Additives to local anesthetics for peripheral nerve blocks: Evidence, limitations, and recommendations

“…Nevertheless, some studies about peripheral nerve blocks have described variable results, demonstrating questionable effects in different species (BAILARD et al, 2014). In the present study, rabbits received this drug in retrobulbar route and good physiologic and ophthalmic stability was observed, characterized by IOP and papillary dilatation maintenance.…”

Section: Discussionmentioning

confidence: 57%

Selected ophthalmic and physiologic parameters in rabbits (Oryctolagus cuniculus) submitted to retrobulbar block with lidocaine, morphine or ketamine

Schaffer¹,

Silveira²,

Nunes³

et al. 2017

Biosci. J.

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ABSTRACT:The aim of the present study was to evaluate selected ophthalmic and physiologic parameters in rabbits submitted to retrobulbar blockade with lidocaine, morphine or ketamine. Eighteen adult rabbits, seven males and eleven females, New Zealand White breed, weighing 3.9 ± 0.7 kg were randomly assigned to perform the retrobulbar block according to the groups: LID (2% lidocaine without a vasoconstrictor -7 mg kg -1 ); MOR (1% morphine -1 mg kg -1 ) or KET (10% Ketamine -5 mg kg -1 ). Ophthalmic and physiologic parameters were assessed, including lacrimal production using Schirmer tear test (STT), corneal touch threshold (CTT), pupillary diameter, intraocular pressure (IOP), pulse rate (PR), respiratory rate (RR), oxyhemoglobin saturation (SpO 2 ), rectal temperature (RT) and systolic, mean and diastolic blood pressures (SAP, MAP and DAP) and were evaluated every 10 minutes for 70 minutes. All drugs used in the present study promoted central positioning of the eyeball for up to one minute later the retrobulbar administration in all cases. There was a significant increase of STT values in MOR and LID, when compared to baseline, while the CTT values had a significant decrease in all groups. KET kept the IOP values unaltered at the time points and there was a significant decrease of pupillary diameter in MOR. There was no significant change in PR, RR and SpO 2 ; however, LID presented significantly lower values of SAP. MOR had increased values for RT when compared to the other two groups. The established parameters may help in ophthalmic procedures using retrobulbar nerve blocks.

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“…Reviews of additives to local anesthetics for peripheral nerve blocks provide insight on the effi cacy of these additives along with their potential safety risks and neurotoxic eff ects (20,21). Few studies have added the longacting amino ester tetracaine to a long-acting amino amide such as bupivacaine to prolong anesthesia and analgesia.…”

Section: Discussionmentioning

confidence: 99%

Effect of Adding Tetracaine to Bupivacaine on Duration of Analgesia in Supraclavicular Brachial Plexus Nerve Blocks for Ambulatory Shoulder Surgery

Pearson

Lowry

Culp

et al. 2015

Baylor University Medical Center Proceedings

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Additives to local anesthetics for peripheral nerve blocks: Evidence, limitations, and recommendations

Abstract: Some additives to local anesthetics can hasten the onset of nerve block, prolong block duration, or reduce toxicity. On the other hand, poorly selected or unnecessary additives may not have the desired effect and may even expose patients to unnecessary risks.

Cited by 185 publications

References 74 publications

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Selected ophthalmic and physiologic parameters in rabbits (Oryctolagus cuniculus) submitted to retrobulbar block with lidocaine, morphine or ketamine

Effect of Adding Tetracaine to Bupivacaine on Duration of Analgesia in Supraclavicular Brachial Plexus Nerve Blocks for Ambulatory Shoulder Surgery

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