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[PMID]:29443788
[Au] Autor:Purdy M; Kinnunen M; Kokki M; Anttila M; Eskelinen M; Hautajärvi H; Lehtonen M; Kokki H
[Ad] Endereço:Department of Surgery, Kanta-Häme Central Hospital, Hämeenlinna.
[Ti] Título:A prospective, randomized, open label, controlled study investigating the efficiency and safety of 3 different methods of rectus sheath block analgesia following midline laparotomy.
[So] Source:Medicine (Baltimore);97(7):e9968, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: There is a controversy regarding the efficacy of rectus sheath block (RSB). The aim of the present study was to evaluate analgesic efficacy and safety of three different methods of RSB in postoperative pain management after midline laparotomy. METHODS: A prospective, randomized, controlled, open-label clinical trial with 4 parallel groups was conducted in a tertiary care hospital in Finland. A total of 57 patients undergoing midline laparotomy were randomized to the control group (n = 12) or to 1 of the 3 active RSB analgesia groups: single-dose (n = 16), repeated-doses (n = 12), or continuous infusion (n = 17). Opioid consumption with iv-patient-controlled analgesia pump was recorded, and pain scores and patients' satisfaction were surveyed on an 11-point numeric rating scale for the first 48 postoperative h. Plasma concentrations of oxycodone and levobupivacaine were analyzed. All adverse events during the hospital stay were recorded. RESULTS: Oxycodone consumption was less during the first 12 h in the repeated-doses and in the continuous infusion groups (P = .07) and in numerical values up to 48 h in the repeated-doses group. Plasma oxycodone concentrations were similar in all 4 groups. Pain scores were lower in the repeated-doses group when coughing during the first 4 h (P = .048 vs. control group), and at rest on the first postoperative morning (P = .034 vs. the other 3 groups) and at 24 h (P = .006 vs. the single-dose group). All plasma concentrations of levobupivacaine were safe. The patients' satisfaction was better in the repeated-doses group compared with the control group (P = .025). No serious or unexpected adverse events were reported. CONCLUSIONS: RSB analgesia with repeated-doses seems to have opioid sparing efficacy, and it may enhance pain relief and patients' satisfaction after midline laparotomy.
[Mh] Termos MeSH primário: Laparotomia/efeitos adversos
Bloqueio Nervoso/métodos
Dor Pós-Operatória/prevenção & controle
Reto do Abdome
[Mh] Termos MeSH secundário: Adulto
Idoso
Analgesia Controlada pelo Paciente
Analgésicos Opioides/administração & dosagem
Analgésicos Opioides/sangue
Anestésicos Locais/administração & dosagem
Anestésicos Locais/sangue
Bupivacaína/administração & dosagem
Bupivacaína/análogos & derivados
Bupivacaína/sangue
Feminino
Seres Humanos
Masculino
Meia-Idade
Oxicodona/administração & dosagem
Oxicodona/sangue
Satisfação do Paciente
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Anesthetics, Local); A5H73K9U3W (levobupivacaine); CD35PMG570 (Oxycodone); Y8335394RO (Bupivacaine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009968


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[PMID]:29369202
[Au] Autor:Ju Y; Tian D; Tan Y; Fu Z
[Ad] Endereço:Department of Pain Management, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, Shandong China.
[Ti] Título:Palliative care with cervical intrathecal infusion and external pump for a late-stage cancer patient with refractory pain: A case report.
[So] Source:Medicine (Baltimore);97(4):e9714, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Intrathecal therapy, with a low complication rate, has become an alternative to standard pain management for treatment of neuropathic cancer pain. PATIENT CONCERNS: Here, we reported a late-stage cancer patient with intractable neuropathic pain in his right neck, shoulder, and upper limb. DIAGNOSES: The pain started 2 years ago when the patient was diagnosed as squamous cell carcinoma with metastasis to right supraclavicular lymph nodes. INTERVENTIONS: Cervical intrathecal infusion of morphine and bupivacaine with patient control analgesia by external pump was performed. The intrathecal catheter was located at the level of C6 vertebra. The initial concentration of bupivacaine and morphine were both 1 mg/mL with infusion rate of 0.3 mL/h and bolus of 0.3 mL. Subsequently, the concentrations increased to 2 mg/mL (bupivacaine) and 1.33 mg/mL (morphine), with infusion rate to 0.6 mL/h and bolus to 0.5 ml. OUTCOMES: The pain intensity decreased from numerical rating scale 6 to 7 to 2 to 3 at rest, and from 10 to 5 to 6 of breakthrough pain. LESSONS: In conclusion, cervical intrathecal infusion requires low concentration but high doses of bupivacaine and morphine, which is safe and effective in cancer patients with refractory pain and short life expectancy.
[Mh] Termos MeSH primário: Infusão Espinal/métodos
Neuralgia/tratamento farmacológico
Manejo da Dor/métodos
Dor Intratável/tratamento farmacológico
Cuidados Paliativos/métodos
[Mh] Termos MeSH secundário: Idoso
Analgesia Controlada pelo Paciente/métodos
Analgésicos Opioides/administração & dosagem
Anestésicos Locais/administração & dosagem
Bupivacaína/administração & dosagem
Carcinoma de Células Escamosas/complicações
Carcinoma de Células Escamosas/secundário
Vértebras Cervicais
Seres Humanos
Masculino
Morfina/administração & dosagem
Neoplasias Primárias Desconhecidas/complicações
Neuralgia/etiologia
Dor Intratável/etiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Anesthetics, Local); 76I7G6D29C (Morphine); Y8335394RO (Bupivacaine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180126
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009714


  3 / 11112 MEDLINE  
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[PMID]:29215511
[Au] Autor:Yeung J; Crisp CC; Mazloomdoost D; Kleeman SD; Pauls RN
[Ad] Endereço:Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, TriHealth Good Samaritan Hospital, Cincinnati, Ohio.
[Ti] Título:Liposomal Bupivacaine During Robotic Colpopexy and Posterior Repair: A Randomized Controlled Trial.
[So] Source:Obstet Gynecol;131(1):39-46, 2018 Jan.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate the effect of liposomal bupivacaine on postoperative pain among patients undergoing robotic sacrocolpopexy with posterior repair. METHODS: This was a randomized, patient-blinded, placebo-controlled trial of women undergoing robotic sacrocolpopexy with posterior repair. Liposomal bupivacaine or normal saline placebo was injected into laparoscopic and vaginal incisions at completion of surgery. Perioperative care was standardized. Visual analog scales were collected at 4, 18, and 24 hours postoperatively in hospital. Starting on postoperative day 1, participants completed twice-daily pain scales and a pain medication diary up until the evening of postoperative day 3. The primary outcome was a 20-mm change in the visual analog scale 18 hours postoperatively. Secondary measures included additional pain scores, satisfaction, and narcotic use. Sample size calculation revealed that 32 patients per arm were required to detect the 20-mm difference with 90% power and an α of 0.05. To allocate for dropout, a goal of 70 was set. RESULTS: Between March 2015 and April 2016, 100 women were screened and 70 women were enrolled: 35 women were randomized to liposomal bupivacaine and 35 to placebo, of whom 64 (91%) were included in the final analysis: 33 liposomal bupivacaine and 31 placebo. No difference in demographics, surgical data, or satisfaction between groups was noted. Median VAS at 18 hours after surgery was not statistically different in those who received liposomal bupivacaine compared with normal saline (15 mm compared with 20 mm; P=.52). Other pain scales and total morphine equivalents were also similar (P=.90). CONCLUSION: In this study of robotic sacrocolpopexy with posterior repair, there were no differences in pain scores or narcotic use between liposomal bupivacaine and placebo injected into laparoscopic and vaginal incisions. Given its lack of clinical benefit, routine use of liposomal bupivacaine is not supported for this surgical intervention. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT02449915.
[Mh] Termos MeSH primário: Bupivacaína/administração & dosagem
Colposcopia/métodos
Dor Pós-Operatória/tratamento farmacológico
Procedimentos Cirúrgicos Robóticos/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Anestésicos Locais
Colposcopia/efeitos adversos
Feminino
Seguimentos
Seres Humanos
Lipossomos/administração & dosagem
Meia-Idade
Medição da Dor
Dor Pós-Operatória/fisiopatologia
Prolapso de Órgão Pélvico/cirurgia
Medição de Risco
Procedimentos Cirúrgicos Robóticos/efeitos adversos
Método Simples-Cego
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anesthetics, Local); 0 (Liposomes); Y8335394RO (Bupivacaine)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171208
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000002375


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[PMID]:28450776
[Au] Autor:Tolesa K; Gebreal GW
[Ad] Endereço:Department of Ophthalmology, Jimma University, Ethiopia.
[Ti] Título:Brainstem Anesthesia after Retrobulbar Block: A Case Report and Review of Literature.
[So] Source:Ethiop J Health Sci;26(6):589-594, 2016 Nov.
[Is] ISSN:2413-7170
[Cp] País de publicação:Ethiopia
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Retro-bulbar anesthesia is one of the most common regional blocks used for intraocular surgeries. Complications associated with regional blocks may be limited to the eye or may be systemic. CASE REPORT: After a retro-bulbar block for glaucoma surgery, a 60-year-old man developed loss of consciousness, apnea with hypotension and bradycardia-features of brainstem anesthesia. We present the clinical features, treatment and comments on how to prevent the problem as well as a review of the literature on reported cases. CONCLUSION: Although it is rare, treating physicians should be aware of the potentially lethal consequences of retro-bulbar block, understand measures to reduce the risks and early recognition and treatment. Facilities where ophthalmic surgeries are performed under local anesthesia should be properly equipped and staffed for advanced resuscitation.
[Mh] Termos MeSH primário: Anestésicos Locais/efeitos adversos
Tronco Encefálico/efeitos dos fármacos
Bupivacaína/efeitos adversos
Trabeculectomia/efeitos adversos
[Mh] Termos MeSH secundário: Anestésicos Locais/administração & dosagem
Apneia/induzido quimicamente
Bupivacaína/administração & dosagem
Glaucoma/cirurgia
Seres Humanos
Hipotensão/induzido quimicamente
Masculino
Meia-Idade
Trabeculectomia/métodos
Inconsciência/induzido quimicamente
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anesthetics, Local); Y8335394RO (Bupivacaine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180205
[Lr] Data última revisão:
180205
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE


  5 / 11112 MEDLINE  
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[PMID]:28450772
[Au] Autor:Nazir N; Jain S
[Ad] Endereço:Department of Anesthesiology, School of Medical Sciences & Research, Sharda University, Greater Noida.
[Ti] Título:A Randomized Controlled Trial Study on the Effect of Adding Dexmedetomidine to Bupivacaine in Supraclavicular Block Using Ultrasound Guidance.
[So] Source:Ethiop J Health Sci;26(6):561-566, 2016 Nov.
[Is] ISSN:2413-7170
[Cp] País de publicação:Ethiopia
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The benefits of regional anesthetic techniques are well established. Use of additives to local anesthetics can prolong these benefits. The aim of this study was to find out the effect of adding dexmedetomidine to bupivacaine for supraclavicular block. METHODS: In this randomized, double-blind study, 70 ASA I & II patients of either sex undergoing elective surgeries on the upper limb were given supraclavicular block under ultrasound guidance. Group C (n=35) received 38 mL 0.25% bupivacaine + 2mL normal saline and group D received 38 mL 0.25% bupivacaine + 1 µg/kg dexmedetomidine (2mL). Patients were observed for, onset of motor and sensory block, duration of motor and sensory block, duration of analgesia, sedation score, hemodynamic changes and any adverse events. RESULTS: In group D, the onset was faster (P< 0.001), durations of sensory and motor block duration of and analgesia were prolonged as compared to group C (P < 0.0001).There was a significant drop in heart rate (HR) from the baseline in group D (P < 0.05) at 30, 60, 90 and 120 min. However, none of the patients dropped HR below 50/min. Mean Arterial Pressure (MAP) remained unaffected. The patients in group D were more effectively sedated than those in group C (P < 0.05). No adverse event was reported in either group. CONCLUSION: Dexmedetomidine as adjuvant to bupivacaine in supraclavicular block resulted in faster action, prolonged motor and sensory block, prolonged analgesia with hemodynamic stability and adequate sedation.
[Mh] Termos MeSH primário: Analgésicos não Entorpecentes/uso terapêutico
Anestésicos Locais/uso terapêutico
Bloqueio do Plexo Braquial/métodos
Bupivacaína/uso terapêutico
Dexmedetomidina/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Analgesia/métodos
Analgésicos não Entorpecentes/administração & dosagem
Anestésicos Locais/administração & dosagem
Bupivacaína/administração & dosagem
Dexmedetomidina/administração & dosagem
Método Duplo-Cego
Quimioterapia Combinada
Feminino
Hemodinâmica
Seres Humanos
Masculino
Meia-Idade
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Analgesics, Non-Narcotic); 0 (Anesthetics, Local); 67VB76HONO (Dexmedetomidine); Y8335394RO (Bupivacaine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180205
[Lr] Data última revisão:
180205
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE


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[PMID]:29181841
[Au] Autor:Ray A; Ray S
[Ad] Endereço:Department of Obstetrics and Gynaecology, DM Wayanad Institute of Medical Sciences, Naseera Nagar ,Meppadi (PO), Wayanad, Wayanad, Kerala, India, 673577.
[Ti] Título:Epidural therapy for the treatment of severe pre-eclampsia in non labouring women.
[So] Source:Cochrane Database Syst Rev;11:CD009540, 2017 11 28.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Pre-eclampsia is a pregnancy-specific multi-organ disorder, which is characterised by hypertension and multisystem organ involvement and which has significant maternal and fetal morbidity and mortality. Failure of the placental vascular remodelling and reduced uteroplacental flow form the etiopathological basis of pre-eclampsia. There are several established therapies for pre-eclampsia including antihypertensives and anticonvulsants. Most of these therapies aim at controlling the blood pressure or preventing complications of elevated blood pressure, or both. Epidural therapy aims at blocking the vasomotor tone of the arteries, thereby increasing uteroplacental blood flow. This review was aimed at evaluating the available evidence about the possible benefits and risks of epidural therapy in the management of severe pre-eclampsia, to define the current evidence level of this therapy, and to determine what (if any) further evidence is required. OBJECTIVES: To assess the effectiveness, safety and cost of the extended use of epidural therapy for treating severe pre-eclampsia in non-labouring women. This review aims to compare the use of extended epidural therapy with other methods, which include intravenous magnesium sulphate, anticonvulsants other than magnesium sulphate, with or without use of the antihypertensive drugs and adjuncts in the treatment of severe pre-eclampsia.This review only considered the use of epidural anaesthesia in the management of severe pre-eclampsia in the antepartum period and not as pain relief in labour. SEARCH METHODS: We searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform (ICTRP) (13 July 2017) and reference lists of retrieved studies. SELECTION CRITERIA: Randomised controlled trials (RCTs) or quasi-RCTs comparing epidural therapy versus traditional therapy for pre-eclampsia in the form of antihypertensives, anticonvulsants, magnesium sulphate, low-dose dopamine, corticosteroids or a combination of these, were eligible for inclusion. Trials using a cluster design, and studies published in abstract form only are also eligible for inclusion in this review. Cross-over trials were not eligible for inclusion in this review. DATA COLLECTION AND ANALYSIS: The two review authors independently assessed trials for inclusion and trial quality. There were no relevant data available for extraction. MAIN RESULTS: We included one small study (involving 24 women). The study was a single-centre randomised trial conducted in Mexico. This study compared a control group who received antihypertensive therapy, anticonvulsant therapy, plasma expanders, corticosteroids and dypyridamole with an intervention group that received epidural block instead of the antihypertensives, as well as all the other four drugs. Lumbar epidural block was given using 0.25% bupivacaine, 10 mg bolus and 5 mg each hour on continuous epidural infusion for six hours. This study was at low risk of bias in three domains but was assessed to be high risk of bias in two domains due to lack of allocation concealment and blinding of women and staff, and unclear for random sequence generation and outcome assessor blinding.The included study did not report on any of this review's important outcomes. Meta-analysis was not possible.For the mother, these were: maternal death (death during pregnancy or up to 42 days after the end of the pregnancy, or death more than 42 days after the end of the pregnancy); development of eclampsia or recurrence of seizures; stroke; any serious morbidity: defined as at least one of stroke, kidney failure, liver failure, HELLP syndrome (haemolysis, elevated liver enzymes and low platelets), disseminated intravascular coagulation, pulmonary oedema.For the baby, these were: death: stillbirths (death in utero at or after 20 weeks' gestation), perinatal deaths (stillbirths plus deaths in the first week of life), death before discharge from the hospital, neonatal deaths (death within the first 28 days after birth), deaths after the first 28 days; preterm birth (defined as the birth before 37 completed weeks' gestation); and side effects of the intervention. Reported outcomesThe included study only reported on a single secondary outcome of interest to this review: the Apgar score of the baby at birth and after five minutes and there was no clear difference between the intervention and control groups.The included study also reported a reduction in maternal diastolic arterial pressure. However, the change in maternal mean arterial pressure and systolic arterial pressure, which were the other reported outcomes of this trial, were not significantly different between the two groups. AUTHORS' CONCLUSIONS: Currently, there is insufficient evidence from randomised controlled trials to evaluate the effectiveness, safety or cost of using epidural therapy for treating severe pre-eclampsia in non-labouring women.High-quality randomised controlled trials are needed to evaluate the use of epidural agents as therapy for treatment of severe pre-eclampsia. The rationale for the use of epidural is well-founded. However there is insufficient evidence from randomised controlled trials to show that the effect of epidural translates into improved maternal and fetal outcomes. Thus, there is a need for larger, well-designed studies to come to an evidence-based conclusion as to whether the lowering of vasomotor tone by epidural therapy results in better maternal and fetal outcomes and for how long that could be maintained. Another important question that needs to be answered is how long should extended epidural be used to ensure any potential clinical benefits and what could be the associated side effects and costs. Interactions with other modalities of treatment and women's satisfaction could represent other avenues of research.
[Mh] Termos MeSH primário: Anestesia Epidural/métodos
Anestesia Obstétrica/métodos
Anestésicos Locais/administração & dosagem
Bupivacaína/administração & dosagem
Pré-Eclâmpsia/terapia
[Mh] Termos MeSH secundário: Corticosteroides/uso terapêutico
Anticonvulsivantes/uso terapêutico
Anti-Hipertensivos/uso terapêutico
Dipiridamol/uso terapêutico
Feminino
Seres Humanos
Substitutos do Plasma/uso terapêutico
Gravidez
Vasodilatadores/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Adrenal Cortex Hormones); 0 (Anesthetics, Local); 0 (Anticonvulsants); 0 (Antihypertensive Agents); 0 (Plasma Substitutes); 0 (Vasodilator Agents); 64ALC7F90C (Dipyridamole); Y8335394RO (Bupivacaine)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD009540.pub2


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[PMID]:29252407
[Au] Autor:Wu T; Smith J; Nie H; Wang Z; Erwin PJ; van Wijnen AJ; Qu W
[Ad] Endereço:From the Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota (TW, JS, WQ); Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota (HN, AJvW); Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota (ZW); Medical Library, Mayo Clinic, Rochester, Minnesota (PJE); Division of Pain Medicine, Mayo Clinic, Rochester, Minnesota (WQ); and Spine Center, Mayo Clinic, Rochester, Minnesota (WQ).
[Ti] Título:Cytotoxicity of Local Anesthetics in Mesenchymal Stem Cells.
[So] Source:Am J Phys Med Rehabil;97(1):50-55, 2018 Jan.
[Is] ISSN:1537-7385
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Cell therapy based on the trophic, mitogenic, and immunomodulatory capacity of mesenchymal stem cells is a promising treatment modality for degenerative musculoskeletal conditions. Local anesthetics have been commonly used in interventional procedures for alleviating pain, but local anesthetics may have negative impact on MSC dosing because of cytotoxicity or other biological effects. Because previous studies have not reached consensus yet on the potential complications of local anesthetics in cell therapy, we reviewed 11 studies that involve in vitro experimentation with MSCs using aminoamide-type anesthetics including lidocaine, ropivacaine, mepivacaine, bupivacaine, articaine, and prilocaine. Three studies that compare the effects of different types of local anesthetic agents showed that ropivacaine has the least detrimental effects on mesenchymal stem cell populations, whereas lidocaine seems to have the most significant effects on stem cell viability. Concentration- and time-dependent effects on cell viability were reported with bupivacaine, ropivacaine, lidocaine, and mepivacaine. We conclude that local anesthetic agents have time- and concentration-dependent detrimental effects on MSCs. However, in vivo studies will be required to understand the interactions of these agents with MSCs, because in vitro studies cannot replicate the pharmacokinetics of anesthetics in vivo or the recovery of MSCs in a more physiological environment.
[Mh] Termos MeSH primário: Amidas/toxicidade
Anestésicos Locais/toxicidade
Bupivacaína/toxicidade
Lidocaína/toxicidade
Mepivacaína/toxicidade
Células Mesenquimais Estromais/efeitos dos fármacos
[Mh] Termos MeSH secundário: Anestesia Local/estatística & dados numéricos
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Amides); 0 (Anesthetics, Local); 7IO5LYA57N (ropivacaine); 98PI200987 (Lidocaine); B6E06QE59J (Mepivacaine); Y8335394RO (Bupivacaine)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171227
[Lr] Data última revisão:
171227
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171219
[St] Status:MEDLINE
[do] DOI:10.1097/PHM.0000000000000837


  8 / 11112 MEDLINE  
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[PMID]:29245214
[Au] Autor:Zhang X; Yang Q; Zhang Z
[Ad] Endereço:Department of Anaesthesia, Huaihe Hospital, Henan University, Henan, PR China.
[Ti] Título:The efficiency and safety of local liposomal bupivacaine infiltration for pain control in total hip arthroplasty: A systematic review and meta-analysis.
[So] Source:Medicine (Baltimore);96(49):e8433, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: This meta-analysis aimed to compare the efficiency and safety of local liposomal bupivacaine infiltration and traditional cocktail analgesia for pain management in total hip arthroplasty (THA). METHODS: PubMed, Embase, Web of science, Medline, and Cochrane library databases were systematically searched. INCLUSION CRITERIA: Participants: patients planned for a THA with a diagnosis of hip osteoarthritis. INTERVENTIONS: liposomal bupivacaine was administrated in the experimental groups for pain control. Comparisons: the control groups received local infiltration of traditional analgesics. OUTCOMES: pain scores, opioids consumption, and postoperative complications among the patients. STUDY DESIGN: randomized control trials (RCTs) and non-RCTs. Methodological Index for Non-Randomized Studies scale was used to assess the methodological quality of the included studies. Meta-analysis was conducted by Stata 11.0 software. Systematic review registration number is CRD42017120981. RESULTS: Four articles involving 308 participants were included. Current meta-analysis revealed that there were significant differences regarding postoperative pain score at 12 hours (standard mean difference [SMD] = -0.496, 95% CI: -0.717 to -0.275, P = .000), 24 hours (SMD = -0.537, 95% CI: -0.760 to -0.313, P = .000), and 48 hours (SMD = -0.802, 95% CI: -1.029 to -0.576, P = .000). Liposomal bupivacaine intervention was found to significantly decrease opioid consumption at 12 hours (SMD = -0.544, 95% CI: -0.766 to -0.323, P = .000), 24 hours (SMD = -0.357, 95% CI: -0.577 to -0.138, P = .001), and 48 hours (SMD = -0.370, 95% CI: -0.589 to -0.151, P = .001). CONCLUSION: Local liposomal bupivacaine infiltration could significantly reduce visual analogue scale (VAS) scores and opioid consumption within the first 48 hours following THA surgery. In addition, there was a decreased risk of nausea and vomiting in liposomal bupivacaine groups. The overall evidence level was low, which means that further research is likely to significantly alter confidence levels in the effect, as well as potentially changing the estimates. In any subsequent research, further studies should focus on the optimal dose of local anesthetics and the potential adverse side effects. In addition, surgeries that can improve pain relief and enable faster rehabilitation and earlier discharges should also be explored. Several potential limitations of this study should be noted. Four articles are included and the sample size in each trial is small. Some important outcome parameters such as range of motion were not fully described and could not be included in the meta-analysis. All included studies were retrospectives which may decrease evidence levels for the meta-analysis. The evidence quality for each outcome was low which may influence the results of the meta-analysis. Short-term follow-ups may lead to the underestimation of complications, such as neurotoxicity and cardiotoxicity. Publication bias is an inherent weakness that exists in all meta-analyses.
[Mh] Termos MeSH primário: Analgésicos/administração & dosagem
Anestésicos Locais/administração & dosagem
Artroplastia de Quadril/efeitos adversos
Bupivacaína/administração & dosagem
Manejo da Dor/métodos
Dor Pós-Operatória/tratamento farmacológico
[Mh] Termos MeSH secundário: Idoso
Analgésicos Opioides/administração & dosagem
Feminino
Seres Humanos
Lipossomos
Masculino
Meia-Idade
Medição da Dor
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Analgesics); 0 (Analgesics, Opioid); 0 (Anesthetics, Local); 0 (Liposomes); Y8335394RO (Bupivacaine)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171222
[Lr] Data última revisão:
171222
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171217
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008433


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[PMID]:27776485
[Au] Autor:Okamoto A; Tanaka M; Sumi C; Oku K; Kusunoki M; Nishi K; Matsuo Y; Takenaga K; Shingu K; Hirota K
[Ad] Endereço:Department of Anesthesiology, Kansai Medical University, Hirakata, Japan.
[Ti] Título:The antioxidant N-acetyl cysteine suppresses lidocaine-induced intracellular reactive oxygen species production and cell death in neuronal SH-SY5Y cells.
[So] Source:BMC Anesthesiol;16(1):104, 2016 10 24.
[Is] ISSN:1471-2253
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The local anesthetic lidocaine can affect intra- and extra-cellular signaling pathways in both neuronal and non-neuronal cells, resulting in long-term modulation of biological functions, including cell growth and death. Indeed, lidocaine was shown to induce necrosis and apoptosis in vitro. While several studies have suggested that lidocaine-induced apoptosis is mitochondrial pathway-dependent, it remains unclear whether reactive oxygen species (ROS) are involved in this process and whether the observed cell death can be prevented by antioxidant treatment. METHODS: The effects of lidocaine and antioxidants on cell viability and death were evaluated using SH-SY5Y cells, HeLa cells, and HeLa cell derivatives. Cell viability was examined via MTS/PES ([3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium, inner salt]/phenazine ethosulfate) assay. Meanwhile, cell apoptosis and necrosis were evaluated using a cell death detection assay with Annexin V-FITC and PI staining, as well as by assaying for caspase-3/7 and caspase-9 activity, and by measuring the release of lactate dehydrogenase, respectively. Mitochondrial transmembrane potential (ΔΨm) was assessed using the fluorescent probe tetramethylrhodamine ethyl ester. RESULTS: Lidocaine treatment resulted in suppression of the mitochondrial electron transport chain and subsequent attenuation of mitochondrial membrane potential, as well as enhanced ROS production, activation of caspase-3/7 and caspase-9, and induction of apoptosis and necrosis in SH-SY5Y cells in a dose- and time-dependent manner. Likewise, the anesthetics mepivacaine and bupivacaine also induced apoptosis in SH-SY5Y cells. Notably, the antioxidants N-acetyl cysteine (NAC) and Trolox successfully scavenged the mitochondria-derived ROS and suppressed local lidocaine-induced cell death. CONCLUSIONS: Our findings demonstrate that the local anesthetics lidocaine, mepivacaine, and bupivacaine inhibited the activity of mitochondria and induced apoptosis and necrosis in a dose-dependent manner. Furthermore, they demonstrate that treatment with the antioxidants NAC, Trolox, and GGA resulted in preservation of mitochondrial voltage and inhibition of apoptosis via suppression of caspase activation.
[Mh] Termos MeSH primário: Acetilcisteína/farmacologia
Antioxidantes/farmacologia
Lidocaína/farmacologia
Espécies Reativas de Oxigênio/metabolismo
[Mh] Termos MeSH secundário: Acetilcisteína/administração & dosagem
Anestésicos Locais/farmacologia
Antioxidantes/administração & dosagem
Apoptose/efeitos dos fármacos
Bupivacaína/farmacologia
Morte Celular/efeitos dos fármacos
Linhagem Celular Tumoral
Sobrevivência Celular/efeitos dos fármacos
Cromanos/farmacologia
Relação Dose-Resposta a Droga
Células HeLa
Seres Humanos
Potencial da Membrana Mitocondrial/efeitos dos fármacos
Mepivacaína/administração & dosagem
Mitocôndrias/efeitos dos fármacos
Neuroblastoma/metabolismo
Fatores de Tempo
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Anesthetics, Local); 0 (Antioxidants); 0 (Chromans); 0 (Reactive Oxygen Species); 98PI200987 (Lidocaine); B6E06QE59J (Mepivacaine); S18UL9710X (6-hydroxy-2,5,7,8-tetramethylchroman-2-carboxylic acid); WYQ7N0BPYC (Acetylcysteine); Y8335394RO (Bupivacaine)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171204
[Lr] Data última revisão:
171204
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE


  10 / 11112 MEDLINE  
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[PMID]:29110430
[Au] Autor:Haydar B
[Ad] Endereço:Department of Anesthesiology, Section of Pediatric Anesthesia, University of Michigan, Ann Arbor, MI, USA.
[Ti] Título:Judging causal associations in observational research on caudal anesthesia and hypospadias repair.
[So] Source:Paediatr Anaesth;27(12):1279, 2017 12.
[Is] ISSN:1460-9592
[Cp] País de publicação:France
[La] Idioma:eng
[Mh] Termos MeSH primário: Anestesia Caudal
Hipospadia
[Mh] Termos MeSH secundário: Bupivacaína
Seres Humanos
Masculino
Uretra
Fístula Urinária
[Pt] Tipo de publicação:LETTER; COMMENT
[Nm] Nome de substância:
Y8335394RO (Bupivacaine)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171108
[St] Status:MEDLINE
[do] DOI:10.1111/pan.13260



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