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Herlofson EAG, Tavola F, Engdahl KS, Bergström AF. Evaluation of primary wound healing and potential complications after perioperative infiltration with lidocaine without adrenaline in surgical incisions in dogs and cats. Acta Vet Scand 2023; 65:21. [PMID: 37312211 DOI: 10.1186/s13028-023-00686-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/03/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Pre-emptive local analgesia with the use of lidocaine is practised increasingly in veterinary medicine as part of applied multimodal analgesia, despite its controversial impact on wound healing. The purpose of this prospective, randomised, double-blinded, placebo-controlled clinical study was to evaluate if preoperative subcutaneous infiltration of lidocaine has a negative impact on primary wound healing of surgical incisions. Fifty-two companion animals (3 cats and 49 dogs) were enrolled in the study. The inclusion criteria were as follows: American Society of Anaesthesiologists (ASA) score I or II, a minimum body weight of 5 kg, and a planned incisional length of at least 4 cm. Surgical incisions were infiltrated subcutaneously with lidocaine without adrenaline or NaCl (placebo). Follow-up questionnaires for owners and veterinarians and thermography of the surgical wound were used to assess wound healing. Antimicrobial use was documented. RESULTS There was no significant difference in either the total score or the individual assessment points between the treatment and the placebo group on the owner or the veterinary questionnaires in regard to primary wound healing (P > 0.05 for all comparisons). No significant difference was found between the thermography results of the treatment and placebo group (P = 0.78), and there was no significant correlation between the total score from the veterinary protocol and thermography results (Spearman's correlation coefficient - 0.10, P = 0.51). Surgical site infections developed in 5/53 (9.4%) surgeries and its occurrence varied significantly between the treatment and the placebo group as all cases of infection were in the placebo group (P = 0.05). CONCLUSION The results of this study indicate that lidocaine used as a local anaesthetic did not affect wound healing in patients with ASA scores I-II. The results suggest that lidocaine infiltration in surgical incisions can be safely used to reduce pain.
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Affiliation(s)
- Erica Anna Gumpert Herlofson
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | | | - Karolina Siri Engdahl
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden.
| | - Annika Filippa Bergström
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
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Novel anti-inflammatory and wound healing controlled released LDH-Curcumin nanocomposite via intramuscular implantation, in-vivo study. ARAB J CHEM 2022. [DOI: 10.1016/j.arabjc.2021.103646] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Pezzanite LM, Hackett ES, McCready E, Easley JT. Outcomes following single, caudally based bilateral versus unilateral frontonasal sinusotomy for treatment of equine paranasal sinus disease. Vet Med Sci 2021; 7:2209-2218. [PMID: 34405566 PMCID: PMC8604118 DOI: 10.1002/vms3.607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background Bilateral sinus disease is relatively uncommon in horses, accounting for 3%–4.5% of horses with sinonasal disease, but may require bilateral paranasal surgery for complete resolution. Complications and recurrence following bilateral sinusotomy have not been reported or compared to those following unilateral procedures. Objective To describe clinical features and outcomes in horses undergoing standing single, caudally based bilateral frontonasal sinusotomy compared to unilateral frontonasal surgery. Methods Records of horses (n = 37) undergoing surgical treatment for sinus disease (five bilateral, 32 unilateral) were retrospectively reviewed (2010–2017) for signalment, presenting complaint, duration of signs preoperatively, diagnostic imaging, treatments administered, duration hospitalization, complications, and owner satisfaction with the procedure. Mann–Whitney testing was used to compare age, duration of hospitalization, and follow‐up time in horses undergoing unilateral or bilateral procedures. Fisher's exact testing was used to determine if sex predilection was present for unilateral or bilateral disease. Survival time and time to recurrence were compared by Kaplan–Meier survival curves and log‐rank curve comparison testing. Significance was assessed at p < 0.05. Results Length of signs prior to admission did not differ between horses with unilateral and bilateral disease (p = 0.09), but there was a tendency for horses with bilateral disease to have clinical signs for longer. Age (p = 0.19) and hospitalization duration (p = 0.53) did not differ between horses undergoing unilateral versus bilateral procedures. Recurrence or failure to resolve signs was reported in 11/32 (34%) of unilateral and 0/5 bilateral cases (p = 0.07). Conclusions The bilateral single, caudally based sinusotomy approach may be considered to effectively treat bilateral paranasal sinus disease without concern for increased risk of life‐threatening complications or longer hospitalization duration than would be typical for unilateral sinusotomy procedures.
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Affiliation(s)
- Lynn M Pezzanite
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Eileen S Hackett
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Erin McCready
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Jeremiah T Easley
- Preclinical Surgical Research Laboratory, Department of Clinical Sciences, Veterinary Teaching Hospital, Translational Medicine Institute, Colorado State University, Fort Collins, Colorado, USA
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Minto BW, Zanato L, Franco GG, Kawamoto FYK, Borsaro CP, Pazzini JM, Carvalho ER, Matsui A. Topical application of lidocaine or bupivacaine in the healing of surgical wounds in dogs. Acta Cir Bras 2020; 35:e202000701. [PMID: 32813774 PMCID: PMC7433664 DOI: 10.1590/s0102-865020200070000001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 06/04/2020] [Indexed: 12/02/2022] Open
Abstract
Purpose: To analyze the anesthetic drugs interference with wound healing when used in the surgical bed. Methods: Macro and microscopic aspects of healing of surgical wounds were evaluated after instillation of topical anesthetics without vasoconstrictor or saline solution 0.9% as control in the transsurgical period. Thirty dogs, males and females were divided into two experimental groups. In both groups, two circular punch lesions of 6 mm diameter were performed in the abdomen. In group 1, lidocaine was instilled in one of the lesions and saline solution in the contralateral lesion. In group 2 the procedure was repeated with the use of bupivacaine. The macroscopic assessment of the lesions was performed on the first, third and tenth postoperative day. The excisional biopsy was performed on the tenth day and the samples were submitted for histopathological examination. Results: The macroscopic analysis had a significant difference between groups. Microscopic analysis was not significant between groups. Conclusions: The topical application of lidocaine and bupivacaine in the surgical wound is feasible and it does not influence skin healing. The benefit of such a practice, which has been the subject of other studies, seems to outweigh the risks.
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Dual effect of procaine-loaded pectin hydrogels: pain management and in vitro wound healing. Polym Bull (Berl) 2020. [DOI: 10.1007/s00289-020-03210-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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The Effect of Dexmedetomidine Added to Preemptive Ropivacaine Infiltration on Postoperative Pain After Lumbar Fusion Surgery: A Randomized Controlled Trial. Spine (Phila Pa 1976) 2019; 44:1333-1338. [PMID: 31095117 DOI: 10.1097/brs.0000000000003096] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A prospective and controlled study of dexmedetomidine added to preemptive ropivacaine infiltration in lumbar fusion surgery. OBJECTIVE Assessment of dexmedetomidine added to preemptive ropivacaine infiltration for the relief of postoperative pain after lumbar fusion surgery. SUMMARY OF BACKGROUND DATA Single local anesthetic preemptive wound infiltration for the relief of postoperative pain does not translate into major or consistent clinical benefits after lumbar fusion surgery. Dexmedetomidine added to local anesthetics prolonged the duration of blockade and enhanced the analgesic in peripheral nerve block. The effect of dexmedetomidine added to preemptive ropivacaine infiltration in lumbar fusion surgery for the relief of postoperative pain has yet not been studied. METHODS Fifty-seven patients with elective posterior lumbar fusion were randomly divided into two groups. Five minutes before incision, the skin and subcutaneous tissues were injected with 20 mL 0.5% ropivacaine in group R (n = 28) and 20 mL 0.5% ropivacaine and 1 ug/kg of dexmedetomidine in group RD (n = 29) in two divided doses (i.e., 10 mL per side of the incision line). After the operation, all patients received intravenous morphine for analgesia. The total morphine consumption, the time of first analgesic demand, numbers of PCA analgesia, Visual Analog Scale, and postoperative adverse effects were collected. RESULTS In group RD, cumulative morphine dose and numbers of PCA analgesia in group RD were significantly reduced, the time of first analgesic demand was significantly delayed compared to the group R. Visual Analog Scale in group RD showed a marked reduction at 8 hours, 12 hours, 16 hours after operation and less patients in group RD experienced postoperative nausea or vomiting compared to the group R. CONCLUSION The addition of dexmedetomidine to preemptive ropivacaine wound infiltration provided a superior analgesic effect, reduced postoperative morphine consumption, and prolonged the time of the first analgesic demand with no serious side effects. LEVEL OF EVIDENCE 2.
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Kesici U, Demirci M, Kesici S. Antimicrobial effects of local anaesthetics. Int Wound J 2019; 16:1029-1033. [PMID: 31148374 DOI: 10.1111/iwj.13153] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 05/11/2019] [Accepted: 05/12/2019] [Indexed: 12/26/2022] Open
Abstract
After the introduction of cocaine to the medical practice, local anaesthetics (LA) became essential in pain control. LA infiltration along the incision may be used to provide surgical anaesthesia or postoperative analgesia. This study aimed to compare the antimicrobial effects of the topical antimicrobial agent mupirocine with those of the LA lidocaine and the combination of lidocaine and adrenalin. In our study, the in vitro antimicrobial effects of 1 mL sterile saline, 20 mg/mL mupirocine, 20 mg/mL Lidocaine, and 20 mg/mL Lidocaine and Adrenaline were tested against Staphylococcus aureus American type culture collection (ATCC) 29213, Pseudomonas aeruginosa ATCC 27853, and Escherichia coli ATCC 25922 as Group C (Control), Group M (Mupirocine), Group L (Lidocaine), and Group LA (Lidocaine + adrenaline), respectively. S aureus ATCC 29213, P aeruginosa ATCC 27853, and E coli ATCC 25922 were cultured onto Mueller-Hinton agar (Oxoid, UK) plates for 18 to 24 hours at 37°C. Colonies from these plates were suspended in sterile saline and a 0.5 McFarland turbidity standard suspension (corresponding to 1.5 × 108 CFU/mL) of each isolate was prepared. S Aureus ATCC 29213 inhibition zone diameter values of Group M, Group LA, and Group L were significantly higher compared with the group C (P ˂ 0.05). P aeruginosa ATCC 27853 inhibition zone diameter values of Group M and Group LA were significantly higher compared with the group C (P ˂ 0.05). E coli ATCC 25922 inhibition zone diameter values of Group M, Group LA, and Group L were significantly higher compared to the group C (P ˂ 0.05). LA infiltration along the incision may be used to provide surgical anaesthesia or postoperative analgesia. Considering that LAs show antimicrobial effects besides their analgesic effects, they may contribute to preventing the development and reducing the rate of surgical infections, decreasing the requirement to administer antibiotics. However, caution should be exercised not to antagonise the effective treatment of surgical infections, remembering that controversy on the antimicrobial effects of LAs remains in the literature. Therefore, further comprehensive studies with larger patient populations are warranted to demonstrate the antimicrobial effects of LAs.
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Affiliation(s)
- Ugur Kesici
- Faculty of Medicine, Department of General Surgery, University of Beykent, Istanbul, Turkey
| | - Mehmet Demirci
- Faculty of Medicine, Department of Microbiology, University of Beykent, Istanbul, Turkey
| | - Sevgi Kesici
- Department of Anesthesiology and Reanimation, Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
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Kaler P, Verma I, Grewal A, Taneja A, Sood D. Comparison of levobupivacaine alone versus levobupivacaine with ketamine in subcutaneous infiltration for postoperative analgesia in lower segment cesarean section. JOURNAL OF OBSTETRIC ANAESTHESIA AND CRITICAL CARE 2019. [DOI: 10.4103/joacc.joacc_25_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Kesici S, Kesici U, Ulusoy H, Erturkuner P, Turkmen A, Arda O. [Effects of local anesthetics on wound healing]. Rev Bras Anestesiol 2018; 68:375-382. [PMID: 29884529 DOI: 10.1016/j.bjan.2018.01.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 01/02/2018] [Accepted: 01/20/2018] [Indexed: 10/14/2022] Open
Abstract
INTRODUCTION Local anesthetic infiltration is used widely for post-operative analgesia in many situations. However the effects of local anesthetics on wound healing are not demonstrated clearly. This study planned to evaluate the effects of lidocaine, prilocaine, bupivacaine and levobupivacaine on wound healing, primarily on wound tensile strength and on collagen ultrastructure. METHODS This study was conducted on male Sprague Dawley rats. On days 0, 8th, 15th, and 21st, all animals were weighed and received a preincisional subcutaneous infiltration of 3mL of a solution according the group. Control saline (C), lidocaine (L) 7mg.kg-1, prilocaine (P) 2mg.kg-1, bupivacaine (B) 2mg.kg-1 and levobupivacaine (LVB) 2.5mg.kg-1. The infiltrations were done at the back region 1.5cm where incision would be performed at the upper, middle and lower part along the midline, under general anesthesia. Wound tensile strengths were measured after 0.7cm×2cm of cutaneous and subcutaneous tissue samples were obtained vertical to incision from infiltrated regions. Tissue samples were also obtained for electron microscopic examination. Evaluations were on the 8th, 15th and 21st days after infiltration. RESULTS There was no difference between groups in the weights of the rats at the 0th, 8th, 15th and 21st days. The collagen maturation was no statistically different between groups at the 8th and 15th days. The maturation scores of the B and L groups at the 21st day was significantly lower than the Group C (1.40, 1.64 and 3.56; respectively). The wound tensile strength was no statistically different between groups at the 8th and 15th days but at the 21st day the Groups B and LVB had significantly lower value than Group C (5.42, 5.54 and 6.75; respectively). CONCLUSION Lidocaine and prilocaine do not affect wound healing and, bupivacaine and levobupivacaine affect negatively especially at the late period.
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Affiliation(s)
- Sevgi Kesici
- Istanbul Aydın University, Vocational School of Health Services, Department of Anesthesiology, Istambul, Turquia.
| | - Ugur Kesici
- University of Beykent, School of Medicine, Department of General Surgery, Istambul, Turquia
| | - Hulya Ulusoy
- Karadeniz Technical University, Faculty of Medicine, Department of Anesthesiology and Reanimation, Trebizonda, Turquia
| | - Pelin Erturkuner
- Istanbul University, Cerrahpasa Medical Faculty, Department of Histology and Embryology, Istambul, Turquia
| | - Aygen Turkmen
- University of Giresun, School of Medicine, Department of Anesthesiology and Reanimation, Giresun, Turquia
| | - Oktay Arda
- Altınbas University, Medical Faculty, Department of Histology and Embryology, Istambul, Turquia
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Korat PS, Kapupara PP. Local infiltration of the surgical wound with levobupivacaine, ibuprofen, and epinephrine in postoperative pain: An experimental study. Biomed Pharmacother 2017; 96:104-111. [DOI: 10.1016/j.biopha.2017.09.131] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Revised: 09/25/2017] [Accepted: 09/25/2017] [Indexed: 11/27/2022] Open
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Dexmedetomidine prolongs levobupivacaine analgesia via inhibition of inflammation and p38 MAPK phosphorylation in rat dorsal root ganglion. Neuroscience 2017; 361:58-68. [DOI: 10.1016/j.neuroscience.2017.08.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 08/02/2017] [Accepted: 08/03/2017] [Indexed: 11/20/2022]
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Biçer C, Yontar Y, Gökahmetoğlu G, Eskitaşçıoğlu T. Comparison of Effects of Levobupivacaine and Ropivacaine Infiltration on Cutaneous Wound Healing in a Rat Model. J INVEST SURG 2017; 31:515-520. [PMID: 28925761 DOI: 10.1080/08941939.2017.1363325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Cihangir Biçer
- a Department of Anesthesiology and Reanimation, Medical Faculty , Erciyes University , Kayseri , Turkey
| | - Yalcin Yontar
- b Department of Plastic, Reconstructive, and Aesthetic Surgery , Kayseri Training and Research Hospital , Kayseri , Turkey
| | - Günhan Gökahmetoğlu
- c Department of Anesthesiology and Reanimation , Kayseri Training and Research Hospital , Kayseri , Turkey
| | - Teoman Eskitaşçıoğlu
- d Department of Plastic, Reconstructive, and Aesthetic Surgery, Medical Faculty , Erciyes University , Kayseri , Turkey
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Sarıtaş TB, Korkmaz M, Sevimli A, Sarıtaş ZK. Comparison of the effects of gabapentin and pregabalin on wound healing in rats. Int Wound J 2016; 13:748-53. [PMID: 25348659 PMCID: PMC7949902 DOI: 10.1111/iwj.12364] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 08/04/2014] [Accepted: 08/06/2014] [Indexed: 11/26/2022] Open
Abstract
Gabapentinoids are effective adjunct drugs for reducing postoperative pain. However, the effects of gabapentinoids on wound healing have not been evaluated yet. In this study we evaluated their effects on wound healing. A total of 17 male Wistar-Albino rats, 250-350 g, were divided into three groups randomly: control group (n = 5, 2 ml saline), gabapentin group (n = 6, 20 mg/kg gabapentin) and pregabalin group (n = 6, 20 mg/kg pregabalin). Until day 13 inflammation scores were significantly lower (P < 0·05) and wound healing was significantly better in the control group when compared with gabapentin and pregabalin groups (P < 0·001). Inflammation scores were significantly lower in pregabalin group when compared with gabapentin group until day 13. But wound healing was significantly better in gabapentin group than in pregabalin group between days 13 and 21. In conclusion when gabapentin and pregabalin were compared, although pregabalin decreases inflammation scores, gabapentin has better results in wound healing.
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Affiliation(s)
- Tuba Berra Sarıtaş
- Department of Anesthesiology and Reanimation, Meram Medical School, Necmettin Erbakan University, Konya, Turkey.
| | - Musa Korkmaz
- Department of Surgery, Faculty of Veterinary Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Alper Sevimli
- Department of Pathology, Faculty of Veterinary Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Zulfikar Kadir Sarıtaş
- Department of Surgery, Faculty of Veterinary Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
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Claroni C, Marcelli ME, Sofra MC, Covotta M, Torregiani G, Giannarelli D, Forastiere E. Preperitoneal Continuous Infusion of Local Anesthetics: What Is the Impact on Surgical Wound Infections in Humans? PAIN MEDICINE 2016; 17:582-589. [PMID: 26235038 DOI: 10.1111/pme.12872] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Continuous surgical wound infusion with local anesthetics is an effective and widely used technique in postoperative pain management. Some aspects of this technique, however, require further investigation. The aim of this study was to retrospectively assess whether continuous infusion of ropivacaine delays the process of wound healing, with an increased incidence of infection. DESIGN In total, 244 patients aged between 18 and 75 years, American society of anesthesiology II-III, underwent hepatobiliary pancreatic surgery, were classified into two groups and retrospectively analyzed: group R (Ropivacaine) included 152 patients whose surgical incision was fitted with a preperitoneal catheter continuously infusing ropivacaine. Group C (Control) included 92 patients receiving a total intravenous postoperative analgesia. The evaluation forms of the surgical wound according to the Southampton wound assessment scale (SWAS) were collected at three time points. The main outcome was the rate of patients with surgical site infection within 30 days postoperatively. RESULTS Twenty-one patients (13.8%) in group R and 9 patients (9.8%) in group C (P = 0.35) presented wound infection. The rate of patients with a wound evaluation of a SWAS grade IV or V in three time frames in Group R and Group C was T0, 1 (0.7%) and 1 (1.08%) (P = 0.72); T1, 25 (16.4%) and 7 (7.6%) (P = 0.04); T2, 8 (5.3%) and 5 (5.4%) (P = 0.53), respectively.onclusions. The incidence of infection in the surgical site according to the centers for disease control definition was comparable in both groups. The description of the wound healing process according to the SWAS scale shows an initial and temporary decrease in maturation in group R which does not persist in the long-term.
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Gomez-Brouchet A, Blaes N, Mouledous L, Fourcade O, Tack I, Francès B, Girolami JP, Minville V. Beneficial effects of levobupivacaine regional anaesthesia on postoperative opioid induced hyperalgesia in diabetic mice. J Transl Med 2015; 13:208. [PMID: 26136113 PMCID: PMC4488045 DOI: 10.1186/s12967-015-0575-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 06/16/2015] [Indexed: 12/26/2022] Open
Abstract
Background Diabetic neuropathy is one of the most common complications of diabetes and causes various problems in daily life. The aim of this study was to assess the effect of regional anaesthesia on post surgery opioid induced hyperalgesia in diabetic and non-diabetic mice. Methods Diabetic and non-diabetic mice underwent plantar surgery. Levobupivacaine and sufentanil were used before surgery, for sciatic nerve block (regional anaesthesia) and analgesia, respectively. Diabetic and non-diabetic groups were each randomly assigned to three subgroups: control, no sufentanil and no levobupivacaine; sufentanil and no levobupivacaine; sufentanil and levobupivacaine. Three tests were used to assess pain behaviour: mechanical nociception; thermal nociception and guarding behaviours using a pain scale. Results Sufentanil, alone or in combination with levobupivacaine, produced antinociceptive effects shortly after administration. Subsequently, sufentanil induced hyperalgesia in diabetic and non-diabetic mice. Opioid-induced hyperalgesia was enhanced in diabetic mice. Levobupivacaine associated to sufentanil completely prevented hyperalgesia in both groups of mice. Conclusion The results suggest that regional anaesthesia can decrease opioid-induced hyperalgesia in diabetic as well as in non-diabetic mice. These observations may be clinically relevant for the management of diabetic patients.
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Affiliation(s)
- Anne Gomez-Brouchet
- Service d'Anatomie Pathologique et Histologie-Cytologie, IUCT Oncopôle, 1 Avenue du Juliot Curie, 31059, Toulouse Cedex 9, France.
| | - Nelly Blaes
- Institute of Metabolic and Cardiovascular Diseases, I2MC, INSERM, U1048, Université Paul Sabatier, 31432, Toulouse, France.
| | - Lionel Mouledous
- CNRS, IPBS, Institut de Pharmacologie et de Biologie Structurale, 205 Route de Narbonne, 31077, Toulouse, France.
| | - Olivier Fourcade
- Department of Anaesthesiology and Intensive Care, Toulouse University Hospital, 31432, Toulouse, France.
| | - Ivan Tack
- Institute of Metabolic and Cardiovascular Diseases, I2MC, INSERM, U1048, Université Paul Sabatier, 31432, Toulouse, France.
| | - Bernard Francès
- Université de Toulouse, Centre de Recherches sur la Cognition Animale, CNRS, UMR 5169, Université Paul Sabatier, 118 Route de Narbonne, 31062, Toulouse, France.
| | - Jean-Pierre Girolami
- Institute of Metabolic and Cardiovascular Diseases, I2MC, INSERM, U1048, Université Paul Sabatier, 31432, Toulouse, France.
| | - Vincent Minville
- Department of Anaesthesiology and Intensive Care, Toulouse University Hospital, 31432, Toulouse, France. .,Institute of Metabolic and Cardiovascular Diseases, I2MC, INSERM, U1048, Université Paul Sabatier, 31432, Toulouse, France.
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Bajwa SJS, Kaur J. Clinical profile of levobupivacaine in regional anesthesia: A systematic review. J Anaesthesiol Clin Pharmacol 2013; 29:530-9. [PMID: 24249993 PMCID: PMC3819850 DOI: 10.4103/0970-9185.119172] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The quest for searching newer and safer anesthetic agents has always been one of the primary needs in anesthesiology practice. Levobupivacaine, the pure S (−)-enantiomer of bupivacaine, has strongly emerged as a safer alternative for regional anesthesia than its racemic sibling, bupivacaine. Levobupivacaine has been found to be equally efficacious as bupivacaine, but with a superior pharmacokinetic profile. Clinically, levobupivacaine has been observed to be well-tolerated in regional anesthesia techniques both after bolus administration and continuous post-operative infusion. The incidence of adverse drug reactions (ADRs) is rare when it is administered correctly. Most ADRs are related to faulty administration technique (resulting in systemic exposure) or pharmacological effects of anesthesia; however, allergic reactions can also occur rarely. The available literary evidence in anesthesia practice indicates that levobupivacaine and bupivacaine produce comparable surgical sensory block, similar adverse side effects and provision of similar labor analgesia with good comparable maternal and fetal outcome. The present review aims to discuss the pharmacokinetic and pharmacological essentials of the safer profile of levobupivacaine as well as to discuss the scope and indications of levobupivacaine based on current clinical evidence.
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Affiliation(s)
- Sukhminder Jit Singh Bajwa
- Department of Anaesthesiology and Intensive Care, Gian Sagar Medical College and Hospital, Banur, Punjab, India
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