Bupivacaine drug-induced liver injury: a case series and brief review of the literature

Chintamaneni, Preethi; Stevenson, Heather L.; Malik, Shahid M.

doi:10.1016/j.jclinane.2016.01.035

Cited by 14 publications

(11 citation statements)

References 10 publications

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“…Bupivacaine is extensively metabolized by the hepatic cytochrome P450 system and excreted by the kidneys. Neurological and cardiovascular complications are the main side effects associated with amide local anesthetics; however, bupivacaine-induced liver injury and cholestasis have been reported with epidural or local administration for the treatment of chronic or postoperative pain ( 26 , 27 ). Lee and Kwak described the occurrence of acute liver injury as a significant complication associated with IA bupivacaine administration after bilateral total knee arthroplasty in an old man with a history of liver transplantation.…”

Section: Discussionmentioning

confidence: 99%

In vitro and in vivo Effects of a Single Dose of Bupivacaine 5% on Donkey Chondrocytes

et al. 2021

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Single intra-articular (IA) injection of long-acting local anesthetics such as bupivacaine is commonly used clinically for postoperative analgesia, in particular, after arthroscopic surgery. Despite their widespread use, the side effects of IA bupivacaine on joint cartilage as well as hepatotoxic and nephrotoxic effects remain to be elucidated. The aim of this study is to assess the in vitro effect of bupivacaine 5% on donkey chondrocytes at different time points, in addition to the in vivo effects of a single IA bupivacaine injection on the middle carpal joint in a group of 10 clinically healthy adult male donkeys. In phase I, the effect of in vitro treatment with bupivacaine 5% or saline 0.9% on freshly isolated donkey chondrocytes for 30, 60 min, 24, 48, and 96 h was investigated using MTT and LIVE/DEAD assay. In phase II, in vivo effects of single injection of bupivacaine on the middle carpal joint of the donkey were evaluated compared with saline 0.9%. Biochemical analysis of collected serum and synovia was performed. Additionally, articular cartilage damage was evaluated using radiography, computed tomography (CT), catabolic marker expression via quantitative polymerase chain reaction (qPCR), and histopathological examination 96 h after injection. Our results showed that after a 30-min exposure to bupivacaine 5%, the viability of donkey chondrocytes was 97.3 ± 4.4% and was not significantly affected at the indicated time points (n = 8, p < 0.05). No significant changes in biochemical analytes of serum and synovial fluid following IA bupivacaine injection were observed, compared with saline injection (n = 5 for each group, p < 0.05). Furthermore, in vivo IA injection of bupivacaine revealed no significant differences in radiography, CT scan, gene expression of cartilage catabolic biomarkers, and histopathological examination. These results provide an evidence for the safety of bupivacaine on the donkey cartilage.

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Section: Discussionmentioning

confidence: 99%

In vitro and in vivo Effects of a Single Dose of Bupivacaine 5% on Donkey Chondrocytes

et al. 2021

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“…Although this is an interesting discovery, discharge times are impacted by many variables such as postoperative pain, emetic symptoms, and system-related delays that was not included in our statistical model. Further exploration is warranted because liposome bupivacaine is considerably more expensive than plain bupivacaine or ropivacaine [ 47 , 48 ] and may not have a pharmacoeconomic advantage when compared to plain bupivacaine or ropivacaine [ 49 , 50 ].…”

Section: Discussionmentioning

confidence: 99%

Liposome Bupivacaine Compared to Plain Local Anesthetics to Reduce Postsurgical Pain: An Updated Meta-Analysis of Randomized Controlled Trials

Kendall

Alves

Oliveira

2018

Pain Research and Treatment

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Objective Peripheral nerve blocks for postoperative analgesia have improved block success, but analgesia efficacy has been limited by the short duration of traditional local anesthetics. The results of randomized trials comparing liposome bupivacaine with conventional local anesthetic formulations (e.g., plain bupivacaine and ropivacaine) have generated conflicting results. This study was conducted to systematically review the effectiveness of analgesic efficacy of liposome bupivacaine infiltration at the surgical site versus plain local anesthetic bupivacaine or ropivacaine in patients undergoing surgery. Methods PRISMA statement guidelines were followed. A search of electronic databases National Library of Medicine's PubMed database, Cochrane Database of Systematic Reviews, Embase, and Google Scholar from January 2012 to September 2017 was performed. Among the 1,612 records identified, 9 randomized controlled trials involving 779 patients were eligible for data extraction and meta-analysis. Results Liposome bupivacaine did not reduce postsurgical pain at rest compared to plain local anesthetics at 24 and 48 hours after surgery. Moreover, liposome bupivacaine did not reduce postoperative opioid consumption at 24, 48, or 72 hours when compared to plain local anesthetics. Liposome bupivacaine did reduce postoperative nausea when compared to plain local anesthetics (P =<0.3). There was no significant difference in hospital length of stay between study groups, the use of plain bupivacaine or ropivacaine, or among orthopedic or nonorthopedic procedures. No manifestations of local anesthetic toxicity were reported. Conclusions Our results suggest that liposome bupivacaine does not have an analgesic advantage when compared to plain local anesthetics at the surgical site for patients undergoing surgical procedures.

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“…The median number of days with elevated fever (≥38.0°C) during a 1-week period was significantly lower in the intervention group than that in the control group. Systemic inflammatory response syndrome is induced by highly invasive surgery, wound infection, and drug-induced hepatic injury and is a major factor in postoperative fever induction in esophageal cancer patients (33)(34)(35). Because of the significant difference in the rate of postoperative infection between the intervention and control groups, we reanalyzed the data after excluding cases of postoperative infection (n = 4).…”

Section: Discussionmentioning

confidence: 99%

New oral hygiene care regimen reduces postoperative oral bacteria count and number of days with elevated fever in ICU patients with esophageal cancer

et al. 2018

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Using a controlled pre/post study design, we investigated the effects of professional mechanical cleaning of the oral cavity with benzethonium chloride, interdental brushes, and hydrogen peroxide on the number of oral bacteria and postoperative complications among esophageal cancer patients in an intensive care unit. Before surgery, 44 patients with esophageal cancer were recruited at Okayama Hospital from January through August 2015. The control group (n = 23) received routine oral hygiene care in the intensive care unit. The intervention group (n = 21) received intensive interdental cleaning with benzethonium chloride solution and tongue cleaning with hydrogen peroxide. The number of oral bacteria on the tongue surface and plaque index were significantly lower in the intervention group than in the control group on postoperative days 1 and 2 (P < 0.05). Additionally, the number of days with elevated fever during a 1-week period was significantly lower in the intervention group than in the control group (P = 0.037). As compared with routine oral hygiene, a new oral hygiene regimen comprising benzethonium chloride, interdental brushes, and hydrogen peroxide significantly reduced the number of oral bacteria and days with elevated fever in patients with esophageal cancer.

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Bupivacaine drug-induced liver injury: a case series and brief review of the literature

Cited by 14 publications

References 10 publications

In vitro and in vivo Effects of a Single Dose of Bupivacaine 5% on Donkey Chondrocytes

In vitro and in vivo Effects of a Single Dose of Bupivacaine 5% on Donkey Chondrocytes

Liposome Bupivacaine Compared to Plain Local Anesthetics to Reduce Postsurgical Pain: An Updated Meta-Analysis of Randomized Controlled Trials

New oral hygiene care regimen reduces postoperative oral bacteria count and number of days with elevated fever in ICU patients with esophageal cancer

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