Clinical Pharmacology and Toxicology of Local Anesthetics and Adjuncts

Martin‐Flores, Manuel

doi:10.1002/9781118783382.ch4

Cited by 25 publications

(45 citation statements)

References 74 publications

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“…These results were unexpected but provide evidence that storage at room temperature rather than refrigerated is likely more suitable for maintaining liposomal stability. However, the previously discussed changes in free bupivacaine concentrations may not be clinically relevant when the wide range of bupivacaine concentrations frequently used for nerve blocks (0.125‐0.75%) are considered . The dosage for liposomal bupivacaine is 0.4 mL/kg.…”

Section: Discussionmentioning

confidence: 99%

Sterility and concentration of liposomal bupivacaine single‐use vial when used in a multiple‐dose manner

et al. 2020

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Objective: To evaluate the sterility of bupivacaine liposome injectable suspension (Nocita ® ) used in a multiple-dose fashion for 5 days.Study design: Triplicate liposomal bupivacaine vials were stored under two conditions, (1) room temperature (24 C) and (2) refrigerated temperature (5 C). A 3-mL aliquot was withdrawn from each vial daily. Samples were inoculated in tryptic soy broth in triplicate and then incubated for 24 hours at 37 C and subcultured every 48 hours onto blood agar and Sabouraud dextrose agar, respectively. Separate 1.5-mL aliquots of liposomal bupivacaine were centrifuged at 3500 g to separate liposome-encapsulated bupivacaine from the solution. Concentration of unencapsulated bupivacaine was analyzed via highpressure liquid chromatography. Data were analyzed by using mixed effects procedure with multiple comparisons.Sample population: Ten 20-mL vials of bupivacaine liposome injectable suspension stored under two conditions, (1) room temperature (24 C) and(2) refrigerated temperature (5 C). Results: Five days of repeated withdrawal from the single-use vials yielded no bacterial growth. One control vial, which was opened and punctured once on the last day of the experiment, yielded fungal growth of an Aspergillus spp, likely an environmental contaminant. The concentration of free bupivacaine did not significantly differ until the fifth day of sampling. Conclusion: When aseptic technique was used, liposomal bupivacaine remained sterile for 5 days. Concentrations of free bupivacaine were unchanged from baseline for 4 days in both refrigerated and room temperature conditions.Clinical significance: Single-use liposomal bupivacaine vials can be used extralabel in a multiple-dose fashion for up to 4 days when stored either refrigerated or room temperature when sterile technique is used.

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Section: Discussionmentioning

confidence: 99%

Sterility and concentration of liposomal bupivacaine single‐use vial when used in a multiple‐dose manner

et al. 2020

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“…All piglets in this study would have been surgically castrated routinely regardless of this study. This study fulfills Spanish legislation for animal protection in experimentation and other scientific purposes, including teaching (Real Decreto 53/2013, 2013. The personnel involved in this study were veterinarians with relevant expertise in the caring and handling of animals.…”

Section: Methodsmentioning

confidence: 99%

“…Intratesticular lidocaine diffuses into the spermatic cords 10 min after the administration and its effect lasts at least 1 h . Bupivacaine is a local anesthetic of a similar group as lidocaine but with a longer latency (~20 min) and long-lasting effect (6 to 7 h) (Martin-Flores, 2013). The sensory blockade induced by a lidocaine-bupivacaine mixture combines the faster onset of lidocaine and the longer duration of bupivacaine.…”

Section: Introductionmentioning

confidence: 99%

“…The sensory blockade induced by a lidocaine-bupivacaine mixture combines the faster onset of lidocaine and the longer duration of bupivacaine. This combination is widely used in other species to provide a long-lasting analgesia with a shorter latency time and might offer an alternative to the short period of analgesia provided by lidocaine (Martin-Flores, 2013). Currently, there are no maximum residue limits for the drug, and hence it is not licensed for use in the European Union (EFSA, 2004).…”

Section: Introductionmentioning

confidence: 99%

“…Local anesthetics are drugs which reversibly inhibit the propagation of impulses along nerve fibers or peripheral nerves (Martin-Flores, 2013). Lidocaine is a local anesthetic of the amide group that helps to reduce the perception of pain at the moment of castration Kluivers-Poodt et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

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Acute physiological responses to castration-related pain in piglets: the effect of two local anesthetics with or without meloxicam

Bonastre

Mitjana

Tejedor

et al. 2016

animal

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Methods to reduce castration-related pain in piglets are still issues of concern and interest for authorities and producers. Our objectives were to estimate the effectiveness of two protocols of local anesthesia (lidocaine and the combination of lidocaine + bupivacaine) as well as the use of meloxicam as a postoperative analgesic in alleviating castration-related pain, measured by acute physiological responses. Eight groups (15 piglets/group) were included in the study: (1) castration without anesthesia or analgesia, without meloxicam (TRAD WITHOUT), (2) castration without anesthesia or analgesia, but with meloxicam (TRAD WITH), (3) handling without meloxicam (SHAM WITHOUT), (4) handling with meloxicam (SHAM WITH), (5) castration after local anesthesia with lidocaine but without meloxicam (LIDO WITHOUT), (6) castration after local anesthesia with lidocaine and meloxicam (LIDO WITH), (7) castration after local anesthesia with lidocaine + bupivacaine without meloxicam (LIDO + BUPI WITHOUT), (8) castration after local anesthesia with lidocaine + bupivacaine and meloxicam (LIDO + BUPI WITH). Acute physiological responses measured included skin surface temperature and serum glucose and cortisol concentrations. On days 4 and 11 post-castration BW was recorded and average daily gain was calculated over this period. Furthermore, piglet mortality was recorded over the 11-day post-castration period. Administration of local anesthetic or meloxicam did not prevent the decrease in skin surface temperature associated with castration. Lidocaine reduced the increase in glucose concentration associated with castration. For castrated pigs, the joint use of lidocaine and meloxicam caused a significant decrease in cortisol concentration; the combination of intratesticular lidocaine and bupivacaine did not seem to be more effective than lidocaine alone. No effect of treatments on mortality and growth were detected.

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Loco‐Regional Anesthesia

Schroeder

2015

Questions and Answers in Small Animal Anesthesia

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Clinical Pharmacology and Toxicology of Local Anesthetics and Adjuncts

Cited by 25 publications

References 74 publications

Sterility and concentration of liposomal bupivacaine single‐use vial when used in a multiple‐dose manner

Sterility and concentration of liposomal bupivacaine single‐use vial when used in a multiple‐dose manner

Acute physiological responses to castration-related pain in piglets: the effect of two local anesthetics with or without meloxicam

Loco‐Regional Anesthesia

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