A comparison of the antibacterial activity of levobupivacaine vs. bupivacaine: an in vitro study with bacteria implicated in epidural infection

Abstract

SummaryPostanaesthetic shivering affects up to 70% of patients after general anaesthesia, and may be very distressing. Various drugs have been used to treat or prevent postanaesthetic shivering, but the ideal one has not yet been found. Sixty patients undergoing elective abdominal or orthopaedic surgery under general anaesthesia were included in a randomised, double-blind study. Patients received clonidine (3 mg.kg Mean arterial blood pressure and heart rate were significantly lower in the clonidine group compared with both other groups. Our results suggest that nefopam and clonidine are effective in the prevention of postanaesthetic shivering. However, following clonidine administration the recovery time was prolonged and hypotension was significantly greater than after nefopam.

Microbial growth in a mixture of hyperbaric bupivacaine and fentanyl prepared in a multi-dose syringe in the operating theatre environment

“…This finding has been repeated in investigations of microbial survival in other types of medication (57). Many of the candidate studies from our literature review examined the antimicrobial activity of bupivacaine at temperatures which were substantially higher than room temperature (14,33,39,(48)(49)(50)(51)(52)(53)(54). In the only study which did observe the antimicrobial activity of bupivacaine at room temperature, the local anaesthetic was found to have generally poor antimicrobial effectiveness (34).…”

“…All have suggested that this activity is concentration-dependent (14,33,34,39,(48)(49)(50)(51)(52)(53)(54), however there is conflicting evidence as to the specifics of bupivacaine's antimicrobial activity. Some suggest that bupivacaine has good action against a variety of pathogens at clinically significant concentrations (14,50,51,54).…”

Comparação dos efeitos da infiltração com bupivacaína, lidocaína e tramadol na cicatrização de feridas em ratos

“…The antibacterial properties of local anesthetics and other agents used in wound infiltration are important. Previous research emphasized the antibacterial properties of bupivacaine [42][43][44] . Controversy surrounds lidocaine antibacterial properties though there are studies in the literature emphasizing its antibacterial properties 45 .…”

Estudo comparativo entre bupivacaína a 0,5% e mistura enantiomérica de bupivacaína (S75-R25) a 0,5% em anestesia peridural

“…Alternativas que mereceriam melhor avaliação seriam o isômero puro S(-)-bupivacaína a 0,75%, ou a S75-R25 em maior concentração, a fim de manter a qualidade do bloqueio motor e de ampliar o grau de analgesia. A adição do isômero R(-)-bupivacaína a 25% poderia trazer benefícios teóricos, como maior potência antibacteriana contra Staphylococcus aureus, S epidermidis, Enterococcus faecalis 18 . Resta saber se a adição de 25% do R(+)-bupivacaína à formulação seria mais vantajosa quando comparada com a solução levobupivacaína a 0,75%, sendo equipotentes tanto quanto à anestesia, quanto à incidência dos efeitos tóxicos.…”

“…Alternatives deserving further evaluations would be the pure isomer 0.75% S(-) bupivacaine or S75-R25 in higher concentrations to maintain motor block quality and enhance analgesia. The association of the isomer 25% R(-) bupivacaine could have theoretical benefits, such as more antibacterial potency against Staphylococcus aureus, S. epidermidis, Enterococcus faecalis 18 . It is still to be known whether the association of 25% R(+) bupivacaine to the formulation would be more advantageous as compared to 0.75% levobupivacaine, being equipotent both in anesthesia and incidence of toxic effects.…”