A Comparative Study of Intrathecal Ephedrine Sulfate, Intrathecal Pontocaine, and Inhalation Anesthesia for Obstetrical Delivery

Penman, W. Robert

doi:10.1016/s0002-9378(16)39175-x

Cited by 5 publications

(2 citation statements)

References 3 publications

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“…6,7,9,18,25,26 However, subtle neurologic deficits may not have been reported. In rat pilot studies, we found that clinical neurotoxicity (as measured by neurobehavioral endpoints) begins at approximately 10% (n ϭ 4, data not shown).…”

Section: Discussionmentioning

confidence: 99%

“…4,5 These adrenergic properties prompted us to reexamine ephedrine as a potential adjuvant for clinical and investigational local anesthetics (LAs). 9 To evaluate ephedrine as a potential adjuvant for clinical and investigational LAs, we (1) assessed whether ephedrine provides dose-dependent reversible block of motor and sensory/nociceptive functions in a rat sciatic nerve block model without degenerative histologic changes and (2) investigated ephedrine's mechanism of nerve blockade by determining its Na ϩ channel-blocking capabilities in cultured cells stably expressing Na ϩ channels. 6,7 However, and to our surprise, we found that ephedrine was used as a sole LA agent more than half a century ago.…”

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Ephedrine Blocks Rat Sciatic Nerve In Vivo and Sodium Channels In Vitro

Hung

Kau

Zizza³

et al. 2005

Anesthesiology

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Background:The sympathomimetic drug ephedrine has been used intrathecally as the sole local anesthetic for labor and delivery. Because ephedrine may be a useful adjuvant to local anesthetics, the authors investigated the local anesthetic properties of ephedrine in a rat sciatic nerve block model and the underlying mechanism in cultured cells stably expressing Na ؉ channels.Methods: After approval of the animal protocol, the sciatic nerves of anesthetized rats were exposed by lateral incision of the thighs, 0.2 ml ephedrine at 0.25, 1, 2.5, or 5% and/or bupivacaine at 0.125% was injected, and the wound was closed. Motor and sensory/nociceptive functions were evaluated by the force achieved by pushing against a balance and the reaction to pinch, respectively. The whole cell configuration of the patch clamp technique was used to record Na ؉ currents from human embryonal kidney cells stably transfected with Na v 1.4 channels.Results: The nociception blockade was significantly longer than the motor blockade at test doses of 2.5 and 5% of ephedrine, or when 1% ephedrine was combined with 0.125% bupivacaine (analysis of variance with repeated measures, P < 0.001, n ‫؍‬ 8/group). In vitro, the 50% inhibitory concentrations of ephedrine at ؊150 and ؊60 mV were 1,043 ؎ 70 and 473 ؎ 13 M, respectively. High-frequency stimulation revealed a usedependent block of 18%, similar to most local anesthetics.Conclusions: Because ephedrine's properties are at least partly due to Na ؉ channel blockade, detailed histopathologic investigations are justified to determine the potential of ephedrine as an adjuvant to clinically used local anesthetics.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Ephedrine Blocks Rat Sciatic Nerve In Vivo and Sodium Channels In Vitro

Hung

Kau

Zizza³

et al. 2005

Anesthesiology

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The history and progress of local anesthesia: multiple approaches to elongate the action

2018

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Analgesia and temporary inhibition of motor activity without interfering with central nervous function have been the essential merits of local anesthesia. Local anesthetics originated from cocaine have played a major role in local analgesia. However, the relatively short duration of action of local anesthetics has been a concern in intra- and post-operative analgesia. From the early age of modern local anesthesia, physicians and medical scientists had been struggling to control the active duration of local anesthetics. Such approach includes: development of long-acting local anesthetics, with physical tourniquet techniques, co-administration of other medicines such as vaso-constrictive agents or analgesics, development of mechanical devices to continuously or intermittently administer local anesthetics, and utilization of pharmaceutical drug delivery systems. In this review, the historical sequence of studies that have been performed in an effort to elongate the action of local anesthetics is presented, referring to epoch-making medical and scientific studies.

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