Effect of pH of Bupivacaine on Duration of Repeated Sciatic Nerve Blocks in the Albino Rat

Baker, C. E.; Berry, R; Elston, Robert C.

doi:10.1213/00000539-199106000-00010

Cited by 14 publications

(6 citation statements)

References 4 publications

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“…The results of this clinical trial disclosed that there was no beneficial effect of alkalization of anesthetic solution in regard to increasing its duration of action. This came in agreement with the results of Backer et al (10) Several factors play a major role in increasing the duration of a dental procedure including the difficulty of operation, age of patient, size of lesion, number of teeth…..etc. The results showed no significant difference in regard to the duration of operation within the same group and between the two groups.…”

Section: Discussionsupporting

confidence: 92%

“…(4,7,15) Another important criterion to which this clinical trial highlighted on was the highly possible pain experienced during the surgical procedure. Although several studies have stated that alkalization of local anesthetic solution did not improve the depth of anesthesia, (9)(10)(11)(12) the finding in the current study showed a significant enhancement in the depth of anesthesia which in turn is important for the full completion of a surgical procedure. This may be explained by the fact that in some studies, the anesthetic solution was injected into relatively normal tissue, (14,15) whereas in the current study, endodontic surgery was performed on infected tissue which of course will weak-en the anesthetic solution due to the acidic environment.…”

Section: Discussioncontrasting

confidence: 73%

“…Other studies failed to show any beneficial effect when alkalization of local anesthetic solution was performed in regard to reducing pain on injection and onset of surgical anesthesia. (10)(11)(12)(13)(14) Some studies adopting alkalinized local anesthetic solutions showed an improvement of properties of local anesthetic solution in regard to reduced pain on injection and onset of surgical anesthesia but failed to show an improved depth of anesthesia during tooth extraction except when assessing the depth of anesthesia for teeth with periapical lesions only. (15) Based on these findings a suggestion was made to assess the effect of alkalization of local anesthetic solution during periapical surgery since this surgery was to be performed on teeth having a periapical lesion.…”

Section: Introductionmentioning

confidence: 99%

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A clinical evaluation on the alkalization of local anesthetic solution in periapical surgery

Al–Sultan¹,

Fathie²,

Hamid³

2006

RDENTJ

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Aims: To assess the effect of alkalization of local anesthetic solution for the purpose of enhancing its efficiency in periapical surgery. Materials and Methods: A total sample of 80 patients, all needing periapical surgery on one or more of their upper anterior tooth (teeth) was subjected to this trial. For the purpose of comparison, the sample was randomly divided into two groups based on the local anesthetic solution that they were to receive before surgery. The first group(control) included those patients who received the commercially available local anesthetic solution with a standard pH of 3.5.The second group (trial group) included those patients who received a pH adjusted local anesthetic solution at 7.2 (using sodium bicarbonate).Prior to, and at the completion of intended surgery, the following data were recorded: Pain during injection, onset of achievement of surgical anesthesia, pain during operation and the duration of operation itself. Results: A significant difference in regard to onset of achievement of surgical anesthesia between both groups was noticed with a faster onset in group two where the patients received a pH adjusted local anesthetic solution when compared to control group where the patients received the commercially available local anesthetic solution. Also, less pain on deposition of solution was noticed in the second group as well as less pain score levels were recorded during operation in regard to the same group. Conclusion: The pH adjusted local anesthetic solutions may provide certain advantages when compared to the commercially available local anesthetic solutions regarding enhancement of anesthetic efficiency, reduced pain on injection as well as during surgery.

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Section: Discussionsupporting

confidence: 92%

Section: Discussioncontrasting

confidence: 73%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A clinical evaluation on the alkalization of local anesthetic solution in periapical surgery

Al–Sultan¹,

Fathie²,

Hamid³

2006

RDENTJ

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“…Bromage et al described it as “a form of acute tolerance or tachyphylaxis, develops in response to repeated applications of LAs.”[ 28 ] Tachyphylaxis is established when the block is waning, and the noxious stimuli persists. [ 29 ]…”

Section: Tachyphylaxismentioning

confidence: 99%

Physiological and pharmacologic aspects of peripheral nerve blocks

Vadhanan

Tripaty

Adinarayanan

2015

J Anaesthesiol Clin Pharmacol

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A successful peripheral nerve block not only involves a proper technique, but also a thorough knowledge and understanding of the physiology of nerve conduction and pharmacology of local anesthetics (LAs). This article focuses on what happens after the block. Pharmacodynamics of LAs, underlying mechanisms of clinically observable phenomena such as differential blockade, tachyphylaxis, C fiber resistance, tonic and phasic blockade and effect of volume and concentration of LAs. Judicious use of additives along with LAs in peripheral nerve blocks can prolong analgesia. An entirely new group of drugs-neurotoxins has shown potential as local anesthetics. Various methods are available now to prolong the duration of peripheral nerve blocks.

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“…The initial decline in duration is surprising, as a previous electrophysiologic groundwork showed a sub‐blocking long‐lasting decrease in excitability that could prolong the effect of subsequent blockades . However, one study investigating the duration of repeated sciatic nerve blocks in the rat using the long acting LA, bupivacaine, showed a similar pattern of nerve block duration …”

Section: Discussionmentioning

confidence: 99%

Intra‐ and inter‐Individual variability in nerve block duration: A randomized cross‐over trial in the common peroneal nerve of healthy volunteers

Madsen

Christiansen

Mølleskov

et al. 2019

Acta Anaesthesiol Scand

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Background:The reported variation in nerve block duration is considerable. To individualize nerve block therapy, knowledge of the intra-vs inter-individual variability is essential. We investigated the relative contribution of these 2 parameters to the overall nerve block duration variability. Methods:With ethics committee approval, we conducted a randomized cross-over trial where 20 healthy volunteers received 8 common peroneal nerve blockades with lidocaine 0.5% on 4 consecutive days. Allocations were 5 mL to either the right or left side and 10 mL to the opposite side on day 1 and 2 and vice versa on day 3 and 4. With fixed needle entry and nerve target, we repeated local anaesthetic deposition for each blockade. The primary outcome was variation in duration of sensory nerve block defined as insensitivity to a cold stimulus. Data were analysed using linear mixed model regression. Results:The mean sensory block duration of 380 (95% CI = [342; 418]) minutes on day one was 55 [33; 77] minutes longer than on day two (P < .001), but there were no differences in mean duration between days 2, 3 and 4. The ratios with 2.5; 97.5 percentiles between inter-and intra-individual variation were 2.4 [0.8; 5.2] for the 5 mL blockades and 3.0 [0.9; 6.7] for the 10 mL blockades. The probabilities of inter-to intra-individual variation-ratios >1 were 96% and 97%. Conclusion: The intra-individual variability is a substantially minor contributor to the overall variability in sensory nerve block duration compared with the inter-individual variability.

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Effect of pH of Bupivacaine on Duration of Repeated Sciatic Nerve Blocks in the Albino Rat

Cited by 14 publications

References 4 publications

A clinical evaluation on the alkalization of local anesthetic solution in periapical surgery

A clinical evaluation on the alkalization of local anesthetic solution in periapical surgery

Physiological and pharmacologic aspects of peripheral nerve blocks

Intra‐ and inter‐Individual variability in nerve block duration: A randomized cross‐over trial in the common peroneal nerve of healthy volunteers

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