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Rogobete AF, Bedreag OH, Sărăndan M, Păpurică M, Preda G, Dumbuleu MC, Vernic C, Stoicescu ER, Săndesc D. Liposomal bupivacaine – New trends in Anesthesia and Intensive Care Units. EGYPTIAN JOURNAL OF ANAESTHESIA 2019. [DOI: 10.1016/j.egja.2014.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Alexandru Florin Rogobete
- Emergency County Hospital, Clinic of Anesthesia and Intensive Care , Bd. Iosif Bulbuca Nr. 10 , 300736 Timişoara, Romania
- “Victor Babeş” University of Medicine and Pharmacy, Faculty of Medicine , Piata E. Murgu 2 , 300041 Timişoara, Romania
- West University of Timişoara, Faculty of Chemistry, Biology, Geography , Str. Pestalozzi 16A , 300115 Timişoara, Romania
| | - Ovidiu Horea Bedreag
- Emergency County Hospital, Clinic of Anesthesia and Intensive Care , Bd. Iosif Bulbuca Nr. 10 , 300736 Timişoara, Romania
- “Victor Babeş” University of Medicine and Pharmacy, Faculty of Medicine , Piata E. Murgu 2 , 300041 Timişoara, Romania
| | - Mirela Sărăndan
- Emergency County Hospital, Clinic of Anesthesia and Intensive Care , Department Anesthesia and Intensive Care “Casa Austria” , Bd. Iosif Bulbuca Nr. 10 , 300736 Timişoara, Romania
| | - Marius Păpurică
- Emergency County Hospital, Clinic of Anesthesia and Intensive Care , Bd. Iosif Bulbuca Nr. 10 , 300736 Timişoara, Romania
- “Victor Babeş” University of Medicine and Pharmacy, Faculty of Medicine , Piata E. Murgu 2 , 300041 Timişoara, Romania
| | - Gabriela Preda
- West University of Timişoara, Faculty of Chemistry, Biology, Geography , Str. Pestalozzi 16A , 300115 Timişoara, Romania
| | - Maria Corina Dumbuleu
- Emergency County Hospital, Clinic of Anesthesia and Intensive Care , Bd. Iosif Bulbuca Nr. 10 , 300736 Timişoara, Romania
| | - Corina Vernic
- “Victor Babeş” University of Medicine and Pharmacy, Faculty of Medicine , Piata E. Murgu 2 , 300041 Timişoara, Romania
| | - Emil Robert Stoicescu
- “Victor Babeş” University of Medicine and Pharmacy, Faculty of Medicine , Piata E. Murgu 2 , 300041 Timişoara, Romania
| | - Dorel Săndesc
- Emergency County Hospital, Clinic of Anesthesia and Intensive Care , Bd. Iosif Bulbuca Nr. 10 , 300736 Timişoara, Romania
- “Victor Babeş” University of Medicine and Pharmacy, Faculty of Medicine , Piata E. Murgu 2 , 300041 Timişoara, Romania
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Bonfim MR, De Simone Melo M, Dreyer E, Borsoi LFA, de Oliveira TG, Udelsmann A. Lipid Therapy with Two Agents in Ropivacaine-Induced Toxicity: Experimental Study in Swine. Braz J Anesthesiol 2012; 62:685-95. [DOI: 10.1016/s0034-7094(12)70167-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Accepted: 12/09/2011] [Indexed: 11/26/2022] Open
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Tsuchiya H, Mizogami M, Shigemi K. Increasing Membrane Interactions of Local Anaesthetics as Hypothetic Mechanism for Their Cardiotoxicity Enhanced by Myocardial Ischaemia. Basic Clin Pharmacol Toxicol 2012; 111:303-8. [DOI: 10.1111/j.1742-7843.2012.00909.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Accepted: 05/23/2012] [Indexed: 11/28/2022]
Affiliation(s)
- Hironori Tsuchiya
- Department of Dental Basic Education; Asahi University School of Dentistry; Mizuho Japan
| | - Maki Mizogami
- Department of Anaesthesiology and Reanimatology; University of Fukui Faculty of Medical Sciences; Eiheiji-cho Japan
| | - Kenji Shigemi
- Department of Anaesthesiology and Reanimatology; University of Fukui Faculty of Medical Sciences; Eiheiji-cho Japan
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Tsuchiya H, Mizogami M, Ueno T, Shigemi K. Cardiotoxic Local Anesthetics Increasingly Interact with Biomimetic Membranes under Ischemia-Like Acidic Conditions. Biol Pharm Bull 2012; 35:988-92. [DOI: 10.1248/bpb.35.988] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Hironori Tsuchiya
- Department of Dental Basic Education, School of Dentistry, Asahi University
| | - Maki Mizogami
- Department of Anesthesiology and Reanimatology, Faculty of Medical Sciences, University of Fukui
| | - Takahiro Ueno
- Department of Anesthesiology, School of Dentistry, Asahi University
| | - Kenji Shigemi
- Department of Anesthesiology and Reanimatology, Faculty of Medical Sciences, University of Fukui
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Lipid emulsion for local anesthetic systemic toxicity. Anesthesiol Res Pract 2011; 2012:131784. [PMID: 21969824 PMCID: PMC3182561 DOI: 10.1155/2012/131784] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Accepted: 08/04/2011] [Indexed: 11/18/2022] Open
Abstract
The accidental overdose of local anesthetics may prove fatal. The commonly used amide local anesthetics have varying adverse effects on the myocardium, and beyond a certain dose all are capable of causing death. Local anesthetics are the most frequently used drugs amongst anesthetists and although uncommon, local anaesthetic systemic toxicity accounts for a high proportion of mortality, with local anaesthetic-induced cardiac arrest particularly resistant to standard resuscitation methods. Over the last decade, there has been convincing evidence of intravenous lipid emulsions as a rescue in local anesthetic-cardiotoxicity, and anesthetic organisations, over the globe have developed guidelines on the use of this drug. Despite this, awareness amongst practitioners appears to be lacking. All who use local anesthetics in their practice should have an appreciation of patients at high risk of toxicity, early symptoms and signs of toxicity, preventative measures when using local anesthetics, and the initial management of systemic toxicity with intravenous lipid emulsion. In this paper we intend to discuss the pharmacology and pathophysiology of local anesthetics and toxicity, and the rationale for lipid emulsion therapy.
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Zhu YM, Yuan ZY, Wu H, Zhou DD, Jing GX. Midazolam in rabbits terminates dysrhythmias caused by intracerebroventricular ropivacaine. J Zhejiang Univ Sci B 2011; 12:668-76. [PMID: 21796808 DOI: 10.1631/jzus.b1000337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The current study was designed to investigate the mechanisms by which ropivacaine may act within the central nervous system (CNS) to produce cardiotoxicity. Eighty New Zealand rabbits were divided into four groups randomly. In Group 1, 20 rabbits received intracerebroventricular (icv) saline, and then received icv ropivacaine 30 min later. In Group 2, 20 rabbits received icv ropivacaine. Whenever dysrhythmias continued for more than 5 min, 0.1 ml saline was administered into the left cerebral ventricle. Ten minutes later, 0.1 ml midazolam was given into the left lateral ventricle. In Group 3, 20 rabbits received icv ropivacaine, and once the dysrhythmias developed, the inspired isoflurane concentration was increased from 0.75% to 1.50%. In Group 4, 20 animals received an intravenous (iv) phenylephrine infusion until dysrhythmias occurred. In Group 1, the rabbits did not develop dysrhythmias in response to icv saline, whereas dysrhythmias did develop in these animals after icv ropivacaine. In Group 2, icv saline had no effect on the dysrhythmias; however, icv midazolam terminated cardiac dysrhythmias. In Group 3, an increase in the concentration of the inspired isoflurane had no effect on dysrhythmias. In Group 4, icv midazolam had no effect on dysrhythmias in response to iv phenylephrine. Ropivacaine administered directly into the CNS is capable of producing cardiac dysrhythmias; midazolam terminated dysrhythmias presumably by potentiation of γ-aminobutyric acid (GABA) receptor activity. Our results suggest that ropivacaine produces some of its cardiotoxicity not only by the direct cardiotoxicity of the drug, but also by the CNS effects of ropivacaine.
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Affiliation(s)
- Yao-Min Zhu
- Department of Anesthesiology, the First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an 710061, China.
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