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Kakade AN, Joshi SS, Naik CS, Mhatre BV, Ansari A. Clinical efficacy of 0.75% ropivacaine vs. 2% lignocaine hydrochloride with adrenaline (1:80,000) in patients undergoing removal of bilateral maxillary third molars: a randomized controlled trial. J Dent Anesth Pain Med 2021; 21:451-459. [PMID: 34703894 PMCID: PMC8520834 DOI: 10.17245/jdapm.2021.21.5.451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/25/2021] [Accepted: 08/27/2021] [Indexed: 11/15/2022] Open
Abstract
Background Lignocaine with adrenaline is routinely used as a local anesthetic for dental procedures. Adrenaline was added to increase the duration of anesthesia. However, epinephrine containing a local anesthetic solution is not recommended in conditions such as advanced cardiovascular diseases and hyperthyroidism. Recently, ropivacaine has gained popularity as a long-acting anesthetic with superior outcomes. The goal of this study was to assess and compare the effectiveness of 0.75% ropivacaine alone and 2% lignocaine with adrenaline (1:80,000) in the removal of bilateral maxillary wisdom teeth using the posterior superior alveolar nerve block technique. Methods This was a single-blind, randomized, split-mouth, prospective study assessing 15 systemically sound outpatients who needed bilateral removal of maxillary third molars. We randomly allocated the sides and sequences of ropivacaine and lignocaine with adrenaline administration. We evaluated the efficacy of both anesthetics with regard to the onset of anesthesia, intensity of pain, variation in heart rate, and blood pressure. Results The onset of anesthesia was faster with lignocaine (138 s) than with ropivacaine (168 s), with insignificant differences (p = 0.001). There was no need for additional local anesthetics in the ropivacaine group, while in the lignocaine with adrenaline group, 2 (13.3%) patients required additional anesthesia. Adequate intraoperative anesthesia was provided by ropivacaine and lignocaine solutions. No significant difference was observed in the perioperative variation in blood pressure and heart rate. Conclusion Ropivacaine (0.75%) is a safe and an adrenaline-free local anesthetic option for posterior superior alveolar nerve block, which provides adequate intraoperative anesthesia and a stable hemodynamic profile for the removal of the maxillary third molar.
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Affiliation(s)
- Aniket Narayan Kakade
- Department of Oral and Maxillofacial Surgery, Terna Dental College, Navi Mumbai, Maharashtra, India
| | - Sanjay S Joshi
- Department of Oral and Maxillofacial Surgery, Terna Dental College, Navi Mumbai, Maharashtra, India
| | - Charudatta Shridhar Naik
- Department of Oral and Maxillofacial Surgery, Terna Dental College, Navi Mumbai, Maharashtra, India
| | - Bhupendra Vilas Mhatre
- Department of Oral and Maxillofacial Surgery, Terna Dental College, Navi Mumbai, Maharashtra, India
| | - Arsalan Ansari
- Department of Oral and Maxillofacial Surgery, Terna Dental College, Navi Mumbai, Maharashtra, India
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Rajpari KN, Andrade NN, Nikalje T. Comparison of anaesthetic efficacy of ropivacaine (0.75% & 0.5%) with 2% lignocaine with adrenaline (1:200000) in surgical extraction of bilateral mandibular 3 rd molars using IANB:a prospective, randomized, single blind study. J Oral Biol Craniofac Res 2021; 11:263-268. [PMID: 33717864 DOI: 10.1016/j.jobcr.2021.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 02/03/2021] [Indexed: 10/22/2022] Open
Abstract
Aim To evaluate and compare the anaesthetic efficacy of 0.75% ropivacaine and 0.5% ropivacaine with 2% lignocaine with 1:200000 Adrenaline (LWA) for surgical extraction of bilateral mandibular 3rd molars using Direct inferior alveolar nerve block (IANB). Material and methods Total of 60 outpatients of both sex,age group of 18-40 included in a prospective, randomized, single blind, split mouth clinical study after satisfying inclusion and exclusion criteria. Group I includes 30 patients and 0.75% ropivacaine as test drug, Group II includes 30 patients and 0.5% ropivacaine as test drug. In both group control drug was LWA.Parameters measured were onset of action, duration of action, systolic blood pressure, diastolic blood pressure, heart rate, visual analogue scale (VAS), faces pain scale (FPS). Result Onset of action of 0.75%/0.5% ropivacaine (101.84 ± 16.92 secs/113.03 ± 12.77 sec) was faster than LWA (Group I-218 ± 21.51 secs, Group II-196.47 ± 26.27 secs). Duration of action of 0.75%/0.5% ropivacaine (343.55 ± 16.44 mins/319.03 ± 19.30 mins) was longer than 2% Lignocaine with 1:200000 adrenaline (Group I I-173 ± 16.86 mins, Group II-175.20 ± 18.02 mins). In Group I - VAS/FPS of 0.75% Ropivacaine (0.97 ± 0.54/1.32 ± 0.65) was significantly lower as compared to LWA (2.90 ± 0.83/3.29 ± 0.69). In group II-VAS/FPS of 0.5% ropivacaine (1.40 ± 0.72/1.47 ± 0.50) was lower as compared to LWA (3.40 ± 0.89/3.30 ± 0.87). Mean systolic blood pressure, diastolic blood pressure, heart rate was lower for ropivacaine (0.75%, 0.5%) than LWA except mean heart rate higher for 0.75% ropivacaine at 10 min after injection. Else mean heart rate lower in other time interval. Conclusion Ropivacaine (0.75%,0.5%) was more efficacious than 2% lignocaine with adrenaline (1:200000) it terms of all measured parameters in study.
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Affiliation(s)
- Kamil N Rajpari
- Dept of Oral and Maxillofacial Surgery, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Neelam N Andrade
- Dept of Oral and Maxillofacial Surgery, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Trupti Nikalje
- Dept of Oral and Maxillofacial Surgery, Nair Hospital Dental College, Mumbai, Maharashtra, India
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Senthilkumar V, Ramesh S. Comparative evaluation of ropivacaine and lidocaine as dental pulp anaesthesia. Bioinformation 2021; 17:229-239. [PMID: 34393442 PMCID: PMC8340712 DOI: 10.6026/97320630017229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/15/2021] [Accepted: 01/26/2021] [Indexed: 11/23/2022] Open
Abstract
Root canal therapy linked to pulpal diseases or trauma is common in modern dental care. The 2% Lidocaine which is considered as the gold standard has some drawbacks in pulpal anaesthesia. Ropivacaine has beneficial anaesthetic effects on pulpal anaesthesia.
Therefore, it is of interest to compare and evaluate the pulpal aesthetic effect using 0.5% Ropivacaine and 2% Lidocaine in symptomatic irreversible pulpitis. A double blinded randomized controlled clinical trial consisting of 110 lower molar and premolar tooth
with irreversible pulpitis cases for root canal therapy were selected and randomly divided into 2 groups. Group A: 2% lidocaine with epinephrine and Group B: 0.5% ropivacaine. The pulp sensibility tests with heat test, cold test and electric pulp test were completed.
The preoperative pain score was measured with Visual Analogue Scale (VAS) pain scale. The classical inferior alveolar nerve block (IANB) technique was administered to all patients by a single operator. Subjects were asked for lip numbness and presence or absence
of lip numbness. Postoperative pain scores were recorded during access opening and on placing files in the canal. There is no statistical difference between the groups during pre operative conditions. The mean pain scores within group A and group B is recorded.
The difference was found to be statistically significant with p value ≤ 0.05. Significant difference between the mean values after and before the treatment is observed. However, there is no statistical significance between the mean pain scores between the access
and pulp. The 0.5% Ropivacaine and 2% Lidocaine with epinephrine does not have any significant difference during access opening. However, 0.5% Ropivacaine groups were effective while placing the file in the canal. Thus, 0.5% Ropivacaine showed better results even
though it was not statistically significant for further consideration in this context.
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Affiliation(s)
- Vijayapriyangha Senthilkumar
- Postgraduate Student, Department of Conservative Dentistry and Endodontics Saveetha Dental College, Saveetha Institute Of Medical And Technical Science Chennai, India
| | - Sindhu Ramesh
- Postgraduate Student, Department of Conservative Dentistry and Endodontics Saveetha Dental College, Saveetha Institute Of Medical And Technical Science Chennai, India
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Tijanic M, Buric N. A randomized anesthethic potency comparison between ropivacaine and bupivacaine on the perioperative regional anesthesia in lower third molar surgery. J Craniomaxillofac Surg 2019; 47:1652-1660. [DOI: 10.1016/j.jcms.2019.07.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 07/08/2019] [Accepted: 07/14/2019] [Indexed: 11/16/2022] Open
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Efficacy and safety of 1% ropivacaine for postoperative analgesia after lower third molar surgery: a prospective, randomized, double-blinded clinical study. Clin Oral Investig 2016; 21:779-785. [PMID: 27114091 DOI: 10.1007/s00784-016-1831-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 04/17/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate postoperative analgesic effect of ropivacaine administered as main or supplemental injection for the inferior alveolar nerve block (IANB) in patients undergoing lower third molar surgery. MATERIALS AND METHODS The double-blind randomized study comprised 72 healthy patients. All patients received two blocks, the IANB for surgical procedure + IANB after surgery for postoperative pain control, and were divided into three groups: (1) 2 % lidocaine/epinephrine + 1 % ropivacaine, (2) 2 % lidocaine/epinephrine + saline, and (3) 1 % ropivacaine + saline. The occurrence of postoperative pain, pain intensity and analgesic requirements were recorded. Data were statistically analyzed using chi-square, Fisher, and Kruskal-Wallis tests and analysis of variance (ANOVA) with Bonferroni and Tukey correction. RESULTS Ropivacaine was more successful than lidocaine/epinephrine in obtaining duration of postoperative analgesia, reduction of pain, and analgesic requirements whether ropivacaine was used for surgical block or administered as a supplemental injection after surgery. CONCLUSIONS Ropivacaine (1 %, 2 ml) resulted in effective postoperative analgesia after lower third molar surgery. CLINICAL RELEVANCE Since pain control related to third molar surgery requires the effective surgical anesthesia and postoperative analgesia, the use of 1 % ropivacaine could be clinically relevant in a selection of appropriate pain control regimen for both surgical procedure and early postsurgical treatment.
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Comparison of Ropivacaine 0.75 % and Lignocaine 2 % with 1:200,000 Adrenaline in Dental Extractions: Single Blind Clinical Trial. J Maxillofac Oral Surg 2016; 17:201-206. [PMID: 29618887 DOI: 10.1007/s12663-016-0902-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 03/21/2016] [Indexed: 10/21/2022] Open
Abstract
Introduction The aim of this study was to evaluate the efficacy, safety and clinical acceptability of the local anaesthetic agent ropivacaine 0.75 % in comparison with lignocaine 2 % with adrenaline 1:200,000 in minor oral surgical procedures. Methods Forty-seven patients, who required bilateral extractions in a single arch, were included in this study. One hundred and sixty-six extractions were performed and all the patients were administered nerve blocks/infiltration. Pre and postoperative pulse, blood pressure, random blood sugar, electrocardiogram and partial oxygen pressure were recorded at specified time intervals. Pain score by visual analogue scale, onset of action and depth of anesthesia were also observed. Duration of anaesthesia was assessed by feeling of numbness and first sign of pain. Results Statistical analysis revealed insignificant difference between both the groups in terms of pulse, blood pressure, random blood sugar, and partial oxygen pressure. The depth of anesthesia was evaluated by pain, comfort during the procedure with visual analog scale and showed no significant difference between the two groups. The onset of action for maxillary infiltration was 33.29 ± 9.2 (ropivacaine), 32.12 ± 6.8 s (2 % lignocaine with adrenaline 1:200,000) and for pterygomandibular nerve block was 181.0 ± 87.5 (ropivacaine), 32.12 ± 6.8 s (2 % lignocaine with adrenaline 1:200,000). Duration of anesthesia when compared was 411.7 ± 66.11 min (ropivacaine) and 107.87 ± 16.54 (2 % lignocaine with adrenaline 1:200,000). On maxillary buccal vestibule infiltration it was also observed that in ropivacaine group there was no requirement of palatal infiltration suggestive of good diffusion property. Conclusion Ropivacaine is a safe, clinically acceptable long acting local anaesthetic agent with added advantage of effective diffusion property. Ethical Committee Approval Number SDC/MISC/2013/239.
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Budharapu A, Sinha R, Uppada UK, Subramanya Kumar AVSS. Ropivacaine: a new local anaesthetic agent in maxillofacial surgery. Br J Oral Maxillofac Surg 2015; 53:451-4. [PMID: 25818492 DOI: 10.1016/j.bjoms.2015.02.021] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 02/28/2015] [Indexed: 11/26/2022]
Abstract
We have compared the anaesthetic efficacy, duration of action, pain, pulpal anaesthesia, and cardiovascular effects of 0.5% ropivacaine or 2% lignocaine hydrochloride in bilateral symmetrical impacted third molars. In a randomised single-blind trial we studied 78 healthy patients who required bilateral extraction of identical impacted lower third molars. A test dose was given to all patients with subdermal infiltration of 0.5% ropivacaine 0.5 ml. A classic inferior alveolar and long buccal nerve block was created using 0.5% ropivacaine 2 ml on one side and 2% lignocaine hydrochloride 2 ml with adrenaline on the other. The time to onset and duration of action were noted. Pain, numbness of the lip and tip of the tongue, and haemodynamic changes were monitored throughout the procedure. The teeth were extracted two weeks apart. The onset of anaesthesia ranged between 2 and 3 min after the injection and lasted for more than 5h. Ropivacaine alone did not cause appreciable changes in the cardiovascular variables, but lignocaine with adrenaline caused a transient increase in arterial pressure and heart rate 2 min after injection. We conclude the 0.5% ropivacaine alone does not affect the cardiovascular system and has more beneficial effects than 2% lignocaine hydrochloride with adrenaline. These findings may be useful for oral and maxillofacial surgeons who are looking for a local anaesthetic with minimal cardiovascular risk and without a vasoconstrictor to provide regional anaesthesia for long procedures.
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Affiliation(s)
- A Budharapu
- Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, India.
| | - R Sinha
- Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, India
| | - U K Uppada
- Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, India
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Giovannitti JA, Rosenberg MB, Phero JC. Pharmacology of local anesthetics used in oral surgery. Oral Maxillofac Surg Clin North Am 2013; 25:453-65, vi. [PMID: 23660127 DOI: 10.1016/j.coms.2013.03.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This article provides a comprehensive review of the pharmacology of local anesthetics as a class, and provides details of the individual drugs available in dental cartridges. Maximum recommended doses of local anesthetics and vasoconstrictors are presented for healthy adult and pediatric patients, and for patients with cardiovascular system impairments. Various complications and reasons for failure of local anesthesia effectiveness are discussed, and current and future trends in local anesthesia are presented to provide an overview of current research in local anesthesia.
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Affiliation(s)
- Joseph A Giovannitti
- Department of Dental Anesthesiology, Center for Patients with Special Needs, University of Pittsburgh School of Dental Medicine, 3501 Terrace Street, G-89 Salk Hall, Pittsburgh, PA 15261, USA.
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Franz-Montan M, de Paula E, Groppo F, Ranali J, Volpato M. Efficacy of liposome-encapsulated 0.5% ropivacaine in maxillary dental anaesthesia. Br J Oral Maxillofac Surg 2012; 50:454-8. [DOI: 10.1016/j.bjoms.2011.07.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2011] [Accepted: 07/14/2011] [Indexed: 11/30/2022]
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Krzemiński TF, Gilowski L, Wiench R, Płocica I, Kondzielnik P, Sielańczyk A. Comparison of ropivacaine and articaine with epinephrine for infiltration anaesthesia in dentistry - a randomized study. Int Endod J 2011; 44:746-51. [PMID: 21470248 DOI: 10.1111/j.1365-2591.2011.01881.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AIM To compare the efficacy, onset time and duration of maxillary infiltration anaesthesia with 0.5% plain ropivacaine or 4% articaine with epinephrine 1 : 100 000 and to determine their possible influence on cardiovascular parameters. METHODOLOGY Sixty volunteers received 1.8 mL of the anaesthetic for buccal infiltration anaesthesia of maxillary central and lateral incisors and canine teeth without caries, restorations or signs of pulpitis. The efficacy, onset time and duration of pulp anaesthesia were assessed with an electric pulp tester. The duration of numbness of the upper lip was also monitored. Blood pressure and heart rate were measured before and after administration of the solutions. RESULTS The efficacy of anaesthesia of lateral and central incisors was 100% for both anaesthetics. There were insignificant differences in effectiveness of canine pulp anaesthesia. The mean onset time was significantly (P < 0.05) shorter for ropivacaine (2.22 min) when compared with articaine (4.08 min). The duration of action and soft tissue anaesthesia were also significantly (P < 0.05) longer for ropivacaine (79.2 and 264 min) when compared with articaine (63.7 and 195.2 min, respectively). Ropivacaine caused significant (P < 0.05) increases in blood pressure and heart rate. CONCLUSIONS Ropivacaine (0.5%) achieved effective and long duration of uninflamed pulp and soft tissue anaesthesia. Ropivacaine could be useful for long-lasting operative procedures without the need for a vasoconstrictor.
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Affiliation(s)
- T F Krzemiński
- Chair and Department of Pharmacology, Medical University of Silesia, Zabrze, Poland
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[Evaluation of anesthetic effect of ropivacaine in surgery of chronic periapical lessions]. ACTA ACUST UNITED AC 2010; 63:366-70. [PMID: 21186548 DOI: 10.2298/mpns1006366t] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Ropivacaine is used in orthopedcs, gyneacology, surgery, ophtamology, whereas experience about its usage in dentistry is still limited. The aim of this research was to compare the anesthetic effect between local anesthetics ropivacaine and bupivacaine, in surgical disposals of chronical periapical lessions in maxilla. MATERIAL AND METHODS The study included the patients that had indications for surgical removal of chronical periapical lessions at one of the frontal teeth of upper jaw. The total total number of examinees was 60, and they were devided in two groups. Ropivacaine chloride (0.75%) was used as a local anesthetic in one group (Naropin 0.75%; Astra Zeneca), and in the other one bupivacaine chloride (0.5%) (Vexelit 0.5%; Zdravlje). The authors applied 1.8 ml of block anesthesia for the n. infraorbitalis (intra-oral approach) as well as 0.2 ml of the local anesthetic from the palatine side for the final branches of N. nasopalatinus in order to observe the following anesthetic parameters. (I) Beginning of anesthesia was followed by the appearence of upper lip numbness. (II) Pain rating scale according to Sisk was used for the objective measurement of the anesthesia quality. (III) The pain intensity during the intervention was measured by visual analogous scale, on which the patient denoted the intensity of pain he had felt during the intervention. (IV) Duration of anesthetic effect--it is followed by soft tissues numbness. RESULTS AND DISCUSSION After the ropivacaine application anesthesia effect started in 1.57 min. and after the usage of bupivacaine in 1.67 min. The mean duration of soft tissue numbness after the application of ropivacaine was 321 minutes. Bupivacaine had a shorter anesthetic effect--296.5 minutes. The quality of anesthesia after the usage of ropivacaine was assessed by the surgeons with average mark--1.76. Interventions in which this anesthetic was used were performed with minimal pain and without additional anesthesia. The quality of anesthesia after the usage of bupivacaine (3.03) was statistically much worse (p < 0.01) in comparison to ropivacaine. In visual analogous scale where patients denoted the intensity of pain during the intervention with ropivacaine the marked average value was 30.1 mm while the average value with usage of bupivacaine was 41.7 mm. The patients from the control group, where bupivacaine was used, had much stronger pain, statistically significant (p < 0.05) in comparison to the group where ropivacaine was used. Our results show that the quality of anesthesia that was attained with 0.5% bupivacaine was much worse than the quality of anesthesia after the application of 0.75% ropivacaine. CONCLUSION Ropivacaine has a potential to replace bupivacaine completely in cases when there is the indication for its usage in oral surgery (longlasting intervention, interventions followed by intensive postoperational pain, nerve blockade).
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Charlet A, Rodeau JL, Poisbeau P. Radiotelemetric and symptomatic evaluation of pain in the rat after laparotomy: long-term benefits of perioperative ropivacaine care. THE JOURNAL OF PAIN 2010; 12:246-56. [PMID: 20840888 DOI: 10.1016/j.jpain.2010.07.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2010] [Revised: 06/22/2010] [Accepted: 07/10/2010] [Indexed: 11/25/2022]
Abstract
UNLABELLED Effective relief of acute and long-term postoperative pain is of utmost importance to patients undergoing surgery. Here, we worked on a controlled procedure of abdominal surgery in the rat inducing persistent postoperative pain symptoms for up to 10 days and tested the efficacy of perioperative care with the local anesthetic ropivacaine. Laparotomy was likewise used to implant radiotelemetric probes by which electrocardiogram, body temperature, and locomotor activity were recorded in freely moving animals. We showed that postoperative pain symptoms (mechanical allodynia) measured in periphery of the scar were associated over time with persistent tachycardia, elevated heart rate variability, and loss of mobility. Furthermore, a single subcutaneous infiltration of the local anesthetic ropivacaine in the periphery of the abdominal incision was sufficient to prevent the appearance of allodynia and the associated cardiac and motor signs of pain, monitored by radiotelemetry. These beneficial effects were observed when the infiltration was performed in the perioperative period, but not later. This study on freely moving animals exhibiting long-lasting postoperative pain symptoms and altered autonomic/motor function illustrates well the importance of the timing of preemptive analgesia care with long-acting local anesthetics. Moreover, it emphasizes the utility of monitoring heart rate variability to quantify spontaneous expression of long-lasting postoperative pain. PERSPECTIVE Speeding the recovery time after surgery using perioperative ropivacaine care is of significant clinical relevance because it might limit the risk of chronic pain and postoperative complications. In humans, chronobiological analysis of heart rate variability could also help quantify spontaneous pain expression with minimal emotional bias.
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Affiliation(s)
- Alexandre Charlet
- Centre National de la Recherche Scientifique, Institut des Neurosciences Cellulaires et Intégratives, Unité Propre de Recherche 3212, Nociception and Pain Department, Strasbourg, France
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Tsirlis A, Karanikola T, Dabarakis N, Liverdos K, Charisi M. Comparative in vitro Study of Relative Anesthetic Potency of Ropivacaine and Lidocaine. ACTA ACUST UNITED AC 2010. [DOI: 10.3923/rjpharm.2010.1.4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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MacMahon PJ, Eustace SJ, Kavanagh EC. Injectable corticosteroid and local anesthetic preparations: a review for radiologists. Radiology 2009; 252:647-61. [PMID: 19717750 DOI: 10.1148/radiol.2523081929] [Citation(s) in RCA: 146] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Corticosteroids and local anesthetics are some of the most commonly administered medications in radiology departments. These medications have marked variability in their formulations, which may increase their adverse event profile for specific procedures. In particular, certain corticosteroid preparations are associated with adverse central nervous system (CNS) sequelae. This is most likely due to distal embolization by particulate formulations. Nonparticulate steroid formulations are not associated with such events. Local anesthetics have severe CNS and cardiac adverse effects if injected intravascularly and have recently been associated with intraarticular chondrolysis if used in large doses. This review discusses these medications with particular emphasis on their established and postulated adverse effects. The administering radiologist should be aware of these potential effects and how best to reduce their occurrence.
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Affiliation(s)
- Peter J MacMahon
- Department of Radiology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland.
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Timponi CF, Oliveira NE, Arruda RMP, Meyrelles SS, Vasquez EC. Effects of the Local Anaesthetic Ropivacaine on Vascular Reactivity in the Mouse Perfused Mesenteric Arteries. Basic Clin Pharmacol Toxicol 2006; 98:518-20. [PMID: 16635112 DOI: 10.1111/j.1742-7843.2006.pto_397.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Previous clinical and experimental studies have indicated that ropivacaine, a local anaesthetic agent, exerts vasoconstrictor effects. In this study, the contractile effects of ropivacaine were investigated in vitro on mesenteric arteriolar beds obtained from 22 adult male C57BL/6J mice. The mesenteric arteriolar bed was perfused at constant rate (2 ml/min.) with oxygenated physiological salt solution using a roller pump. First we studied the effects of ropivacaine (3.2x10(-4) to 2.2x10(-2) mol/l) on the perfusion pressure and observed a dose-dependent pressor response, reaching a maximal increase of 26.0+/-3.7 mmHg. In a second study, we observed that after the mechanical removal of the endothelium ropivacaine-induced contractile responses were significantly reduced to a maximal of 13.5+/-0.7 mmHg. In a third set of experiments, we observed that under the effect of the cyclooxygenase inhibitor indomethacin (0.01 micromol/l) the ropivacaine-induced pressor response was significantly reduced to a maximal increase of 17.5+/-0.4 mmHg. This is the first evidence that this long-acting local anesthetic causes vasoconstriction in the perfused mesenteric arteriolar bed and that, at least in part, this effect is mediated by the endothelium since the cyclooxygenase inhibitor indomethacin reduced the ropivacaine-induced vasoconstriction to approximately 50%.
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Affiliation(s)
- Clarisse F Timponi
- Laboratory of Transgenes and Cardiovascular Control, Physiological Sciences Graduate Program, Biomedical Center, Federal University of Espirito Santo, Vitoria, ES, Brazil
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