Safety of local anesthetics

Cherobin, Ana Carolina Figueiredo Pereira; Tavares, Glaysson Tassara

doi:10.1016/j.abd.2019.09.025

Cited by 57 publications

(51 citation statements)

References 31 publications

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“…Local anesthesia also has its adverse reactions such as pain, edema, bruise, infection, hyperalgesia, and muscle Trismus due to needle penetration in the skin and some adverse reactions that are related to the complications such as local or systemic toxicity, allergic and idiosyncratic reactions (3). Lidocaine is widely used as an anesthetic choice for blepharoplasty because of a rapid onset of its effect (1.5 min), intermediate length of efficacy (1.5 -2 h), and good toleration (14).…”

Section: Discussionmentioning

confidence: 99%

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Hypnotic Anesthesia for Blepharoplasty Surgery: A Case Report

Fathi

Sabermoghaddam

Azaraein³

et al. 2021

Arch Neurosci

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Introduction: Blepharoplasty, which is performed for either functional or cosmetic purposes, is one of the most common surgeries around the world. This procedure can be performed under either local or general anesthesia. It depends on the surgical indication, patient’s demand, surgeon’s plan, and need for auxiliary operations. It has been proved that both local and general anesthesia have different complications. Hypnosis is a skill by which hypnotherapists can make changes in perceptual experience and can be used instead of anesthetic drugs on some occasions. The present study was conducted to survey the effectiveness of hypnosis used as an alternative to anesthesia procedures. Case Presentation: A 54-year-old woman was scheduled for bilateral upper lid cosmetic blepharoplasty. Hypnotic anesthesia was conducted owing to her fear of anesthesia and drug-related side effects. Hypnotic anesthesia was accomplished by a hypnotherapist who was an anesthesiologist, and the operation was done without any surgical complications. Conclusions: Hypnosis may be a good alternative to local anesthesia and lead to a reduction in analgesics consumption.

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Section: Discussionmentioning

confidence: 99%

“…It has been proved that both local and general anesthesia have different complications, and finding new strategies to reduce intra-and post-operative complications is one of the important challenges that need to focus on it (3,4). Hypnosis is a skill by which hypnotherapists can make changes in perceptual experience.…”

Section: Introductionmentioning

confidence: 99%

Hypnotic Anesthesia for Blepharoplasty Surgery: A Case Report

Fathi

Sabermoghaddam

Azaraein³

et al. 2021

Arch Neurosci

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“…13 Some authors have discussed that this method may decrease patient safety as abdominal anesthetics likely have higher intravascular absorption than other methods of administration. 14 Cases of toxicity have been reported, a specific syndrome of local anesthetic systemic toxicity (LAST) has been described. 14 Bupivacaine is a long acting, potent local anesthetic agent that is commonly used in gynecologic surgery.…”

Section: Introductionmentioning

confidence: 99%

A Systematic Review and Meta-Analysis of Intraperitoneal Bupivacaine in Laparoscopic Gynecologic Surgery

Marchand¹,

Ware²,

Govindan³

et al. 2021

JPR

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Objective: We set out to evaluate whether the instillation of bupivacaine versus a saline solution into the peritoneal cavity at time of laparoscopic gynecologic surgery will reduce postoperative pain and postoperative opioid consumption. Data Sources: We searched six databases: Web of Science, SCOPUS, Cochrane CENTRAL, ClinicalTrials.Gov, MEDLINE and PubMed. Our search strategy had no restriction on time or languages and included all studies that met our search algorithm up to March of 2021. Methods of Study Selection:We included only randomized trials that met our search strategy for the outcomes of 1) pain intensity 24 hours after surgery, 2) pain intensity 6 hours after surgery, and 3) length of hospital stay. Tabulation, Integration, and Results: We analyzed continuous data using mean difference (MD) with relative 95% confidence interval (CI). We included 8 randomized clinical trials. We found that intraperitoneal bupivacaine showed significant difference from the saline group regarding pain intensity 24 hours after surgery (MD= −0.73 [−1.10, −0.36]) (P = 0.01) and pain intensity 6 hours after surgery (MD= −1.12 [−2.22, −0.02]) (P = 0.05). Overall, patients allocated to the placebo group seemed to need other analgesics earlier than patients allocated to the bupivacaine group (MD=145. 08 [51.37, 238.79] (P = 0.02)). There was no significant difference regarding the length of hospital stay (MD= −0.44 [−1.44, 0.56]) (P = 0.39). Conclusion: Bupivacaine significantly reduced the visual analog pain score for pain compared with that of the placebo at 6 and 24 hours postoperatively. There was no significant difference in hospital stay. Prospero Registration: CRD42021254268.

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“…Among these strategies, the application of a local anaesthetic at the surgical site is limited by the short duration of action of most drugs. For example, the analgesic effect of bupivacaine lasts 4–8 h despite the addition of adrenaline 3 . Ropivacaine is a long‐acting amide local anaesthetic with a potentially improved safety profile, but not duration of action, compared with bupivacaine 4,5 …”

Section: Introductionmentioning

confidence: 99%

“…For example, the analgesic effect of bupivacaine lasts 4-8 h despite the addition of adrenaline. 3 Ropivacaine is a longacting amide local anaesthetic with a potentially improved safety profile, but not duration of action, compared with bupivacaine. 4,5 Various attempts have been made to increase the duration of action of local anaesthetics.…”

mentioning

confidence: 99%

Population pharmacokinetic analysis of ropivacaine extended‐release from a temperature‐responsive hydrogel in rats

Bang

Nam

Hwang³

et al. 2021

Clin Exp Pharma Physio

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Therapeutic agents with a short half‐life need to be administered frequently to achieve sustained and effective concentrations. This could be accomplished using sustained drug delivery technology. PF‐72 (TGel Bio, Inc., Seoul, Korea) is a drug delivery system based on a powder obtained from lyophilisation of a reverse thermal hydrogel, which could assist in achieving prolonged pain relief if mixed with an anaesthetic and injected into the incision site following surgery. The pharmacokinetic parameters related to the absorption of the local anaesthetic ropivacaine delivered using this hydrogel were quantified. Ten rats were divided into two groups (n = 5 each), and equal doses (4 mg/kg) of different formulations were subcutaneously injected into the abdomen. The experimental group received PF‐72 mixed with 0.75% ropivacaine, and the control group received 0.75% ropivacaine. Blood was collected at specific times to measure the plasma concentration of ropivacaine. Population pharmacokinetic analysis was performed using NONMEM VII level 4 (ICON Development Solutions, Dublin, Ireland). The one‐compartment absorption model, which combines zero‐order absorption and first‐order absorption, was used to describe the change in ropivacaine plasma concentration over time. The type of formulation was a significant covariate for zero‐order absorption duration (experimental group, 92.9 min; control group, 60.5 min). The addition of PF‐72 to 0.75% ropivacaine increased the duration of absorption into the blood, suggesting a longer lasting effect of the analgesic injected into the surgical wound.

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Safety of local anesthetics

Cited by 57 publications

References 31 publications

Hypnotic Anesthesia for Blepharoplasty Surgery: A Case Report

Hypnotic Anesthesia for Blepharoplasty Surgery: A Case Report

A Systematic Review and Meta-Analysis of Intraperitoneal Bupivacaine in Laparoscopic Gynecologic Surgery

Population pharmacokinetic analysis of ropivacaine extended‐release from a temperature‐responsive hydrogel in rats

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