Comparison of the pharmacological properties of 0.375% bupivacaine with epinephrine, 0.5% ropivacaine and a mixture of bupivacaine with epinephrine and lignocaine – a randomized prospective study

Bobik, Piotr; Kosel, Juliusz; Świrydo, Paulina; Tałałaj, Marcin; Czaban, Igor; Radziwon, Wojciech

doi:10.1080/2000656x.2020.1720999

Cited by 11 publications

(5 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In common, they all showed an accelerated block-onset when a short-acting drug was added to a long-acting drug, but at the expense of block duration [ 69 , 74 , 75 ]. These findings have been reproduced in recent studies [ 76 , 77 ].…”

Section: Clinical Conceptssupporting

confidence: 85%

Peripheral Regional Anesthesia Using Local Anesthetics: Old Wine in New Bottles?

Gasteiger

Kirchmair

Hoerner

et al. 2023

JCM

View full text Add to dashboard Cite

During the past decade, numerous efforts were undertaken aiming at prolonging the analgesic effect of regional anesthesia. With the development of extended-release formulations and enhanced selectivity for nociceptive sensory neurons, a very promising contribution to the development of pain medications has been achieved. At present, liposomal bupivacaine is the most popular, non-opioid, controlled drug delivery system, but its duration of action, which is still controversially discussed, and its expensiveness have decreased initial enthusiasm. Continuous techniques can be seen as an elegant alternative for providing a prolonged duration of analgesia, but for logistic or anatomical reasons, they are not always the best choice. Therefore, focus has been directed towards the perineural and/or intravenous addition of old and established substances. As for perineural application, most of these so-called ‘adjuvants’ are used outside their indication, and their pharmacological efficacy is often not or only poorly understood. This review aims to summarize the recent developments for prolonging the duration of regional anesthesia. It will also discuss the potential harmful interactions and side effects of frequently used analgesic mixtures.

show abstract

Section: Clinical Conceptssupporting

confidence: 85%

Peripheral Regional Anesthesia Using Local Anesthetics: Old Wine in New Bottles?

Gasteiger

Kirchmair

Hoerner

et al. 2023

JCM

View full text Add to dashboard Cite

show abstract

“…Mixing lidocaine with bupivacaine does not reduce the onset time of infraclavicular [4], axillary [5] or peribulbar block [6]. When used for axillary block, the addition of lidocaine shortened the duration of sensory and motor block compared with bupivacaine with adrenaline or plain ropivacaine [7]. One small study did show a reduction in onset time while maintaining the duration of analgesia when lidocaine was used in addition to ropivacaine for sciatic nerve blockade [8].…”

Section: Resultsmentioning

confidence: 99%

Pharmacological and clinical implications of local anaesthetic mixtures: a narrative review

Nestor

Sepúlveda

et al. 2021

Anaesthesia

View full text Add to dashboard Cite

Summary Various techniques have been explored to prolong the duration and improve the efficacy of local anaesthetic nerve blocks. Some of these involve mixing local anaesthetics or adding adjuncts. We did a literature review of studies published between 01 May 2011 and 01 May 2021 that studied specific combinations of local anaesthetics and adjuncts. The rationale behind mixing long‐ and short‐acting local anaesthetics to hasten onset and extend duration is flawed on pharmacokinetic principles. Most local anaesthetic adjuncts are not licensed for use in this manner and the consequences of untested admixtures and adjuncts range from making the solution ineffective to potential harm. Pharmaceutical compatibility needs to be established before administration. The compatibility of drugs from the same class cannot be inferred and each admixture requires individual review. Precipitation on mixing (steroids, non‐steroidal anti‐inflammatory drugs) and subsequent embolisation can lead to serious adverse events, although these are rare. The additive itself or its preservative can have neurotoxic (adrenaline, midazolam) and/or chondrotoxic properties (non‐steroidal anti‐inflammatory drugs). The prolongation of block may occur at the expense of motor block quality (ketamine) or block onset (magnesium). Adverse effects for some adjuncts appear to be dose‐dependent and recommendations concerning optimal dosing are lacking. An important confounding factor is whether studies used systemic administration of the adjunct as a control to accurately identify an additional benefit of perineural administration. The challenge of how best to prolong block duration while minimising adverse events remains a topic of interest with further research required.

show abstract

“…It has a prolonged action time and low cardiac and neurotoxicity. It has higher blocking efficacy on pain-conducting Aδ and C nerve fibers than Aβ nerve fibers, and at lower concentrations, it produces sensory and motor blocks, which are unique pharmacological characteristics [23] . It has been reported that the analgesic effect of lidocaine administered by subcutaneous infiltration does not exceed 2 hours, whereas that of ropivacaine reaches 12 hours.…”

Section: Discussionmentioning

confidence: 99%

“…It has higher blocking efficacy on pain-conducting Aδ and C nerve fibers than Aβ nerve fibers, and at lower concentrations, it produces sensory and motor blocks, which are unique pharmacological characteristics. [ 23 ] It has been reported that the analgesic effect of lidocaine administered by subcutaneous infiltration does not exceed 2 hours, whereas that of ropivacaine reaches 12 hours. [ 24 ] Another study found that ropivacaine was superior to lidocaine in terms of nerve block efficacy and postoperative analgesia duration.…”

Section: Discussionmentioning

confidence: 99%

Comparison of lidocaine and ropivacaine stellate ganglion blockade in treating upper limb postherpetic neuralgia

Fan

Zheng

et al. 2022

Medicine

View full text Add to dashboard Cite

To provide a basis for treating postherpetic neuralgia (PHN), we compared the efficacy of lidocaine and ropivacaine stellate ganglion block (SGB) in PHN treatment in the upper limbs. Data from 252 patients with upper-limb PHN were retrospectively analyzed. The lidocaine group (n = 118) was treated with oral pregabalin capsules 75 mg twice a day, tramadol hydrochloride sustained release tablets 100 mg twice a day, and amitriptyline 25 mg once at night combined with ultrasound-guided lidocaine SGB; the ropivacaine group (n = 134) was orally administered the same medicines combined with ultrasound-guided ropivacaine SGB. The visual analog scale (VAS), self-rating anxiety scale (SAS), and adverse reactions were compared between the groups before treatment and at 1 week, 1 month, and 3 months after treatment. There were no significant differences between the lidocaine and ropivacaine groups in terms of sex, age, height, weight, and pain duration ( P > .05). There was no significant difference between the groups in VAS and SAS scores before treatment ( P > .05). At 1 week, 1 month, and 3 months after ultrasound-guided SGB treatment, the VAS and SAS scores were significantly lower in the ropivacaine group than in the lidocaine group ( P < .05). There were no significant differences between the groups in terms of adverse reactions ( P > .05). For ultrasound-guided SGB treatment of upper limb PHN, ropivacaine is superior to lidocaine. Ultrasound-guided ropivacaine SGB is safe and effective for the treatment of upper limb PHN.

show abstract

Comparison of the pharmacological properties of 0.375% bupivacaine with epinephrine, 0.5% ropivacaine and a mixture of bupivacaine with epinephrine and lignocaine – a randomized prospective study

Cited by 11 publications

References 13 publications

Peripheral Regional Anesthesia Using Local Anesthetics: Old Wine in New Bottles?

Peripheral Regional Anesthesia Using Local Anesthetics: Old Wine in New Bottles?

Pharmacological and clinical implications of local anaesthetic mixtures: a narrative review

Comparison of lidocaine and ropivacaine stellate ganglion blockade in treating upper limb postherpetic neuralgia

Contact Info

Product

Resources

About