Levobupivacaína versus bupivacaína em anestesia peridural para cesarianas: estudo comparativo

Bergamaschi, Felipe; Balle, Vanessa Rezende; Gomes, Marcos Emanuel Wortmann; Machado, Sheila Braga; Mendes, Florentino Fernandes

doi:10.1590/s0034-70942005000600003

Cited by 7 publications

(3 citation statements)

References 14 publications

(31 reference statements)

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“…However, in one study comparing levobupivacaine to racemic bupivacaine and to 50% enantiomeric excess bupivacaine in humans undergoing low abdomen surgery, a decrease in SAP has been observed (Tanaka et al, 2005). Levobupivacaine alone has been shown to decrease MAP in humans during elective surgeries (Glaser et al, 2002), whereas hemodynamic stability has been described in women undergoing epidural anesthesia for cesarean-section as well as in their newborns (Bergamaschi et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

Epidural levobupivacaine alone or combined with different morphine doses in bitches under continuous propofol infusion

Albuquerque¹,

Araújo²,

Ferreira³

et al. 2015

Arq. Bras. Med. Vet. Zootec.

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The aim of this study was to assess the cardiopulmonary, analgesic, adverse effects, serum concentration of cortisol and plasma levels of levobupivacaine and morphine in bitches undergoing propofol anesthesia and epidural analgesia with levobupivacaine alone or combined with morphine. This was a randomized 'blinded' prospective clinical study using 32 adult bitches weighing 9.8±4.1kg that were admitted for elective ovariohysterectomy. Twenty minutes after administration of acepromazine and midazolam, anesthesia was induced with propofol (4mg kg -1 ) and maintained by a continuous rate infusion (CRI). Each animal was randomly assigned to one of four epidural groups: GL = levobupivacaine alone (0.33mg kg -1 ); GLM0.1 = levobupivacaine and morphine (0.1mg kg -1 ); GLM0.15 = levobupivacaine and morphine (0.15mg kg -1 ); and GLM0.2 = levobupivacaine and morphine (0.2mg kg -1 ). Variables obtained during anesthesia were heart rate, respiratory rate, systolic, mean and diastolic arterial blood pressures, oxyhemoglobin saturation, inspired oxygen fraction, end-tidal carbon dioxide tension, blood gases, serum cortisol, and plasma levels of levobupivacaine and morphine. The onset and duration times of the blockade were recorded. Arterial pressures were significantly increased in all groups at the times of ovarian pedicle clamping. There was a decrease in pH, together with an increase in both PaO 2 and PaCO 2 over time. Serum cortisol levels were increased in TESu compared to TB, T30 and TR. Limb spasticity, muscle tremors, opisthotonos and diarrhea were observed in some animals during propofol infusion and ceased with the end of CRI. Reactions happened at different moments and lasted for different periods of time in each individual. Epidural with levobupivacaine alone or combined with morphine allowed for ovariohysterectomy to be performed under low propofol infusion rates, with minimal changes in cardiovascular variables and in serum cortisol levels. Adverse effects were observed in very few animals in each group. Keywords: dog, opioid, ovariohysterectomy, blood gas, regional anaesthesia (0,33mg/kg); GLM0,1 = levobupivacaína + morfina (0,1mg/kg); GLM0,15 = levobupivacaína + morfina (0,15mg/kg) e GLM0,2 = levobupivacaína + morfina (0,2mg/kg RESUMO Objetivou-se avaliar os efeitos cardiovasculares, analgésico, adversos, a concentração sérica de cortisol e os níveis plasmáticos de levobupivacaína e morfina em cadelas submetidas à infusão contínua de propofol e analgesia peridural com levobupivacaína isolada ou associada à morfina. Para tanto, realizou-se um estudo clínico prospectivo randomizado com 32 cadelas adultas pesando 9,8 ± 4,1kg, que foram submetidas à ovário-histerectomia eletiva. Vinte minutos após a administração de acepromazina e midazolam, os animais foram induzidos com propofol (4mg/kg) e mantidos por uma infusão contínua (CRI) do mesmo fármaco. Cada animal foi alocado aleatoriamente em um dos quatro grupos: GL = levobupivacaína isolada

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Section: Discussionmentioning

confidence: 99%

Epidural levobupivacaine alone or combined with different morphine doses in bitches under continuous propofol infusion

Albuquerque¹,

Araújo²,

Ferreira³

et al. 2015

Arq. Bras. Med. Vet. Zootec.

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“…[26] The incidence of hypotension is similar when either levobupivacaine or bupivacaine is used for epidural anesthesia for cesarean section. [28] Levobupivacaine and bupivacaine when used in thoracic epidural anesthesia provide comparable sensory block and intraoperative hemodynamics as well as similar duration of post-operative analgesia after thoracic surgery. [29]…”

Section: Clinical Utilitymentioning

confidence: 99%

Clinical profile of levobupivacaine in regional anesthesia: A systematic review

Bajwa

Kaur

2013

J Anaesthesiol Clin Pharmacol

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The quest for searching newer and safer anesthetic agents has always been one of the primary needs in anesthesiology practice. Levobupivacaine, the pure S (−)-enantiomer of bupivacaine, has strongly emerged as a safer alternative for regional anesthesia than its racemic sibling, bupivacaine. Levobupivacaine has been found to be equally efficacious as bupivacaine, but with a superior pharmacokinetic profile. Clinically, levobupivacaine has been observed to be well-tolerated in regional anesthesia techniques both after bolus administration and continuous post-operative infusion. The incidence of adverse drug reactions (ADRs) is rare when it is administered correctly. Most ADRs are related to faulty administration technique (resulting in systemic exposure) or pharmacological effects of anesthesia; however, allergic reactions can also occur rarely. The available literary evidence in anesthesia practice indicates that levobupivacaine and bupivacaine produce comparable surgical sensory block, similar adverse side effects and provision of similar labor analgesia with good comparable maternal and fetal outcome. The present review aims to discuss the pharmacokinetic and pharmacological essentials of the safer profile of levobupivacaine as well as to discuss the scope and indications of levobupivacaine based on current clinical evidence.

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“…In a similar direction, simulations with the two bupivacaine (BVC) enantiomers helped to elucidate the higher cardiotoxicity observed for the R-form than the S-form [56]. The effect of R-BVCs (at 1:3 molar concentration) is to disorganize the membrane (decrease the order parameters); this effect is seen for both tails [51].…”

Section: Atomistic Simulationsmentioning

confidence: 97%

Molecular Dynamics Simulations to Study Drug Delivery Systems

Albano¹,

Paula²,

Pickholz³

2018

Molecular Dynamics

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Molecular dynamics simulation is a very powerful tool to understand biomolecular processes. In this chapter, we go over different applications of this methodology to drug delivery systems (DDS) carried out in the group. DDS-a formulation or a device that enables the introduction of a therapeutic substance in the body and improves its efficacy and safety by controlling the rate, time, and place of release of drugs-are an important component of drug development and therapeutics. Biocompatible nanoparticles are materials in the nanoscale that emerged as important players, improving efficacy of approved drugs, for example. The molecular understanding of the encapsulation process could be very helpful to guide the nanocarrier for a specific system. Here we discuss different applications of drug delivery carriers, such as liposomes, polymeric micelles, and polymersomes using atomistic and coarse grain (CG) molecular dynamics simulations.

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Levobupivacaína versus bupivacaína em anestesia peridural para cesarianas: estudo comparativo

Abstract: Levobupivacaine and bupivacaine were equally effective for epidural block in patients undergoing cesarean section.

Cited by 7 publications

References 14 publications

Epidural levobupivacaine alone or combined with different morphine doses in bitches under continuous propofol infusion

Epidural levobupivacaine alone or combined with different morphine doses in bitches under continuous propofol infusion

Clinical profile of levobupivacaine in regional anesthesia: A systematic review

Molecular Dynamics Simulations to Study Drug Delivery Systems

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