Thirty years after the bupivacaine controversy: what have we learned?

Shannon, James A.; Douglas, Joanne

doi:10.1007/s12630-010-9276-6

Cited by 1 publication

(1 citation statement)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Second, in response to concerns of bupivacaine cardiotoxicity, epidural anesthetic technique became more cautious. 8 Test doses containing epinephrine began to be given before administration of larger volumes of local anesthetics. In addition, local anesthetic doses began to be given incrementally, with serial doses punctuated by observation periods.…”

Section: The Legacy Of Dr George Albrightmentioning

confidence: 99%

The Bupivacaine Story: A Tribute to George A. Albright, MD (1931–2020)

Larson

Youssefzadeh

Moon

2022

Anesthesia &Amp; Analgesia

View full text Add to dashboard Cite

In 1979, George A. Albright, MD (1931–2020) published a controversial editorial in Anesthesiology that raised the question of bupivacaine cardiotoxicity. In it, he presented several cases of rapid cardiovascular collapse after administration of the highly lipophilic local anesthetic and called for further investigation. Although the scientific community initially resisted Dr Albright’s idea, his editorial would ultimately lead to several important advancements in anesthesiology. In 1983, the US Food and Drug Administration issued a black box warning that recommended against the use of 0.75% bupivacaine in obstetric anesthesia. This warning would remain in place until 1999. In addition, Dr Albright’s article led to the following changes: laboratory research that proved the cardiotoxicity of bupivacaine; the development of safer, stereoselective agents like ropivacaine; and the acceptance of lipid emulsion as a treatment for local anesthetic toxicity. In this article, C. Philip Larson, Jr, MDCM, Editor-in-Chief of Anesthesiology at the time of publication of Albright’s manuscript, provides a unique perspective on the bupivacaine story.

show abstract

Section: The Legacy Of Dr George Albrightmentioning

confidence: 99%