The duration of action of bupivacaine, levobupivacaine, ropivacaine and pethidine in peripheral nerve block in the rat

Dyhre, Henrik; Lang, Michael; Wallin, Ronnie; Renck, H.

doi:10.1111/j.1399-6576.1997.tb04656.x

Cited by 63 publications

(29 citation statements)

References 11 publications

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“…16,17 With respect to the duration of lip anesthesia, the studies with 0.5% bupivacaine show figures between 319 and 570 minutes, the latter closer to that obtained in this study for racemic bupivacaine (612 minutes) and the mixture of 75% levobupivacaine and 25% dextrobupivacaine solution (590 minutes). 9,18 In vivo studies in animals 19,20 for sciatic nerve block and in humans for epidural anesthesia and infiltration in medicine [21][22][23] have not found any difference with respect to onset and duration of anesthesia between racemic bupivacaine and levobupivacaine.…”

Section: Discussionmentioning

confidence: 99%

Anesthetic Efficacy of Bupivacaine Solutions in Inferior Alveolar Nerve Block

Volpato¹,

Ranali²,

Ramacciato³

et al. 2005

Anesthesia Progress

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The purpose of this study was to compare the anesthetic efficacy of 2 bupivacaine solutions. Twenty-two volunteers randomly received in a crossover, double-blinded manner 2 inferior alveolar nerve blocks with 1.8 mL of racemic bupivacaine and a mixture of 75% levobupivacaine and 25% dextrobupivacaine, both 0.5% and with 1 : 200,000 epinephrine. Before and after the injection, the first mandibular premolar was evaluated every 2 minutes until no response to the maximal output (80 reading) of the pulp tester and then again every 20 minutes. Data were analyzed using the Wilcoxon paired test and the paired t test. No differences were found between the solutions for onset and duration of pulpal anesthesia and duration of soft tissue anesthesia (P Ͼ .05). It was concluded that the solutions have similar anesthetic efficacy.Key Words: Bupivacaine; Levobupivacaine; Inferior alveolar nerve block; Anesthetic efficacy; Pulpal anesthesia. Racemic bupivacaine has been used as a local anesthetic in medicine and dentistry for many years. The 2 main indications for its use in dentistry are lengthy procedures and management of postoperative pain, as in endodontic, surgical, and periodontal procedures, among others.1 Although no case of toxicity has been documented in dentistry, a number of authors have reported its potent cardiac toxic effects, even in small doses.2 Studies that compared racemic bupivacaine and levobupivacaine have shown less toxicity for the latter. onset of action and prolonged analgesia with this solution than with other mixtures of bupivacaine enantiomers. Considering the lower toxicity of levobupivacaine, the purpose of this study was to compare the anesthetic efficacy of racemic bupivacaine and the mixture of 75% levobupivacaine and 25% dextrobupivacaine, both in the concentration of 0.5% with 1 : 200,000 epinephrine. METHODSThe Ethical Committee in Human Research at the Piracicaba Dentistry School, State University of Campinas, São Paulo, Brazil, approved this study; written consent was obtained from each subject. The sample size was based on a previous 6 study and confirmed by using the software nQuery Advisor 4.0 for Windows. Twenty-two subjects (9 men and 13 women) who ranged in age from 21 to 51 years (average age, 25 years) participated in this study. All the subjects were in good health, and none were taking any medication that would alter pain

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Section: Discussionmentioning

confidence: 99%

Anesthetic Efficacy of Bupivacaine Solutions in Inferior Alveolar Nerve Block

Volpato¹,

Ranali²,

Ramacciato³

et al. 2005

Anesthesia Progress

View full text Add to dashboard Cite

show abstract

“…Several studies comparing ropivacaine with levobupivacaine and racemic bupivacaine for different nerve blocks showed that nerve blocks produced by ropivacaine have a clinical profile similar to that obtained with bupivacaine and levobupivacaine when used at similar concentrations and doses [4,11,12]. Other studies, however, found prolongation of sensory analgesia with levobupivacaine compared to ropivacaine [13].…”

Section: Discussionmentioning

confidence: 99%

“…Animal studies on conduction blocks produced by bupivacaine, levobupivacaine, and ropivacaine in isolated nerves showed that the onset and duration of nerve block induced by equimolar doses of these three agents are similar [11]. Several studies comparing ropivacaine with levobupivacaine and racemic bupivacaine for different nerve blocks showed that nerve blocks produced by ropivacaine have a clinical profile similar to that obtained with bupivacaine and levobupivacaine when used at similar concentrations and doses [4,11,12].…”

Section: Discussionmentioning

confidence: 99%

A Comparison of Levobupivacaine and Ropivacaine for Interscalene and Femoral Nerve Blocks: A Randomized, Double-Blind, Prospective Clinical Trial

Hanna¹,

Sloan

2011

J Anesthe Clinic Res

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Setting: Operating room of a university medical center.Patients: Thirty-five patients undergoing shoulder arthroscopy and thirty-six patients undergoing anterior cruciate ligament (ACL) reconstruction.Interventions: Patients undergoing shoulder arthroscopy were administered interscalene blocks, and patients undergoing ACL reconstruction were administered femoral nerve blocks. Patients in each group were randomized to receive either levobupivacaine 0.5% or ropivacaine 0.5%. Measurements:On postoperative days one and two, patients reported on the time of postoperative pain onset, the time when movement resumed in the operative limb, the time when pain medication was first required, and the amount of pain medication used. Patient satisfaction was measured 48 hours after the procedure on a 1-10 verbal numeric rating scale.Main results: Time to onset of anesthesia, intraoperative and postoperative opioid requirements, duration of postoperative analgesia, and overall patient satisfaction were similar between patients who received levobupivacaine and those who received ropivacaine. Conclusions:The study demonstrates that levobupivacaine and ropivacaine produce comparable postoperative analgesia when used for interscalene and femoral nerve blocks.Animal studies on conduction blocks produced by bupivacaine, levobupivacaine, and ropivacaine in isolated nerves showed that the onset and duration of nerve block induced by equimolar doses of these three agents are similar [11]. Several studies comparing ropivacaine with levobupivacaine and racemic bupivacaine for different nerve blocks showed that nerve blocks produced by ropivacaine have a clinical profile similar to that obtained with bupivacaine and levobupivacaine when used at similar concentrations and doses [4,11,12]. Other studies, however, found prolongation of sensory analgesia with levobupivacaine compared to ropivacaine [13]. A recent clinical trial comparing levobupivacaine 0.5% with ropivacaine 0.5% for the management of postoperative ankle surgery pain found that levobupivacaine provided more long lasting postoperative analgesia compared with the same dose

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“…The stereoselective effects induced by the bupivacaine isomers, R(+) and S(−), have been intensively studied to determine which causes less cardiotoxicity while still providing potent nerve blockade. Previous laboratory and clinical studies have shown that R(+)and S(−) bupivacaine have similar local anesthetic durations [26]; however, R(+) bupivacaine is associated with a more intense negative chronotropism [19] and a more arrhythmogenic effect than the S(−) isomer [9][10][11]. In the present study, RS(±) bupivacaine, especially at the higher concentrations, significantly lowered HR in 16 and 2-week-old rats, with the effect more prominent in the older animals.…”

Section: Discussionmentioning

confidence: 99%

Influence of age on bupivacaine cardiac arrhythmogenic effects

Kiuchi¹,

Zapata‐Sudo²,

Trachez³

et al. 2017

Cardiovasc Disord Med

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The cardiotoxic effects of bupivacaine, a widely used local anesthetic, may be age-dependent because neonates and children tolerate a higher plasma concentration of bupivacaine after intravenous administration than adults. No studies have compared the toxicity profiles of the bupivacaine isomers in human neonates and children, but differences in the lethal dose have been observed between adult and younger rats. Here, we determined the age dependency of cardiac toxicity induced by racemic RS(±) bupivacaine and its levo S(−) isomer in hearts obtained from 2-and 16-week-old male Wistar rats (n=30 each) using a Langendorff ex vivo assay. We found that both RS(±) and S(−) bupivacaine significantly reduced heart rate and prolonged the PR interval and QRS complex duration. The effects of both compounds were significantly greater in older rats, and RS(±) bupivacaine had a greater effect than S(−) bupivacaine. Furthermore, RS(±) bupivacaine induced significantly more severe arrhythmias in 16-week-old than in 2-week-old rats. By contrast, the same concentration of S(−) bupivacaine was associated with mild arrhythmias in both age groups. Thus, although RS(±) bupivacaine induced greater cardiotoxicity than S(−) bupivacaine, the effects of both compounds were age related, with hearts from older animals showing more signs of toxicity.

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The duration of action of bupivacaine, levobupivacaine, ropivacaine and pethidine in peripheral nerve block in the rat

Abstract: Equimolar doses of the investigated local anaesthetics exerted similar durations of sensory blockade in a peripheral nerve block model in the rat.

Cited by 63 publications

References 11 publications

Anesthetic Efficacy of Bupivacaine Solutions in Inferior Alveolar Nerve Block

Anesthetic Efficacy of Bupivacaine Solutions in Inferior Alveolar Nerve Block

A Comparison of Levobupivacaine and Ropivacaine for Interscalene and Femoral Nerve Blocks: A Randomized, Double-Blind, Prospective Clinical Trial

Influence of age on bupivacaine cardiac arrhythmogenic effects

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