BACKGROUND Highly lipophilic local anesthetics interfere with mitochondrial energy metabolism. These metabolic effects could, in part, explain some toxic effects of local anesthetics, such as bupivacaine-induced myocardial depression. The purpose of this study was to compare the optically pure isomers of bupivacaine on heart mitochondrial bioenergetics. METHODS Both bupivacaine enantiomers we...

BACKGROUND Early studies suggested that ropivacaine had clinical advantages over bupivacaine with respect to cardiotoxicity and motor block, and that it was suitable for epidural caesarean section. This study was set up to compare epidural 0.75% ropivacaine with a popular bupivacaine/fentanyl mixture for elective caesarean section. METHODS Eighty women having elective caesarean section under ...

BACKGROUND Caudal epidural analgesia with bupivacaine is very popular in paediatric anaesthesia for providing intra- and postoperative analgesia. Several adjuvants have been used to prolong the action of bupivacaine. OBJECTIVES To compare the efficacy of ketamine, fentanyl and clonidine in terms of quality and duration of analgesia they produce when added with caudal bupivacaine by single sho...

BACKGROUND While lipid emulsion may reverse the systemic toxicity of bupivacaine, the pharmacokinetics and tissue distribution of bupivacaine after lipid emulsion infusion are not clear. In this study, we assessed the influence of lipid emulsion administration on the pharmacokinetics and tissue distribution of bupivacaine. METHODS Rats in the lipid group were administered IV bupivacaine at th...

BACKGROUND The control of postoperative pain is important in children, and poor pain control leads to organ dysfunction and behavioral problems. OBJECTIVES We compared the analgesic effects of suppository acetaminophen, bupivacaine wound infiltration, and caudal block with bupivacaine on postoperative pain in pediatric inguinal herniorrhaphy. PATIENTS AND METHODS In this double-blinded, ran...

BACKGROUND Dexamethasone has been studied as an effective adjuvant to prolong the analgesia duration of local anesthetics in peripheral nerve block. However, the route of action for dexamethasone and its potential neurotoxicity are still unclear. METHODS A mouse sciatic nerve block model was used. The sciatic nerve was injected with 60ul of combinations of various medications, including dexam...

We studied 20 patients undergoing thoracotomy, in a double-blind, placebo-controlled crossover trial of intercostal bupivacaine. Bupivacaine 0.25% was infused at 5 ml h-1 through each of two catheters placed in the intercostal space at operation. Mean (95% confidence limits) 24-h requirements for morphine from a patient-controlled analgesia device were 29 (22-37) mg during bupivacaine infusion ...

After one extradural injection of 0.25% bupivacaine 0.3 ml and 3H-bupivacaine 0.005 mCi in multilamellar liposomes, no systemic radioactivity (plasma, liver, heart muscle) was obtained for 1 h, and the labelling was less than that of systemic distribution of plain bupivacaine for the following 3 h. In contrast, radioactivity in the lumbar spinal nerves peaked in the first hour and remained high...

BACKGROUND Amitriptyline has been reported to be a more potent local anesthetic than bupivacaine. In keeping with the objective of identifying drugs for prolonged cutaneous analgesia, the authors compared the cutaneous analgesic effectiveness of amitriptyline and bupivacaine in rats. METHODS Rats were subcutaneously injected on shaved dorsal skin. The skin wheal raised after injection of 0.6 ...

BACKGROUND Animal models show us that specific activation of the p38 mitogen-activated protein kinase (MAPK) may be a pivotal step in lidocaine neurotoxicity, but this has not been investigated in the case of two very widely used local anesthetics, bupivacaine and ropivacaine. We investigated the hypotheses that these drugs (A) are less neurotoxic than the prototype local anesthetic, lidocaine ...