Local anesthetics

Heavner, James E.

doi:10.1097/aco.0b013e3281c10a08

Cited by 138 publications

(121 citation statements)

References 39 publications

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“…They are used in a wide range of clinical situations to prevent or reduce acute pain, chronic pain and cancer pain (2). A retrospective analysis of patients undergoing cancer surgery suggests that using regional anesthesia may reduce cancer recurrence and improve survival rate (3,4).…”

Section: Introductionmentioning

confidence: 99%

Amide-linked local anesthetics induce apoptosis in human non-small cell lung cancer

Wang

Jiang

et al. 2016

J. Thorac. Dis.

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Background: A retrospective analysis of patients undergoing cancer surgery suggested that using local anesthetics could reduce cancer recurrence and improve survival rate. Previous studies have indicated that local anesthetics may induce apoptosis in several kinds of cells in vitro, but the mechanism is unclear. Methods: Cell viability was analyzed by MTS; reactive oxygen species (ROS), mitochondrial membrane potential (MMP, ∆Ψm), cell cycle distribution, and cell apoptosis assay were detected by flow cytometry; DNA damage was measured by comet assay; cell invasion and migration were observed by microscopy; The expression level of related proteins was detected by western blot assay. Results: The results indicated that lidocaine and ropivacaine could decrease viability, induce G0/G1 phase arrest and apoptosis in human non-small cell lung cancer (NSCLC) cells A549 and H520. Invasion and migration were suppressed. Western blot indicated the related apoptotic pathways proteins changed accordingly. Additionally, lidocaine and ropivacaine downregulated ∆Ψm, provoked DNA damage, upregulated ROS production and activated mitogen-activated protein kinase (MAPK) pathways in A549 and H520 cells. Conclusions:The cytotoxic effect of amide-linked local anesthetics on NSCLC cells were mainly due to apoptosis. The antitumor mechanism of lidocaine and ropivacaine may involve apoptotic pathways and MAPK pathways.

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Section: Introductionmentioning

confidence: 99%

Amide-linked local anesthetics induce apoptosis in human non-small cell lung cancer

Wang

Jiang

et al. 2016

J. Thorac. Dis.

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“…In a review study conducted in 1995, Brown et al 7 reported a rate of 1.2 complications per 10,000 epidural anesthesias, similar what was found by Auroy et al 8 in France. New local anesthetics of long duration were synthetized and launched in the market such as ropivacaine and levobupivacaine which would be safer alternatives 9 . In 1998, Weinberg et al 10 demonstrated that a lipid emulsion (LE) was efficient in the treatment of local anesthetic cardiotoxicity, increasing by 50% the mean lethal dose of bupivacaine, however these solutions had been used for parenteral nutrition since 1961!…”

Section: Introductionmentioning

confidence: 99%

Hemodynamic changes in lipid emulsion therapy (SMOFlipid) for bupivacaine toxicity in swines

et al. 2012

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PURPOSE:To evaluate the hemodynamic changes following SMOFlipid emulsion therapy with after bupivacaine intoxication in swines. METHODS: Large White pigs were anesthetized with thiopental, tracheal intubation was performed and mechanical ventilation was instituted. Hemodynamic variables were recorded with invasive pressure monitoring and pulmonary artery catheterization (Swan-Ganz catheter). After a 30-minute resting period, 5 mg.kg -1 of bupivacaine by intravenous injection was administered and new hemodynamic measures were performed 1 minute later; the animals were than randomly divided into two groups and received 4 ml.kg -1 of saline solution or 4 ml.kg -1 of SMOFlipid emulsion 20%. Hemodynamic changes were then re-evaluated at 5, 10, 15, 20 and 30 minutes. RESULTS: Bupivacaine intoxication caused fall in arterial blood pressure, cardiac index, ventricular systolic work index mainly and no important changes in vascular resistances. SMOFlipid emulsion therapy was able to improve blood pressure mainly by increasing vascular resistance since the cardiac index had no significant improvement in our study. Hemodynamic results of the use of lipid emulsion in bupivacaine intoxication were better than the control group. CONCLUSION: The SMOFlipid emulsion is a option for reversing hypotension in cases of intoxication by bupivacaine. Key words: Anesthesia, Local. Bupivacaine. Lipids. Hemodynamics. Fat Emulsions, Intravenous. Swine. RESUMO OBJETIVO:Avaliar as alterações hemodinâmicas da terapia lipídica com SMOFlipid após intoxicação com bupivacaína em suínos. MÉTODOS: Suínos da raça Large White foram anestesiados com tiopental, realizada intubação traqueal e mantidos em ventilação mecânica. As variáveis hemodinâmicas foram registradas através de pressão invasiva e cateterização da artéria pulmonar (cateter de Swan-Ganz). Após período de 30 minutos de repouso, 5 mg.kg -1 de bupivacaína foram injetados por via endovenosa e novas medidas hemodinâmicas foram realizadas 1 minuto após; os animais foram então aleatoriamente divididos em dois grupos e receberam 4 ml.kg -1 de solução salina ou 4 ml.kg -1 da emulsão tipo SMOFlipid a 20%. As alterações hemodinâmicas foram reavaliadas aos 5, 10, 15, 20 e 30 minutos. RESULTADOS: A intoxicação pela bupivacaína causou queda da pressão arterial, índice cardíaco e do trabalho sistólico dos ventrículos principalmente sem importantes alterações das resistências vasculares. A terapia com a emulsão SMOFlipid foi capaz de melhorar a pressão arterial através, principalmente, do aumento das resistências vasculares uma vez que o índice cardíaco não apresentou melhora expressiva em nosso estudo. Os resultados hemodinâmicos com o uso da emulsão lipídica na intoxicação pela bupivacaína foram melhores que no grupo controle. CONCLUSÃO: A emulsão SMOFlipid é uma opção para reverter a hipotensão em caso de intoxicação pela bupivacaína.

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“…To varying extents, local anesthetics administered at appropriate concentrations may block both sensory and motor function in the innervated area [34]. High doses of local anesthetics have the potential to induce myotoxicity and neurotoxicity [2]. Although myotoxicity has been observed in laboratory studies of local anesthetics [35][36][37], clinically relevant myotoxicity appears to be rare [38].…”

Section: Risks Of Myotoxicity and Neurotoxicity With Local Anestheticsmentioning

confidence: 99%

“…Levobupivacaine, the S enantiomer of bupivacaine, was developed based on the belief that the pure S enantiomer would have less potential for toxicity than the R enantiomer and racemic mixture of bupivacaine [2,11]. However, the clinical relevance of this potential difference is unclear, as the safety profiles of bupivacaine and levobupivacaine appear to be very similar with standard/typical clinical usage [11].…”

Section: Introductionmentioning

confidence: 99%

“…The first such use involved cocaine administration during eye surgery in 1884, and, although effective, cocaine was associated with considerable toxicities that prompted subsequent development of safer alternatives ( Figure 1) [1,2]. Today, local or regional administration of anesthetics is integral to prevention of perioperative pain [3][4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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Liposome bupivacaine in peripheral nerve blocks and epidural injections to manage postoperative pain

Ilfeld

2013

Expert Opinion on Pharmacotherapy

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Local anesthetics

Abstract: Local anesthetics have similar chemical structure but differing pharmacokinetic properties and spectra of pharmacodynamic effects that influence selection of agents for use in various clinical situations.

Cited by 138 publications

References 39 publications

Amide-linked local anesthetics induce apoptosis in human non-small cell lung cancer

Amide-linked local anesthetics induce apoptosis in human non-small cell lung cancer

Hemodynamic changes in lipid emulsion therapy (SMOFlipid) for bupivacaine toxicity in swines

Liposome bupivacaine in peripheral nerve blocks and epidural injections to manage postoperative pain

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