Axillary brachial plexus block duration with mepivacaine in patients with chronic renal failure. Case–control study

Mojica, Viviana; Nieuwveld, Daniela; Herrera, Ana Eugenia; Mestres, Gaspar; López, Ana Marı́a; Sala‐Blanch, Xavier

doi:10.1016/j.redare.2017.02.006

“…However, some reports have shown that the pharmacokinetics of ropivacaine is not affected by renal failure ( 21 ). Furthermore, in another study, no significant differences were observed in the duration of brachial plexus block using 20 mL of 1.5% mepivacaine in patients with renal failure compared to those without renal failure ( 22 ). Therefore, study population, difference in drugs, drug dosage, and other factors affecting drug metabolism may explain the differences in the duration of brachial plexus block in patients with renal failure.…”

Section: Discussionmentioning

confidence: 95%

Factors associated with prolonged duration of ultrasound-guided brachial plexus block for the upper limb fracture surgery: a cross-sectional study

Li¹,

Zhao²,

Feng³

et al. 2023

Ann Transl Med

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Background Previous studies of factors associated with prolonged duration of ultrasound-guided brachial plexus block have included multiple surgical procedures or multiple anesthetic approaches, all of which are important confounders, and there is no study based on a single method of anesthesia exploring the factors affecting the resolution of brachial plexus block during upper limb surgery, especially in Asians. This study aimed to identify the risk factors affecting the prolonged duration of US-guided brachial plexus block in American Society of Anesthesiologists (ASA) I–II grade patients to improve postoperative analgesia. Methods This study enrolled patients scheduled to undergo surgery for upper limb fracture in Anting Hospital, Shanghai from May 2021 to September 2021. Inclusion criteria: (I) patients aged 18 years and above; (II) ASA I–II grade patients; (III) success of US-guided brachial plexus block. Based on the median duration of brachial plexus block, patients were divided into a <5-hour group and a ≥5-hour group. The factors were selected base on previous studies conclution and clinical demographic characteristics of patients. Multivariable logistic regression was used to estimate relevant influencing factors. Results A total of 129 patients (51.2% males; 51.01±16.54 years old) were analyzed. The duration of brachial plexus block was 2–12 hours, with a median duration of 5.09 hours. Multivariable analysis suggested that age 40–49 years [odds ratio (OR): 4.841; 95% confidence interval (CI): 1.033 to 22.695; P=0.045], 50–59 years (OR: 4.730, 95% CI: 1.149 to 19.474; P=0.031), 60 years (OR: 8.540; 95% CI: 1.605 to 45.449; P=0.012), gender (OR: 3.314; 95% CI: 1.330 to 8.257; P=0.010), alanine aminotransferase (ALT; OR: 5.817, 95% CI: 1.509 to 22.472; P=0.011), and glomerular filtration rate (GFR) <60 (OR: 22.700; 95% CI: 1.994 to 198.386; P=0.012) were the risk factors for the duration of brachial plexus block. Conclusions It is advisable to use the lowest effective dose for the shortest possible time when using ropivacaine in upper limb fracture surgery patients with elevated ALT (≥40 U/L) and lower GFR (<60 mL/min) in male patients aged ≥60 years.

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“…Using an online-encrypted spreadsheet, the following data were prospectively recorded: demography, length of surgery, and analgesia (hours and minutes, hh: mm); motor and sensoria blockade assessed with modified Bromage scale (from grade 0 "Lack of movement" to grade 4 "Full muscle strength in relevant muscle groups") 7 and Pinprick technique (blockade level from T10 to T4) 8 , respectively; vital signs during pre-, trans-, and post-operatory (mean arterial pressure [MAP], heart rate [HR], respiratory rate [RR], and oxygen saturation [SpO 2 ]); drug-related adverse events (e.g., nausea, vomiting, shaking chills, hypotension, bradycardia, rash, allergies, or hypersensitivity).…”

Section: Procedure Monitoring and Retrieval Of Informationmentioning

confidence: 99%

Epidural anesthesia for cesarean section with 0.125% versus 0.25% bupivacaine: an Ecuadorian prospective cohort

Díaz-Pérez,

Bajaña-Chávez,

Cañola-Cortez

et al. 2023

CIRUE

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Background: In a cesarean section, epidural analgesia with 0.125% bupivacaine and 1.5% lidocaine or 0.25% bupivacaine with 1.0% lidocaine concentrations can be used. A higher concentration of bupivacaine reaches better analgesia but with a higher rate of drug-related adverse events. Aim: The aim of the study was to assess analgesia and safety of 0.125% bupivacaine and 1.5% lidocaine or 0.25% bupivacaine with 1.0% lidocaine during cesarean. Materials and methods: Prospective cohort stratified following both bupivacaine concentrations. Results: One hundred women with full-term pregnancies were selected (fifty per cohort). At 20 and 30 min after epidural administration, there was a higher proportion of motor blockade cases from the 0.125% bupivacaine and 1.5% lidocaine cohort (p = 0.0229 and p = 0.0006, respectively). There was no significant difference among sensitive blockage. A 0.25% bupivacaine and 1.0% lidocaine concentration showed a tendency to hypotension (p < 0.001) and bradycardia (p = 0.4100). From 0.125% bupivacaine and 1.5% lidocaine cohort, 25 cases (50%) presented at least one adverse event; in contrast with 44/50 (88%) from 0.25% bupivacaine and 1.0% lidocaine cohort (p < 0.001). Conclusion: In epidural analgesia during cesarean, using 0.125% bupivacaine and 1.5% lidocaine presented similar analgesia than 0.25% bupivacaine and 1.0% lidocaine. However, a higher bupivacaine concentration is significantly related to more frequent drug-related adverse events (especially hypotension).

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“…Using an online-encrypted spreadsheet, the following data were prospectively recorded: demography, length of surgery, and analgesia (hours and minutes, hh: mm); motor and sensoria blockade assessed with modified Bromage scale (from grade 0 "Lack of movement" to grade 4 "Full muscle strength in relevant muscle groups") 7 and Pinprick technique (blockade level from T10 to T4) 8 , respectively; vital signs during pre-, trans-, and post-operatory (mean arterial pressure [MAP], heart rate [HR], respiratory rate [RR], and oxygen saturation [SpO 2 ]); drug-related adverse events (e.g., nausea, vomiting, shaking chills, hypotension, bradycardia, rash, allergies, or hypersensitivity).…”

Section: Procedure Monitoring and Retrieval Of Informationmentioning

confidence: 99%

Anestesia epidural en cesárea con bupivacaina al 0125% vs 0.25%: una cohorte prospectiva en pacientes ecuatorianas

Díaz-Perez¹,

Bajaña-Chávez²,

Cañola-Cortez³

et al. 2021

CIRU

1

0

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Background: In a cesarean section, epidural analgesia with 0.125% bupivacaine and 1.5% lidocaine or 0.25% bupivacaine with 1.0% lidocaine concentrations can be used. A higher concentration of bupivacaine reaches better analgesia but with a higher rate of drug-related adverse events. Aim: The aim of the study was to assess analgesia and safety of 0.125% bupivacaine and 1.5% lidocaine or 0.25% bupivacaine with 1.0% lidocaine during cesarean. Materials and methods: Prospective cohort stratified following both bupivacaine concentrations. Results: One hundred women with full-term pregnancies were selected (fifty per cohort). At 20 and 30 min after epidural administration, there was a higher proportion of motor blockade cases from the 0.125% bupivacaine and 1.5% lidocaine cohort (p = 0.0229 and p = 0.0006, respectively). There was no significant difference among sensitive blockage. A 0.25% bupivacaine and 1.0% lidocaine concentration showed a tendency to hypotension (p < 0.001) and bradycardia (p = 0.4100). From 0.125% bupivacaine and 1.5% lidocaine cohort, 25 cases (50%) presented at least one adverse event; in contrast with 44/50 (88%) from 0.25% bupivacaine and 1.0% lidocaine cohort (p < 0.001). Conclusion: In epidural analgesia during cesarean, using 0.125% bupivacaine and 1.5% lidocaine presented similar analgesia than 0.25% bupivacaine and 1.0% lidocaine. However, a higher bupivacaine concentration is significantly related to more frequent drug-related adverse events (especially hypotension).

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Axillary brachial plexus block duration with mepivacaine in patients with chronic renal failure. Case–control study

Cited by 3 publications

References 19 publications

Factors associated with prolonged duration of ultrasound-guided brachial plexus block for the upper limb fracture surgery: a cross-sectional study

Factors associated with prolonged duration of ultrasound-guided brachial plexus block for the upper limb fracture surgery: a cross-sectional study

Epidural anesthesia for cesarean section with 0.125% versus 0.25% bupivacaine: an Ecuadorian prospective cohort

Anestesia epidural en cesárea con bupivacaina al 0125% vs 0.25%: una cohorte prospectiva en pacientes ecuatorianas

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