Duration of Action of Bupivacaine Hydrochloride Used for Palatal Sensory Nerve Block in Infant Pigs

Holman, Shaina Devi; Gierbolini-Norat, Estela M.; Lukasik, S; Campbell-Malone, Regina; Ding, Peng; German, Rebecca Z.

doi:10.1177/089875641403100205

Cited by 8 publications

(7 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Additionally, patch EMG electrodes were placed on the ventral surface of the anterior mylohyoid (MH) muscle. Lastly, three 2-mm piezoelectric crystals (Sonometrics, London, ON) were inserted into the midline of the genioglossus muscle (Holman et al 2012;Konow et al 2010) (Fig. 1).…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Sucking and swallowing rates after palatal anesthesia: an electromyographic study in infant pigs

Holman

Waranch

Campbell-Malone

et al. 2013

Journal of Neurophysiology

Self Cite

View full text Add to dashboard Cite

Infant mammalian feeding consists of rhythmic suck cycles and reflexive pharyngeal swallows. Although we know how oropharyngeal sensation influences the initiation and frequency of suck and swallow cycles, the role of palatal sensation is unknown. We implanted EMG electrodes into the mylohyoid muscle, a muscle active during suckling, and the thyrohyoid muscle, a muscle active during swallowing, in eight infant pigs. Pigs were then bottle-fed while lateral videofluoroscopy was simultaneously recorded from the electrodes. Two treatments were administered prior to feeding and compared with control feedings: 1) palatal anesthesia (0.5% bupivacaine hydrochloride), and 2) palatal saline. Using the timing of mylohyoid muscle and thyrohyoid muscle activity, we tested for differences between treatment and control feedings for swallowing frequency and suck cycle duration. Following palatal anesthesia, four pigs could not suck and exhibited excessive jaw movement. We categorized the four pigs that could suck after palatal anesthesia as group A, and those who could not as group B. Group A had no significant change in suck cycle duration and a higher swallowing frequency after palatal saline ( P = 0.021). Group B had significantly longer suck cycles after palatal anesthesia ( P < 0.001) and a slower swallowing frequency ( P < 0.001). Swallowing frequency may be a way to predict group membership, since it was different in control feedings between groups ( P < 0.001). The qualitative and bimodal group response to palatal anesthesia may reflect a developmental difference. This study demonstrates that palatal sensation is involved in the initiation and frequency of suck and swallow cycles in infant feeding.

show abstract

Section: Methodsmentioning

confidence: 99%

“…The same experimenter administered all injections. The duration of anesthesia with these nerve blocks is from 1 to 3 h in anesthetized infant pigs before oral reflexes are observed (Holman et al 2013). The order of the treatments and control was randomized for each pig using a random number generator.…”

Section: Methodsmentioning

confidence: 99%

Sucking and swallowing rates after palatal anesthesia: an electromyographic study in infant pigs

Holman

Waranch

Campbell-Malone

et al. 2013

Journal of Neurophysiology

Self Cite

View full text Add to dashboard Cite

show abstract

“…After the epiglottis marker was either placed or verified, and the treatment was given, recovery from general anesthesia took 5 to 10 minutes. Bupivacaine hydrochloride has a minimal duration of action of 1 hour until oral reflexes are observed in infant pigs …”

Section: Methodsmentioning

confidence: 99%

“…Bupivacaine hydrochloride has a minimal duration of action of 1 hour until oral reflexes are observed in infant pigs. 16…”

Section: Surgical Proceduresmentioning

confidence: 99%

Swallowing kinematics and airway protection after palatal local anesthesia in infant pigs

et al. 2013

Self Cite

View full text Add to dashboard Cite

Objective Abnormal kinematics during swallowing can result in aspiration which may become life threatening. We tested the role of palatal sensation in the motor control of pharyngeal swallow in infants. Study Design In eight infant pigs, we reduced palatal sensation using local anesthesia (PLA) and measured the impact on swallowing kinematics and airway protection. Methods The pigs drank milk containing barium while we simultaneously recorded videofluoroscopy and electromyography from fine wire bipolar electrodes in several hyolaryngeal muscles. We compared these results to control feedings and feedings following palatal saline injections (PSA). Results After PLA, four pigs had extreme jaw movements and abnormal tongue movement uncharacteristic of sucking. For this reason, we evaluated differences between these “Group B” pigs and the others that could suck normally after PLA, “Group A”. In the four Group A pigs, after PLA there was less hyoid elevation (p<0.001) but normal jaw and tongue movements. In Group B, in addition to greater jaw movement (p<0.001) there was more anterior and superior tongue movement (p<0.001) and a larger range of hyoid movement (p<0.001) Conclusion The airway was protected in all of the pigs, indicating that these changes allowed successful adaptation to the reduction in palatal sensation. However, the oral and pharyngeal phases of the swallow were functionally linked and trigeminal sensation influenced the motor control of the pharyngeal swallow.

show abstract

“…Our findings are consistent with prior data demonstrating inverse relationship between half-life and age for bupivacaine. 24 Our youngest patients who received bupivacaine clearly saw a benefit in pain reduction. In contrast, teen-aged patients who received bupivacaine reported less favorable postoperative outcomes in terms of pain control and opioid use compared to those who did not.…”

Section: Discussionmentioning

confidence: 94%

Pre- Versus Post-Tonsillectomy Intraoperative Bupivacaine Injection in the Pediatric Population: An Age- and Surgical Indication-Stratified Analysis

Greene

Eapen

et al. 2020

Ear Nose Throat J

View full text Add to dashboard Cite

Objectives: Postoperative respiratory depression is of concern in children undergoing adenotonsillectomy receiving postoperative opioids and may be mitigated with intraoperative bupivacaine. This study aims to compare the impact of bupivacaine on postoperative pain and sedation in various pediatric age and surgical indication subgroups. Methods: This is a case series with chart review of 181 patients <18 years old undergoing adenotonsillectomy at a tertiary care center (2013-2016). Postoperative outcomes were compared between those who received intraoperative bupivacaine before (pre-tonsillectomy) or after (post-tonsillectomy) tonsil removal and those who did not (none) using χ2 test and analysis of variance. Subanalysis was performed after stratifying into age and surgical indication subgroups. Results: Ninety-eight patients were included in the pre-tonsillectomy group, 47 in the post-tonsillectomy group, and 36 in the none group. The number of postanesthesia care unit opioid doses ( P = .159) and pain scores at arrival ( P = .362) or discharge ( P = .255) were not significantly different between treatment groups overall. Among 0- to 5-year-olds, pre-tonsillectomy injection was associated with lowest mean (SD) discharge pain score of 0.55 (1.29) pre-tonsillectomy versus 0.71 (1.37) post-tonsillectomy versus 2 (1.63) none group ( P = .004). Among 12- to 17-year-olds, no injection was associated with lowest mean (SD) discharge pain score of 2.33 (0.52) pre-tonsillectomy versus 5 (2.65) post-tonsillectomy versus 1.63 (1.60) none group ( P = .020). Injection in patients with obstructive sleep apnea and/or sleep-disordered breathing did not improve postoperative outcomes. Conclusion: Intraoperative bupivacaine may improve pain scores in younger pediatric populations, though it may not impact the amount of postoperative opioid use. Prospective analysis with a larger sample size is warranted to better outline opioid usage and pain control in this group.

show abstract

Duration of Action of Bupivacaine Hydrochloride Used for Palatal Sensory Nerve Block in Infant Pigs

Cited by 8 publications

References 15 publications

Sucking and swallowing rates after palatal anesthesia: an electromyographic study in infant pigs

Sucking and swallowing rates after palatal anesthesia: an electromyographic study in infant pigs

Swallowing kinematics and airway protection after palatal local anesthesia in infant pigs

Pre- Versus Post-Tonsillectomy Intraoperative Bupivacaine Injection in the Pediatric Population: An Age- and Surgical Indication-Stratified Analysis

Contact Info

Product

Resources

About