Effect of epinephrine on the distribution of ropivacaine and lidocaine using radioactive isotopes in rat maxilla and pulp

Fujita, Kyohei; Sunada, Katsuhisa

doi:10.1007/s10266-020-00536-6

Cited by 4 publications

(3 citation statements)

References 19 publications

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“…The general somato-visceral pain incidence in our study was 9.47%, with one EPIA converted to GA with endotracheal intubation. Our findings are very close to Sharawi N, et al study's findings in lidocaine-use with 3 additives [21], in purpose to achieve the highest quality of surgical analgesia, but better compared to 3% chloroprocaine results [21], and other many previous studies, with different LAs, additives, different anesthesia techniques and positions [13,20,[22][23][24]. It is actually known that epidural adrenaline has antinociceptive properties and enhances analgesia duration when co-administered with Las [25][26].…”

Section: Discussionsupporting

confidence: 89%

Risk Factors Associated with Somato-Visceral Pain Investigation, in Scheduled Cesarean Section under Epidural Anesthesia with Lidocaine 2% and Adrenaline

BIZIMANA¹,

Wang²

2023

Int J Anesthetic Anesthesiol

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Background: Epidural anaesthesia with 2% lidocaine has been reported to be more effective in caesarean section, but somato-visceral pain remains a potential complication, and can generate many dire effects including mother psychological impairment and burden. Pain during caesarean deliveries is a challenge, but any study was performed to identify risk factors associated to it.We conducted this study to identify pain risk factors, investigate whether surgical anaesthesia length is sufficient, and discover possible correlation between pain rate and surgery duration, while assessing 2% lidocaine efficacy. Methods and methods:This study enrolled 612 patients who underwent scheduled caesarean section under 2% lidocaine epidural and adrenaline, at 1st affiliated hospital of Chongqing medical university in 2019. Pain was considered only for patients with successfully epidural anaesthesia. Exclusion criteria included emergencies and general anaesthesia, 100 mmhg < baseline systolic blood pressure > 140 mmhg, pregnancy term < 37 weeks and > 42 weeks. SPSS 25.0 was used and adequate tests were performed for statistical analysis. P < 0.05 was adopted for statistical significance.Results: Total local anaesthetic dose < 12 ml was more likely associated with pain during caesarean section than a total local anaesthetic ≥ 12 ml. Baseline systolic blood pressure < 120 mmhg was greater associated with pain during caesarean section than that > 120 mmhg. Maternal height > 160 cm was also associated pain during caesarean section. Conclusion:The variables involved in pain prevalence were total local anesthetic dose, systolic baseline blood pressure, and parturient height. Surgical analgesia length was overall judged sufficient. There was no correlation between pain rate and surgery duration. The identified risk factors associated with pain will help to reduce pain incidence and will help to improve mother-baby peripartum condition.

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Section: Discussionsupporting

confidence: 89%

Risk Factors Associated with Somato-Visceral Pain Investigation, in Scheduled Cesarean Section under Epidural Anesthesia with Lidocaine 2% and Adrenaline

BIZIMANA¹,

Wang²

2023

Int J Anesthetic Anesthesiol

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“…Furthermore, recent researches by Aliza Olapour et al [41] said that lidocaine's sensory and motor block were superior to the Ropivacaine's, and epinephrine was found to exert an essential role [39] . Moreover, Meechan and co-authors [42] let know that anesthesia effects of ropivacaine in their study were inferior to those with lidocaine-epinephrine. A fresh clinical research in Japan [43] support the idea that the more cephalad the epidural catheter is placed, the more the quality of analgesia is, but did not find any difference between epidural catheter placement inT10-11 and T11-12 in post-cesarean section for pain relief.…”

Section: Discussionmentioning

confidence: 95%

Incidence of Hypotension and Associated-risk Factors in Epidural Anesthesia With 2% Lidocaine and Epinephrine During Elective Cesarean Section, Efficacy and Safety Assessment

2021

GJACR

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Background: Cesarean section is a worldwide common surgery that requires anesthetic techniques. Many local anesthetics are being now used, but are associated with, dose- dependent and at different level, some side effects including toxicity. Hypotension was described as the first and threat side effect associated to neuraxial techniques. Despite many preventive strategies, it continues to challenge anesthesia providers around the world. Lidocaine was found to be less toxic compared with others commonly used and has been recommended for anesthesia procedures requiring large dose of local anesthetic including epidural anesthesia. The main purpose of this research was to determine the incidence of hypotension and identify the possible risk factors associated with it and thus, assess the efficacy and safety when lidocaine is applied together with epinephrine, in epidural anesthesia for elective cesarean delivery. Materials and methods: This retrospective observational institutional-based study, recruited 612 parturients who underwent elective cesarean section under epidural anesthesia with 2% lidocaine and 1/200000 epinephrine, at 1st affiliated hospital of Chongqing Medical University in 2019. Exclusion criteria included any contraindication to elective cesarean section delivery, general anesthesia, baseline systolic blood pressure < 100mmh and > 140 mm hg, gestational age < 37 weeks and > 42 weeks etc. SPSS 26.0 version and different appropriated tests were used for statistical analysis. P value < 0.05 was accepted as statistically significant. Results: The hypotension incidence was 13.2%, and identified factors associated with it were Baseline Systolic Blood Pressure < 120mmhg, gestational age < 40 weeks, maternal body weight ≤ 60 kg and duration of cesarean delivery (surgery) > 45 minutes. Conclusion: The variables in correlation with increased hypotension rate are baseline systolic blood pressure, gestational age, maternal weight, and surgery duration. 2%Lidocaine with epinephrine as adjuvant presented best outcomes towards both mother and neonates, was therefore efficacy and safe under the anesthetic conditions of our study.

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“…The improvement of the anesthesia effect with the addition of epinephrine is significant. One advantage is local vasoconstriction, resulting in a prolonged duration of anesthesia ( Tschopp et al, 2018 ), reduced bleeding at the site of administration, and the increased concentration of local anesthetic in pulp tissue ( Fujita & Sunada, 2021 ; Tanaka et al, 2016 ). The addition of epinephrine also delayed the absorption of the local anesthetic, resulting in a gradual increase in lidocaine levels in the blood with no peak and a peaceful transfer to the fetus with increased safety ( Lee & Shin, 2017 ).…”

Section: Preoperative Prophylaxismentioning

confidence: 99%

Physiology of pregnancy and oral local anesthesia considerations

Zhou

Zhong

Pan

et al. 2023

PeerJ

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Background Safe and effective local anesthesia is a prerequisite for emergency oral surgeries and most dental treatments. Pregnancy is characterized by complex physiological changes, and increased sensitivity to pain. Pregnant women are particularly vulnerable to oral diseases, such as caries, gingivitis, pyogenic granuloma and third molar pericoronitis. Maternally administered drugs can affect the fetus through the placenta. Therefore, many physicians and patients are reluctant to provide or accept necessary local anesthesia, which leads to delays in the condition and adverse consequences. This review is intended to comprehensively discuss the instructions for local anesthesia in the oral treatment of pregnant patients. Methodology An in-depth search on Medline, Embase, and the Cochrane Library was performed to review articles concerned with maternal and fetal physiology, local anesthetic pharmacology, and their applications for oral treatment. Results Standard oral local anesthesia is safe throughout the pregnancy. At present, 2% lidocaine with 1:200,000 epinephrine is considered to be the anesthetic agent that best balances safety and efficacy for pregnant women. Maternal and fetal considerations must be taken into account to accommodate the physiological and pharmacological changes in the gestation period. Semi-supine position, blood pressure monitoring, and reassurance are suggested for high-risk mothers to reduce the risk of transient changes in blood pressure, hypoxemia, and hypoglycemia. For patients with underlying diseases, such as eclampsia, hypertension, hypotension, and gestational diabetes, the physicians should use epinephrine cautiously and control the dose of anesthetic. New local anesthesia formulations and equipment, which contribute to minimizing injection pain and relieving the anxiety, have and are being developed but remain understudied. Conclusions Understanding the physiological and pharmacological changes during pregnancy is essential to ensure the safety and efficiency of local anesthesia. Optimal outcomes for the mother and fetus hinge on a robust understanding of the physiologic alterations and the appropriate selection of anesthetic drugs and approaches.

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Effect of epinephrine on the distribution of ropivacaine and lidocaine using radioactive isotopes in rat maxilla and pulp

Cited by 4 publications

References 19 publications

Risk Factors Associated with Somato-Visceral Pain Investigation, in Scheduled Cesarean Section under Epidural Anesthesia with Lidocaine 2% and Adrenaline

Risk Factors Associated with Somato-Visceral Pain Investigation, in Scheduled Cesarean Section under Epidural Anesthesia with Lidocaine 2% and Adrenaline

Incidence of Hypotension and Associated-risk Factors in Epidural Anesthesia With 2% Lidocaine and Epinephrine During Elective Cesarean Section, Efficacy and Safety Assessment

Physiology of pregnancy and oral local anesthesia considerations

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