Neurological Complications Following the Use of Continuous Extradural Analgesia With Bupivacaine

Dunne, Nancy; Kox, W. J.

doi:10.1093/bja/66.5.617

Cited by 9 publications

(2 citation statements)

References 5 publications

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“…Bupivacaine, an amide-type local anesthetic, is one of the most widely used local anesthetics for surgical anesthesia and pain management. Previous studies have reported that bupivacaine might be neurotoxic and even clinically recommended dose of bupivacaine also can cause severe neurological complications, which brings extra medical and economic burden to the patients and their families [1][2][3]. However, the exact mechanism underlying the neurotoxicity of bupivacaine is unclear.…”

Section: Introductionmentioning

confidence: 99%

[Retracted] Resveratrol Suppresses Bupivacaine‐Induced Spinal Neurotoxicity in Rats by Inhibiting Endoplasmic Reticulum Stress via SIRT1 Modulation

Luo

Zhao

Lai

et al. 2023

BioMed Research International

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Bupivacaine (BUP) may cause neurotoxic effects after spinal anesthesia. Resveratrol (RSV), a natural agonist of Silent information regulator 1 (SIRT1), protects various tissues and organs from damage by regulating endoplasmic reticulum (ER) stress. The aim of this study is to explore whether RSV could alleviate the neurotoxicity induced by bupivacaine via regulating ER stress. We established a model of bupivacaine-induced spinal neurotoxicity in rats using intrathecal injection of 5% bupivacaine. The protective effect of RSV was evaluated by injecting intrathecally with 30 μg/μL RSV in total of 10 μL per day for 4 consecutive days. On day 3 after bupivacaine administration, tail-flick latency (TFL) tests and the Basso, Beattie, and Bresnahan (BBB) locomotor scores were assessed to neurological function, and the lumbar enlargement of the spinal cord was obtained. H&E and Nissl staining were used to evaluate the histomorphological changes and the number of survival neurons. TUNEL staining was conducted to determine apoptotic cells. The expression of proteins was detected by IHC, immunofluorescence, and western blot. The mRNA level of SIRT1 was determined by RT-PCR. Bupivacaine caused spinal cord neurotoxicity by inducing cell apoptosis and triggering ER stress. RSV treatment promoted the recovery of neurological dysfunction after bupivacaine administration by suppressing neuronal apoptosis and ER stress. Furthermore, RSV upregulated SIRT1 expression and inhibited PERK signaling pathway activation. In summary, resveratrol suppresses bupivacaine-induced spinal neurotoxicity in rats by inhibiting endoplasmic reticulum stress via SIRT1 modulation.

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Section: Introductionmentioning

confidence: 99%

[Retracted] Resveratrol Suppresses Bupivacaine‐Induced Spinal Neurotoxicity in Rats by Inhibiting Endoplasmic Reticulum Stress via SIRT1 Modulation

Luo

Zhao

Lai

et al. 2023

BioMed Research International

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show abstract

“…Lignocaine levels can be assessed in most hospital laboratories allowing titration of continuous epidural infusions (Tobin et al 1993). The toxicity of local anaesthetics requires the monitoring of plasma drug concentration to predict unwanted reactions (Dunne & Kox, 1991).…”

Section: Evidence Of Neurological Damagementioning

confidence: 99%