 20-ml volume for epidural analgesia in the first stage of labor. The aim of this study was to assess the relative analgesic potencies of epidural bupivacaine and ropivacaine by determining their respective minimum local analgesic concentrations. METHODS: Seventy-three parturients at < or = 7 cm cervical dilation who requested epidural analgesia were allocated to one of two groups in this double-blinded, randomized, prospective study. After a lumbar epidural catheter was placed, 20 ml of the test solution was given, either ropivacaine (n = 34) or bupivacaine (n = 39). The concentration of local anesthetic was determined by the response of the previous patient in that group to a higher or lower concentration using up-down sequential allocation. Analgesic efficacy was assessed using 100-mm visual analog pain scores with < or = 10 mm within 30 min defined as effective. An effective result directed a 0.01% wt/vol decrement for the next patient. An ineffective result directed a 0.01% wt/vol increment. RESULTS: The minimum local analgesic concentration of ropivacaine was 0.111% wt/vol (95% confidence interval, 0.100-0.122), and the minimum local analgesic concentration of bupivacaine was 0.067% wt/vol (95% confidence interval, 0.052-0.082). Ropivacaine was significantly less potent than bupivacaine, with a potency ratio of 0.6 (95% confidence interval, 0.49-0.74). No difference in motor effects was observed. CONCLUSION: Ropivacaine was significantly less potent than bupivacaine for epidural analgesia in the first stage of labor.  (+info)

  • In practice 3 X 10 ml ampoules of bupivacaine 0.25 solution with adrenaline 1 200 000 are admixed with 3 X 10 ml ampoules of 1 ligno-caine to produce 3 X 20 ml. (ormedmedical.us)
  • However, cellular levels of p62 protein were significantly increased upon bupivacaine treatment (1.29 ± 0.15 vs. 1.00 ± 0.15), suggesting that the drug impaired autophagosome clearance. (sigmaaldrich.com)
  • Women received either 15 ml of 0.9% saline (n=42) or 15 ml of 0.5% bupivacaine (n=43), which was instilled intraperitoneally. (elsevier.com)
  • HTX-011, a fixed-dose combination of the local anesthetic bupivacaine with the nonsteroidal anti-inflammatory drug (NSAID) meloxicam being investigated for application into the surgical site to reduce postoperative pain and the need for opioid analgesics for 72 hours. (jspargo.com)
  • The recommended local anaesthetic agent is a mixture of bupivacaine and lignocaine with the addition of adrenaline 1 200 000. (ormedmedical.us)
  • The benefits of this mixture are the rapid onset of action of the lignocaine solution, the prolonged action of the bupivacaine and the possibility of reduced local haemorrhage with the addition of adrenaline. (ormedmedical.us)
  • abstract = "The aim of this randomised, double-blind, placebo-controlled trial was to evaluate the effectiveness of intraperitoneal instillation of bupivacaine following laparoscopy and dye test. (elsevier.com)
  • These findings suggest myocardial depression owing to bupivacaine sodium channel blocking of myocardial nerve and tissue and subsequent reduction of myocardial contractility. (mysciencework.com)
  • Comparison of the effects of continuous intrapleural vs epidural administration of 0.5% bupivacaine on pain, metabolic response and pulmonary function following cholecystectomy. (regionh.dk)
  • Motor blockade was observed between one and three hours in treatments using bupivacaine. (bmj.com)
  • Twenty patients undergoing elective cholecystectomy were prospectively randomised to receive either intrapleural (bolus 20 ml followed by 10 ml/h) or thoracic epidural (bolus 9 ml followed by 5 ml/h) bupivacaine 0.5% for 8 h postoperatively to assess the effect of these two techniques on pain, pulmonary function and the surgical stress response. (regionh.dk)
  • a lipid infusion such as propofol increases the dose of bupivacaine required to induce cardiac arrest, and, therefore, this strategy has been suggested as a potential means to improve outcomes from such toxicity. (lww.com)
  • The higher potency of R (+)-bupivacaine to block the inactivated state of the cardiac Na + channel may explain its higher toxicity because of the large contribution of the inactivated-state block during the plateau phase of the cardiac action potential. (ahajournals.org)
  • A serum bupivacaine concentration, obtained 2.5 hours after injection, was 0.76 mcg per mL, which is consistent with previous reports of bupivacaine toxicity 1 and higher than bupivacaine concentrations reported in older boys after circumcision. (aafp.org)
  • 6 This case exemplifies the principle that relatively small volumes of bupivacaine may result in local anesthetic toxicity. (aafp.org)
  • Acute bupivacaine toxicity as a result of venous leakage under the tourniquet cuff during a Bier block. (aafp.org)
  • GB suppressed bupivacaine-induced mitochondrial depolarization and mitochondria complex I and III inhibition and increased cleaved caspase-3 and Htra2 expression, which was strongly indicative of activation of mitochondria-dependent apoptosis with concomitantly enhanced expressions of Grp78, caspase-12 mRNA, protein, and ER stress. (hindawi.com)
  • Results published in Orthopedics showed similar efficacy between injectable liposomal bupivacaine and an interscalene brachial plexus block among patients who underwent total shoulder arthroplasty. (healio.com)
  • Patients and Methods: Fifty-six patients under- going elective forearm and hand surgery under supraclavicular brachial plexus block were allocated randomly into one of two groups of 28 patients each to receive either 25 ml (0.5%) bupivacaine with 1 ml of NS or 25 ml (0.5%) bupivacaine with 1 ml (20 mg) nalbuphine. (scirp.org)
  • A "heavy" solution (0.75% bupivacaine in 8.25% glucose) will provide the muscular relaxation required for abdominal surgery. (who.int)
  • An expanded recall was issued on August 29, 2013 for one lot of 0.75% Bupivacaine HCl Injection, USP (7.5 mg/mL), 30 mL Single-dose Vial (NDC 0409-1165-02). (asahq.org)
  • What are the possible side effects of bupivacaine? (cigna.com)
  • Bupivacaine is related chemically and pharmacologically to the amide-type local anesthetics. (rxlist.com)
  • Bupivacaine is an amide local anaesthetic used in hyperbaric and isobaric forms. (cochrane.org)
  • All local anesthetics contain three structural components: an aromatic ring, a connecting group which is either an ester (procaine) or an amide (bupivacaine), and an ionizable amine group. (statpearls.com)
  • This study aimed to evaluate the effect of liposomal bupivacaine infiltration on total amount of opioid use, incidence of AEs and length of stay (LOS) after minimally invasive (MIS) sigmoid coloctomy. (bmj.com)
  • Unsurprisingly, the researchers found that patients who received liposomal bupivacaine following complex cytoreductive surgery required significantly fewer doses of intravenous opioids during the first and second postoperative days than those whose pain was managed with bupivacaine HCl. (obgyn.net)
  • This prospective, randomized, clinical study was performed in 80 patients who were assigned to four groups to receive different doses of intrathecal hyperbaric bupivacaine (5 mg, 7.5 mg, 10 mg and 12.5 mg in Groups 1, 2, 3, and 4 respectively). (dovepress.com)
  • Unilateral sensory and motor block can be achieved with doses of 5 mg and 7.5 mg hyperbaric bupivacaine 0.5% with a stable hemodynamic state. (dovepress.com)
  • He received two 1-mL doses of 0.5% bupivacaine, spaced apart by two to three minutes. (aafp.org)
  • The primary objective of this randomised clinical study was to evaluate the frequency of unilateral block when different doses of hypobaric bupivacaine solution were used for single limb orthopaedic surgery. (thefreelibrary.com)
  • The proposed study aims to investigate the effect of three different doses of oral clonidine on subarachnoid block, anxiolysis, sedation, hemodynamic stability and their side effects, in patients undergoing surgeries below umbilicus in order to find out its optimum dose as a premedication agent with spinal anaesthesia Bupivacaine . (omicsonline.org)
  • Bupivacaine may be neurotoxic at high doses, activating p38 MAPK, increasing levels of ROS and WDR53, and inducing apoptosis in neuroblastoma cells. (lktlabs.com)
  • This Cochrane Review summarizes the best available evidence for the effectiveness and safety of the denser form of bupivacaine compared to the isobaric form when spinal anaesthesia (injection of medications into the lower back) is used for delivery of a baby by caesarean section. (cochrane.org)
  • We included all randomized controlled trials (RCTs) involving parturients undergoing spinal anaesthesia for elective caesarean section that compared the use of hyperbaric with isobaric bupivacaine. (cochrane.org)
  • Preoperative oral clonidine 4 μg kg-1 appears to be the optimum dose for optimization of spinal anaesthesia with bupivacaine as it prolongs the sensory block maximally with minimal side effects. (omicsonline.org)
  • Bupivacaine is the most common drug used in the spinal anaesthesia but its high dosage is associated with the increased incidence of hypotension [ 8 ]. (alliedacademies.org)
  • Bupivacaine is available as a generic medication and is not very expensive. (wikipedia.org)
  • Bupivacaine may also be used for purposes not listed in this medication guide. (cigna.com)
  • This is a research study testing SABER™-Bupivacaine (an experimental pain-relieving medication). (bioportfolio.com)
  • This is a research study of SABER® -Bupivacaine, an experimental medication designed to relieve pain up to 3 days after surgery. (bioportfolio.com)
  • This is an extension to a previous research trial testing SABER™-Bupivacaine (an experimental pain-relieving medication). (bioportfolio.com)
  • Bupivacaine added to liposomal bupivacaine addressed the delayed onset of this medication and gave an accurately matched comparison with the ropivacaine cocktail. (healio.com)
  • In the case of bupivacaine, there are no specific foods that you must exclude from your diet when receiving this medication. (rxwiki.com)
  • Conclusions Both the large level of pulse-dependent block and the failure of the pure inactivated-state block model indicate that bupivacaine interacts with the activated (or open) state of the cardiac sodium channel in addition to its block of the inactivated state. (ahajournals.org)
  • These data indicate that bupivacaine is not transported through the brain capillary wall, i.e., the blood-brain barrier, from the bovine albumin-bound pool, but bupivacaine is partially available for transfer from the circulating AAG-bound pool. (aspetjournals.org)
  • Different formulations of bupivacaine are not bioequivalent even if the milligram strength is the same. (rxlist.com)
  • see Non-Interchangeability with Other Formulations of Bupivacaine ]. (rxlist.com)
  • The aim of this randomised, double-blind, placebo-controlled trial was to evaluate the effectiveness of intraperitoneal instillation of bupivacaine following laparoscopy and dye test. (wiley.com)
  • In this study, we tried to solve this challenge by increasing the dose of bupivacaine to achieve a proper spinal level accompanied by prolonged sitting up to avoid hypotension. (nih.gov)
  • Most common complication was hypotension, detected in 16 (66.7%) levobupivacaine group patients and in 10 (43.5%) bupivacaine group patients (p = 0.11). (scielo.br)
  • These results implicate bupivacaine-induced ROS-dependent mitochondria, ER dysfunction, and apoptosis, which can be attenuated by GB through its antioxidant property. (hindawi.com)
  • For example, bupivacaine may inhibit mitochondrial respiratory complexes I and III, leading to decreased ATP production, collapse of the mitochondrial membrane potential (Δ ψ m), overproduction of reactive oxygen species (ROS), and ultimately liberation of cytochrome c and activation of the caspase-3-dependent apoptosis pathway [ 10 - 12 ]. (hindawi.com)
  • DRG was prepared from adult C57BL/6 mice and incubated with 10 mM bupivacaine in vitro to induce apoptosis. (ovid.com)
  • SiRNA-mediated TNF-α or TNF-R1 inhibition, but not TNF-R2 inhibition, rescued bupivacaine-induced DRG apoptosis. (ovid.com)
  • In other cellular models, bupivacaine induces depolarization of the mitochondrial membrane potential, resulting in apoptosis. (lktlabs.com)
  • Bupivacaine-induced apoptosis independently of WDR35 expression in mouse neuroblastoma Neuro2a cells. (lktlabs.com)
  • Bupivacaine induces apoptosis via mitochondria and p38 MAPK dependent pathways. (lktlabs.com)
  • Each vial contains bupivacaine at a nominal concentration of 13.3 mg/mL. (rxlist.com)
  • The novel delivery system contains bupivacaine within a carrier molecule that allows gradual release over an extended period. (healio.com)
  • patients treated with femoral nerve block used twice as much as those treated with bupivacaine. (medscape.com)
  • However, elderly patients are more likely to have low blood pressure or kidney problems, which may require caution and an adjustment in the dose for patients receiving bupivacaine injection. (mayoclinic.org)
  • We included 53 patients in this study whom were randomly divided into two groups, namely Group B and Group C. In Group B (25 patients), each patient received 3 mL of bupivacaine and left 5 min sitting up, whereas in Group C (28 patients), each patient received 2.5 mL of bupivacaine and was asked to lie supine immediately. (nih.gov)
  • High blood levels of bupivacaine must be avoided in patients with hepatic impairment. (who.int)
  • The objective of this study was to compare the block durations and haemodynamic effects associated with intrathecal levobupivacaine or bupivacaine in elderly patients undergoing transurethral prostate surgery. (biomedsearch.com)
  • Participated in this study 47 patients being 24 in the levobupivacaine group and 23 in the bupivacaine group. (scielo.br)
  • Using liposomal bupivacaine to control pain in patients after gynecological surgery reduced the amount of narcotics needed and may lead to faster recovery times, a recent study found. (obgyn.net)
  • During the first day following surgery, 21.5% of the patients treated with liposomal bupivacaine required opioids, while 46.9% of patients who received bupivacaine HCI were given opioids to control pain. (obgyn.net)
  • By day two, just 7.4% of patients treated with liposomal bupivacaine were given opioids compared with 27.2% in the other group. (obgyn.net)
  • RESULTS: Sixty-seven liposomal bupivacaine and 262 elastomeric bupivacaine pump patients were included. (ivteam.com)
  • Conclusion When added to an aggressive ERP, liposomal bupivacaine does not decrease the amount of total opioid consumption, the incidence of AEs or the LOS in patients undergoing MIS sigmoid resection. (bmj.com)
  • Among patients undergoing shoulder arthroplasty, liposomal bupivacaine was shown to provide better pain relief at 19 to 21 weeks post-surgery with fewer complications compared with continuous interscalene nerve block, according to research published in the Journal of Shoulder & Elbow Surgery . (clinicalpainadvisor.com)
  • In this prospective clinical trial, 70 patients undergoing shoulder arthroplasty were randomly assigned to receive continuous interscalene nerve block (n=36) or liposomal bupivacaine (n=34) with a single bolus interscalene block. (clinicalpainadvisor.com)
  • We performed real-time ultrasound guidance for infraorbital nerve blocks in TN patients using a high concentration of tetracaine dissolved in bupivacaine. (deepdyve.com)
  • All patients could not continue drug therapy with carbamazepine due to side effects and they received an ultrasound-guided infraorbital nerve block with a high concentration of tetracaine dissolved in bupivacaine.MethodsThe patient was placed in the supine position and the patient's face was sterilized and draped. (deepdyve.com)
  • However, elderly patients are more likely to have kidney or liver problems, which may require caution for patients receiving bupivacaine liposome injection. (findatopdoc.com)