Bupivacaine is used to provide prolonged anesthesia and postoperative analgesia. The human cytochrome P450 (CYP) involved in bupivacaine degradation into pipecolylxylidine (PPX), its major metabolite, has, to our knowledge, never been described. Microsome samples were prepared from six human livers and incubated in the presence of bupivacaine. The concentrations of PPX in the microsomal suspens...

BACKGROUND Information on molecular targets that may be involved in the neurotoxicity of bupivacaine is limited. Suppression of Kv3 channels has been demonstrated to result in abnormal patterns in the electroencephalogram and in seizures. Inhibition of Kv3 channels by bupivacaine may consequently contribute to its neuroexcitatory side-effects. Data on the effects of bupivacaine on these potassi...

introduction: tonsillectomy is one of the most common surgeries performed worldwide. post-operative pain arising from tonsillectomy is one of the earliest complications that can postpone oral nutrition and increase the hospitalization period. administration of opioids via injection is usually preferred to relive pain in these patients. however, the side effects of this approach prompted us to s...

Background: The use of large doses of opioid analgesics to treat pain after cardiac surgery can prolong the time to tracheal extubation and interfere with recovery of bowel and bladder function in the postoperative period. Therefore, the authors investigated the efficacy of a continuous infusion of bupivacaine 0.25% or 0.5%, at the median sternotomy site, for 48 h after cardiac surgery in reduc...

BACKGROUND Postoperative pain control after total shoulder arthroplasty (TSA) can be challenging. Liposomal bupivacaine and interscalene nerve block are 2 common pain control protocol for TSA patients. However, whether liposomal bupivacaine was superior than interscalene nerve block was unknown. This meta-analysis aimed to illustrate the efficacy liposomal bupivacaine versus interscalene nerve ...

Background: Different solutions are possible for thoracic epidural analgesia in cardiac surgery. So far, local anesthetics alone or in combination with either clonidine or opioids have been used. Aims: To determine the stress protection provided by different epidural solutions throughout cardiac surgery. Study Design: A randomized, prospective, double blind study in patients undergoing off-pump...

Adrenaline may decrease uterine blood flow and influence transplacental distribution of bupivacaine. Sixteen pregnant rabbits received an i.v. infusion of 0.125% bupivacaine either plain (n = 8) or with adrenaline 1.25 microgram ml-1. At 15-min intervals following the start of the infusion, rabbit fetuses were removed serially and bupivacaine concentrations measured in maternal arterial plasma,...