Bupivacaine in Vain, a Case of Bupivacaine Toxicity

Nlandu, Zola; Malik, M. I. A.; Soleye, S.; Osantoski, T.; Rabeeah, Zahraa

doi:10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a4839

Cited by 2 publications

(1 citation statement)

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“…This may imply that rather than loading within spaces between acylated fibers, the excess bupivacaine could dry on top of membranes and thus release instantly from the surface. Median values of 5 mg and 2.5 mg of bupivacaine were chosen because the 10 mg loading concentration saw the highest proportional burst release of 5 mg, which based on other studies was likely a toxic amount 31 . When combining bupivacaine with C2DA, release followed a similar pattern, with a slight burst during the first timepoint followed by a sustained average release of about 0.25 mg per time point, which is below previously reported toxic levels of 0.6 mg/ml 32 .…”

Section: Discussionmentioning

confidence: 99%

In vitro evaluation of loaded chitosan membranes for pain relief and infection prevention

et al. 2021

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Wounds resulting from surgeries, implantation of medical devices, and musculoskeletal trauma result in pain and can also result in infection of damaged tissue. Up to 80% of these infections are due to biofilm formation either on the surface of implanted devices or on surrounding wounded tissue. Bacteria within a biofilm have intrinsic growth and development characteristics that allow them to withstand up to 1,000 times the minimum inhibitory concentration of antibiotics, demonstrating the need for new therapeutics to prevent and treat these infections. Cis‐2‐decenoic acid (C2DA) is known to disperse preformed biofilms and can prevent biofilm formation entirely for some strains of bacteria. Additionally, local anesthetics like bupivacaine have been shown to have antimicrobial effects against multiple bacterial strains. This study sought to evaluate hexanoic acid‐treated electrospun chitosan membranes (HA‐ESCM) as wound dressings that release C2DA and bupivacaine to simultaneously prevent infection and alleviate pain associated with musculoskeletal trauma. Release profiles of both therapeutics were evaluated, and membranes were tested in vitro against Methicillin‐resistant Staphylococcus aureus (MRSA) to determine efficacy in preventing biofilm infection and bacterial growth. Results indicate that membranes release both therapeutics for 72 hr, and release profile can be tailored by loading concentration. Membranes were effective in preventing biofilm growth but were toxic to fibroblasts when loaded with 2.5 or 5 mg of bupivacaine.

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Section: Discussionmentioning

confidence: 99%