Small-Dose Ropivacaine Hydrochloride with Fentanyl versus       Large-Dose of Ropivacaine Hydrochloride for Cesarean Section

Huang, Jinwen; Liu, Xia; Ding, Shaoli; Zhu, Lei; Yan, Wenjun

doi:10.29271/jcpsp.2019.04.301

Cited by 4 publications

(2 citation statements)

References 16 publications

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“…In the present study, we found that ropivacaine suppressed the viability and growth of HepG2 cells in a dose-dependent manner. Consistently, the effective anti-proliferative doses of ropivacaine were similar to those reported previously [ 32 , 47 ]. The reduction of G1/G0 phase cells is prevalent in the majority of cancer cells, which eventually display phenotypes of S phase arrest or G2/M phase arrest [ 48 , 49 ].…”

Section: Discussionsupporting

confidence: 90%

Ropivacaine suppresses tumor biological characteristics of human hepatocellular carcinoma via inhibiting IGF-1R/PI3K/AKT/mTOR signaling axis

et al. 2021

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Ropivacaine, a common local anesthetic in the clinic, has anti-proliferative and pro-apoptotic effects in numerous cancers, however, the underlying regulatory mechanism of ropivacaine in hepatocellular carcinoma remains unclear. In the current study, human HepG2 cells were stimulated with different ropivacaine concentrations. Cell Counting Kit-8 assay, cell colony formation, and cell cycle were used to monitor cell viability. Cell apoptosis, migration, and invasion were determined by flow cytometry and transwell assays. Tumor xenograft experiments were performed to prove the anti-cancer effect of ropivacaine in vivo . A high dose of ropivacaine inhibited proliferation and promoted apoptosis of HepG2 cells in a dose-dependent manner. Ropivacaine challenge also arrested cells in the G2 phase, followed by a decline in the protein expression of cyclin D1 and cyclin-dependent kinase 2, and an increase in p27 levels in HepG2 cells. Additionally, different ropivacaine doses suppressed cell migration and invasion by upregulating E-cadherin expression and downregulating N-cadherin expression. Mechanically, ropivacaine challenge gradually restrained insulin-like growth factor-1 receptor (IGF-1 R) expression and the activities of phosphorylated-PI3K, AKT, and mTOR in HepG2 cells with increased ropivacaine doses. In the tumor xenograft experiment, ropivacaine was confirmed to inhibit tumor growth, accompanied by inhibition of the IGF-1 R/PI3K/AKT/mTOR signaling axis. In conclusion, ropivacaine suppressed tumor biological characteristics and promoted apoptosis, resulting in the suppression of hepatocellular carcinoma progression by targeting the IGF-1 R/PI3K/AKT/mTOR signaling pathway. It is possible that ropivacaine-mediated local anesthesia may be developed as a novel surgical adjuvant drug for treating hepatocellular carcinoma.

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Section: Discussionsupporting

confidence: 90%

Ropivacaine suppresses tumor biological characteristics of human hepatocellular carcinoma via inhibiting IGF-1R/PI3K/AKT/mTOR signaling axis

et al. 2021

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“…Diseases such as colon cancer, abdominal masses, and gastric cancer mostly require open surgery [ 15 ], and the presence of postoperative pain after anesthesia will severely compromise patients’ prognosis, especially in elder patients, which necessitates effective analgesic measures [ 16 , 17 ]. Clinical experience has revealed intolerance to intrathecal anesthesia in some patients, which prevents its extensive use in practice.…”

Section: Discussionmentioning

confidence: 99%

Analgesic effects of different concentrations of ropivacaine in transversalis fascia plane block during laparotomy

Tian

Zhan²,

Ke³

et al. 2022

BMC Anesthesiol

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Objective To explore the analgesic effects of different concentrations of ropivacaine in transversalis fascia plane (TFP) block during laparotomy. Methods Ninety patients who underwent laparotomy admitted to our hospital from March 2019 to March 2020 were selected as the study subjects and were divided equally into a low concentration group, a medium concentration group, and a high concentration group according to the randomized grouping method. The low concentration group adopted 0.4% ropivacaine 40 ml, the medium concentration group was given 0.5% ropivacaine 40 ml, and the high concentration group was given 0.6% ropivacaine 40 ml. The hemodynamic indexes and the incidence of adverse reactions in the two groups were compared. The Numerical Rating Scale (NRS) was used to assess the postoperative pain in the three groups, the Bruggrmann comfort scale (BCS) was used to assess the comfort level in the three groups, and the Mini-mental State Examination (MMSE) was used to evaluate the postoperative cognitive function of the three groups of patients. Results The mean artery pressure (MAP) and heart rate (HR) levels at T1 and T2 were significantly lower in the medium concentration group than in the other two groups (P < 0.05). The low concentration group had a significantly higher NRS score at T2 than the medium concentration group and the high concentration group (P < 0.05). A significantly higher BCS score was observed in the high concentration group than the other two groups (P < 0.05). There were significantly higher Ramsay scores and MMSE scores in the medium concentration group than in the low concentration and high concentration groups (P < 0.05). The overall incidence of adverse reactions of the high concentration group was significantly higher than that of the low concentration group (P < 0.05), but showed similar results with the medium concentration group. Conclusion The medium concentration group exhibits a better analgesic effect than the low concentration group and higher safety than the high concentration group. Therefore, the use of medium concentration ropivacaine in TFP block may provide a referential basis for clinical treatment.

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A clinical study on spinal anaesthesia with an equal dose and different concentrations of ropivacaine combined with epidural anaesthesia during caesarean section

Li,

Liu,

Zhao

et al. 2024

Preprint

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Background: Patients who undergo spinal anaesthesia combined with epidural block during caesarean section often have prolonged dyskinesia and leg numbness after the operation. This study explored whether small-dose and low-concentration local anaesthetics can meet the needs of surgery while helping relieve motor blocks earlier, reduce discomfort during leg numbness, and promote early maternal activity to provide additional options for women undergoing caesarean section. Methods: One hundred and twenty patients who underwent elective caesarean section were randomly divided into three groups according to the local anaesthetic concentration: 0.6%, 0.5%, and 0.4% ropivacaine. In all the groups, the puncture point, total dose and injection speed were the same, and an epidural catheter was inserted. Additionally, 2% lidocaine was added to the epidural catheter when the effect of spinal anaesthesia decreased during the operation. The primary outcome was the duration of lidocaine supplementation. Other secondary outcomes were the onset time, duration, highest sensory and motor block levels, use of additional epidural drugs, vital signs, adverse reactions, satisfaction and so on. Results: The sensory and motor block levels decreased faster and were shorter in the 0.4% ropivacaine group than in the other two groups, but additional epidural drugs were needed. Intraoperative circulation was more stable. There were no significant differences in adverse reactions or satisfaction among the groups. Conclusions: A small dose of 0.4% ropivacaine can meet the needs of surgery during combined spinal-epidural anaesthesia for caesarean section, and parturients can recover lower limb sensation and motor function faster after surgery; however, it is necessary to determine the operation time and administer epidural drugs in a timely manner. Trial registration: ChiCTR-2000030968 (Chictr.org.cn); registered on 20/03/2020.

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Small-Dose Ropivacaine Hydrochloride with Fentanyl versus Large-Dose of Ropivacaine Hydrochloride for Cesarean Section

Abstract: Objective: To compare the effect of small-dose ropivacaine hydrochloride combined with fentanyl versus large-dose of ropivacaine hydrochloride for cesarean section.

Cited by 4 publications

References 16 publications

Ropivacaine suppresses tumor biological characteristics of human hepatocellular carcinoma via inhibiting IGF-1R/PI3K/AKT/mTOR signaling axis

Ropivacaine suppresses tumor biological characteristics of human hepatocellular carcinoma via inhibiting IGF-1R/PI3K/AKT/mTOR signaling axis

Analgesic effects of different concentrations of ropivacaine in transversalis fascia plane block during laparotomy

A clinical study on spinal anaesthesia with an equal dose and different concentrations of ropivacaine combined with epidural anaesthesia during caesarean section

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