Intrathecal Ropivacaine in Rabbits: Pharmacodynamic and Neurotoxicologic Study

Malinovsky, Jean-Marc; Charles, Florence; Baudrimont, M; Péreón, Yann; Corre, Pascal Le; Pinaud, M.; Benhamou, Dan

doi:10.1097/00000542-200208000-00021

Cited by 52 publications

(34 citation statements)

References 23 publications

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“…Sonal N. Bhat et.al [10] in their study noted that the fall in systolic and the diastolic blood pressure from the 5 min interval was more in the Ropivacaine group, which was almost comparable with Bupivacaine group by the end of the surgery. De Kock et al [11] , McNamee et al [12] & Malinovsky et al [13] in their studies reported statistically significant intra-operative hypotension with higher concentrations of intrathecally administered Ropivacaine, which was different from our study findings. In our study, onset time of sensory block was similar in the 3 groups and most of the patients in all the three groups had a maximum sensory level of T6.…”

Section: Discussioncontrasting

confidence: 99%

Comparison of Intrathecal Bupivacaine, Ropivacaine (0.75%) and Ropivacaine (0.75%) with Clonidine (30µg) for Lower Abdominal and Lower Limb Surgeries with Regard to Quality of Anaesthesia and Safety

Alex¹,

Gopinath²,

Ramadas³

et al. 2016

AIMDR

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Background: A prospective randomized study was conducted to study the efficacy and safety of Bupivacaine, Ropivacaine and Ropivacaine with clonidine intrathecally for lower abdominal and lower limb surgeries. Methods: 120 patients undergoing lower abdominal and lower limb surgeries of 120 minutes or lesser duration were randomized into three groups, n = 40. Group A received 3 ml 0.5% Bupivacaine (15 mg)+ 0.2ml normal saline, Group B received 3 ml of 0.75% isobaric Ropivacaine (22.5 mg)+ 0.2ml normal saline and Group C received 3ml of 0.75% Ropivacaine (22.5mg)+ clonidine 30 µg. Quality of subarachnoid blockade and hemodynamic changes were compared. Results: Onset time and time to maximum motor blockade was rapid in all the three groups ; duration of motor blockade was significantly shorter in Ropivacaine group and comparable between Bupivacaine and Ropivacaine with clonidine group. Onset of sensory blockade and maximum sensory block level achieved were comparable between three groups. Time to, onset of maximum sensory block and regression of sensory block by 2 segments were shorter in the Bupivacaine group compared to the other 2 groups. Better hemodynamic profiles were noted in Ropivacaine groups compared to Bupivacaine group. There were no statistically significant differences between the Quality of sedation and the side effects between the groups. Conclusion: Hemodynamic profile was better with Ropivacaine and onset, quality, duration of analgesia, etc. were comparable with Bupivacaine when clonidine 30µg was added as adjuvant.

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Section: Discussioncontrasting

confidence: 99%

Comparison of Intrathecal Bupivacaine, Ropivacaine (0.75%) and Ropivacaine (0.75%) with Clonidine (30µg) for Lower Abdominal and Lower Limb Surgeries with Regard to Quality of Anaesthesia and Safety

Alex¹,

Gopinath²,

Ramadas³

et al. 2016

AIMDR

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“…A Ac ck kn no ow wl le ed dg ge em me en nt t The grading of the immunocytochemical examination was as follows: 0= none; 1= rare (2-3), 2= few (3-10), 3= moderate (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) and 4= serious (> 20 neurons).…”

Section: Resultsmentioning

confidence: 99%

“…19 Zhong et al observed histopathologic changes characterized by inflammation, vacuolization and apoptosis, but no behavioral changes in rats treated with ropivacaine during 48 hours, with 90 min. intervals, applied in concentrations of 0.75% and 1%.…”

Section: Discussionmentioning

confidence: 99%

Neurotoxic Effects of Ketamine and Different Doses of Ropivacaine Administered Intrathecally in Rabbits

Sezen¹,

Demiraran²,

Güven³

et al. 2013

Turkiye Klinikleri J Med Sci

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A AB BS S T TR RA AC CT T O Ob b j je ec c t ti i v ve e: : Although a variety of anesthetic medicines are used intrathecally, experimental neurotoxic studies on these drugs are not sufficient. In our study, we used immunocytochemical examination to assess the neurotoxic potential of ketamine and different doses of ropivacaine administered intrathecally. M Ma a t te e r ri i a al l a an nd d M Me et t h ho od ds s: : Thirty rabbits were divided into five groups which were inserted spinal catheters under anesthesia. Each group received in a volume of 0.3 ml, as follows: the R0.2 group received 0.2% ropivacaine, the R0.75 group received 0.75% ropivacaine, the R1 group received 1.0% ropivacaine, the K group received preservative-free S (+) ketamine and the C group received 0.9% NaCl. The onset and duration of action were recorded by using Motor Dysfunction Index (MDI). Rabbits were observed for five days and then euthanasized. After catheters were removed, brains and spinal tissue samples were evaluated by light microscopy and immunocytochemical examination. R Re e s su ul lt ts s: : The longest onset of action was observed in the K group. Among the ropivacaine groups, the onset of action diminished and the duration of action extended with an increase in dose significantly. There was axonal degeneration in the R1 group, but this finding not reach significance. In the ketamine group, significant neuronal degeneration and reduction in number of neurons in the brain sections were observed . In the 1% ropivacaine group, a relative increase in neurofilament intensity was detected using immunocytochemical assessments in the medulla spinalis and brain sections. C Co on nc c l lu u s si i o on n: : The intrathecal applications of 1% ropivacaine and ketamine can induce neurotoxic damage, despite a lack of observed functional neurologic deficits.K Ke ey y W Wo or rd ds s: : Ro pi va ca i ne; ke ta mi ne; in jec ti ons, spi nal Ö ÖZ ZE ET T A Am ma aç ç: : İntratekal olarak uygulanan anestezik ilaçların çeşitliliğine karşın, bu ilaçların deneysel nörotoksik çalışmaları yeterli değildir. Çalışmamızda, intratekal olarak verilen ketamin ve farklı dozlardaki ropivakainin nörotoksik potansiyelini immunohistokimyasal olarak değerlendir-meyi amaçladık. G Ge e r re eç ç v ve e Y Yö ön n t te em m l le er r: : Anestetize edilerek spinal kateter yerleştirilmiş 30 tavşan 5 gruba ayrıldı. Grup R0.2'de ropivakain %0,2, grup R0.75'de ropivakain %0,75, grup R1'de ropivakain %1,0, grup K'de preservative-free S (+) ketamin ve grup C'de %0,9 NaCl 0,3 ml volümde spinal kateterden uygulandı. Etki başlangıç zamanı ve etki süreleri Motor Dysfunction Index (MDI) kullanılarak kaydedildi. Tavşanlar 5 gün gözlendikten sonra ötenazi uygulandı. Kateterler çıkar-ılarak beyin ve spinal doku örnekleri ışık mikroskopisi ve immunohistokimyasal metodla değer-lendirildi. B Bu ul l g gu u l la ar r: : En uzun etki başlangıcı grup K'de gözlemlendi. Ropivakain grupları içinde doz artışı ile birlikte etki başlangıç süreleri kısalarak, etki süreleri uzamış olarak t...

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“…A study by Malinovsky et al 21 indicated that intrathecally administered lidocaine, but not ropivacaine, was neurotoxic (although no lidocainespecific lesions were identified). In contrast, Yamashita et al 22 reported ropivacaine-induced vacuolation in the dorsal column in up to 10% of cases, but no sensory or motor dysfunction, while lidocaine-induced vacuolation of the dorsal column was noted in 50% or more animals and was associated with marked neurodysfunction.…”

Section: Discussionmentioning

confidence: 99%

Intrathecally administered ropivacaine is less neurotoxic than procaine, bupivacaine, and levobupivacaine in a rat spinal model

Takenami

Wang

Nara

et al. 2012

Can J Anesth/J Can Anesth

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Purpose The aim of this study was to compare the neurotoxicity of intrathecal procaine, bupivacaine, levobupivacaine, and ropivacaine in an animal model. Methods The study comprised two experiments. In the concentration experiment, rats (n = 78) were administered 0.12 lLÁg -1 body weight (BW) of 2% or 20% procaine, 0.5% or 5% bupivacaine, 0.5% or 5% levobupivacaine, or 0.5% or 5% ropivacaine. Based on the findings, the doses were increased by volume in the subsequent volume experiment using 0.12, 0.24, or 0.48 lLÁg -1 BW of 6% procaine, 6% levobupivacaine, or 6% ropivacaine (n = 79). Walking behaviour and sensory threshold were analyzed, and a histological examination of the spinal cord, posterior and anterior roots, and cauda equina was performed. Results The concentration experiment showed abnormalities only in the 5% bupivacaine group, and these abnormal findings were in the posterior root (PR) and posterior column (PC). The volume experiment revealed that procaine 0.24 lLÁg -1 was neurotoxic, mainly affecting the PR. At 0.48 lLÁg -1 , severe injury was observed in the PR and PC in all six procaine rats and four of six levobupivacaine rats, while milder injury was limited to the PR in one of six ropivacaine rats, which differed significantly from the former two groups (P = 0.006 and P = 0.014, respectively). Electron microscopy showed axonal degeneration. Conclusion All four local anesthetics seemed to cause identical neurotoxic lesions commencing in the PR and Author contributions Tamie Takenami designed and initiated this study, took part in all aspects of the experiments, collected data for statistical analysis, and wrote the manuscript. Guoqin Wang performed statistical tests, assisted with the statistical analysis, and proposed the method of statistical analysis to validate the injury score. Yoshihiro Nara assisted with catheterization, drug injection, and securing the catheters. He also performed evaluations for the ambulation and paw stimulation tests. Sayano Fukushima assisted with the assessment of the injury scores. Saburo Yagishita verified the pathological changes. Hiromi Hiruma and Tadashi Kawakami allowed use of their laboratory during the study and reviewed the manuscript. Hiromi Hiruma, Tadashi Kawakami, and Hirotsugu Okamoto offered their advice. 123Can J Anesth/J Can Anesth (2012) 59: 456-465 DOI 10.1007/s12630-012-9685-9 extending to the PC by axonal degeneration. Bupivacaine appeared to be the most neurotoxic of the four drugs, and the neurotoxicity at higher doses increased by volume with procaine [ levobupivacaine [ ropivacaine. RésuméObjectif L'objectif de cette e´tude e´tait de comparer la neurotoxicite´intrathe´cale de la procaı¨ne, de la bupivacaı¨ne, de la le´vobupivacaı¨ne et de la ropivacaı¨ne dans un mode`le animal. Méthodes L'e´tude a comporte´deux expe´rimentations. Dans une expe´rience sur la concentration, des rats (n = 78) ont reçu 0,12 lLÁg -1 de poids corporel de procaı¨ne a`2 % ou 20 %, de bupivacaı¨ne a`0,5 % ou 5 %, de le´vobupivacaı¨ne a`0,5 % ou 5 % ou de...

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Intrathecal Ropivacaine in Rabbits: Pharmacodynamic and Neurotoxicologic Study

Abstract: Ropivacaine induced dose-dependent spinal anesthesia, and did not induce any neurotoxicologic lesion in this experimental animal model.

Cited by 52 publications

References 23 publications

Comparison of Intrathecal Bupivacaine, Ropivacaine (0.75%) and Ropivacaine (0.75%) with Clonidine (30µg) for Lower Abdominal and Lower Limb Surgeries with Regard to Quality of Anaesthesia and Safety

Comparison of Intrathecal Bupivacaine, Ropivacaine (0.75%) and Ropivacaine (0.75%) with Clonidine (30µg) for Lower Abdominal and Lower Limb Surgeries with Regard to Quality of Anaesthesia and Safety

Neurotoxic Effects of Ketamine and Different Doses of Ropivacaine Administered Intrathecally in Rabbits

Intrathecally administered ropivacaine is less neurotoxic than procaine, bupivacaine, and levobupivacaine in a rat spinal model

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