Neuraxial analgesia is frequently administered to women in labor. For many years, bupivacaine has been used because of its long duration of action, lack of excessive motor block, and minimal fetal and neonatal effects. However, bupivacaine is one of the most cardiotoxic local anesthetics in current use and motor block is still a problem. Many local anesthetics such as bupivacaine exist in 2 for...

In a randomized, double-blind study of 39 mothers in labour, we have compared a loading dose of 0.5% bupivacaine 6.0 ml and fentanyl 100 micrograms given extradurally, followed by an infusion of 0.08% bupivacaine 15 ml h-1 plus fentanyl 37.5 micrograms h-1, with a loading dose of 0.5% bupivacaine 6.0 ml and saline 2.0 ml, followed by an extradural infusion of 0.08% bupivacaine alone, per hour. ...

BACKGROUND Chondrolysis initiated by postoperative, intra-articular pain pumps has recently been described by multiple institutions. PURPOSE To evaluate the in vitro chondrotoxicity of anesthetic formulations commonly used in pain pumps. STUDY DESIGN Controlled laboratory study. METHODS Freshly isolated human articular chondrocytes were cultured for 24-, 48-, and 72-hour trials in a custo...

Currently, there is no consensus on how to determine the optimal dose of intrathecal bupivacaine for an individual undergoing an elective cesarean section. In this study, we developed a regression equation between intrathecal 0.5% hyperbaric bupivacaine volume and abdominal girth and vertebral column length, to determine a suitable block level (T5) for elective cesarean section patients.In phas...

OBJECTIVES To compare the efficacy of continuous extrapleural intercostal nerve block with bupivacaine 0.5% in 1:200,000 epinephrine and continuous lumbar epidural block with morphine in controlling post-thoracotomy pain and to measure serum bupivacaine concentrations during extrapleural infusion. DESIGN A prospective, randomized, controlled trial. SETTING St. Joseph's Hospital, Hamilton, O...

Background: Major abdominal surgery results in homodynamic instability mainly due to endogenous prostacyclin release, bleeding, major intercompartemental fluid shift and the hormonal surgical response. This study compared the effects of low thoracic epidural anesthesia with 0.125% and 0.25% bupivacaine on haemodynamic variables, sevoflurane requirements, and stress hormone responses during panc...

BACKGROUND Cardiovascular resuscitation upon intoxication with lipophilic ion channel-blocking agents has proven most difficult. Recently, favorable results have been reported when lipid rescue therapy is performed, i.e., the infusion of a triglyceride-rich lipid emulsion during resuscitation. However, the mechanism of action is poorly understood. METHODS The authors investigate the effects o...

The current study examined the possibility that high local anesthetic concentrations within the central nervous system could contribute to the toxic cardiovascular effects observed clinically after an accidental intravenous injection. Equal numbers of molecules of lidocaine (1.6 microliter of a 2% solution) and bupivacaine (1.0 microliter of a 4% solution) were injected at three vasomotor and c...

conclusions magnesium infiltration did not decrease total dose and number of episodes needed for morphine rescue analgesic. bupivacaine infiltration into surgical site was more effective than magnesium sulfate infiltration in postoperative pain control. objectives to compare postoperative analgesic effect of infiltration of magnesium versus bupivacaine into incision of inguinal hernia repair. p...