Differences in Local Anesthetic Effects of Optically Active Isomers of local Anesthetic Compounds

Tomin, J.; Živanov-Čurlis, Jelena; Popović, Dejan; Glogovac, S.; Basic, Dijana

doi:10.1080/13102818.2006.10817373

Cited by 6 publications

(5 citation statements)

References 9 publications

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“…Some amount of local anesthetics that have some systemic effect can also pass into the blood when used in regional anesthesia (30). In our study, it was probably some amount of local anesthetic passed into the blood (we did not analyze the amount).…”

Section: Discussionmentioning

confidence: 73%

Erektör spina plan bloğunun perkütan nefrolitotomi cerrahisi maliyetine etkisi

Peker

Peker²

2020

Journal of Health Sciences and Medicine

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Aim: The analgesic effect of ESPB for percutaneous nephrolithotomy have been reported in a few study. However there is not any study yet in terms of the effect of ESPB on the cost of anesthesia. The aim of the study is to evaluate the effect of ESPB on sevoflurane and opioid consumption and cost for percutaneous nephrolithotomy. Material and Method: The patients who underwent percutaneous nephrolithotomy were divided into two groups as ESPB group (Group B; N, 30) and non-ESPB group (Group K; N, 31) whether ESPB was performed or not in this prospective observatioanl study. Total consumption of sevoflurane, remifentanyl and total consumption of tramadol was recorded. Total consumption of sevoflurane, remifentanil and tramadol was multiplied by the unit price of the drug (milliliter and milligram) for determining cost estimation. Results: The total amount of remifentanil, sevoflurane and tramadol consumption were significantly lower in the Group B (respectively; p=0.009, p=0.001, p<0.001). The total remifentanil, sevoflurane and tramadol costs were found to be statistically significantly lower in the Group B (respectively: p=0.006, p=0.001, p<0.001). Conclusion: The ESPB is a cost-effective procedure and contributes to the multimodal anesthesia.

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Section: Discussionmentioning

confidence: 73%

Erektör spina plan bloğunun perkütan nefrolitotomi cerrahisi maliyetine etkisi

Peker

Peker²

2020

Journal of Health Sciences and Medicine

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“…[15] R (+) and S (-) enantiomers of local anesthetics exhibits different affinity for different ion channels of sodium, potassium and calcium; this results in significant reductions in central nervous system and cardiac toxicity with S (-) enantiomer as compared to R(+) enantiomer. [16,17] The volume of local anesthetic used in this study is 23 mL, which is the volume of drug used in various studies on ultrasound guided interscalene brachial plexus block for providing perioperative anesthesia and analgesia. [18,19] The onset of sensory block (2.40±.67min for Group B and 2.59±.62min for Group R) and motor block (4.23±.81min for Group Band and 4.31±.60min for Group R) was clinically faster in the present study compared to a similar study done Eroglu A13 who reported a onset of block to be 21±13 min with bupivacaine and18±12min with ropivacaine.…”

Section: Discussionmentioning

confidence: 99%

Comparative Evaluation of Magnesium as an Adjuvant To 0.5% Bupivacaine and 0.5% Ropivacaine In Ultrasound Guided Interscalene Brachial Plexus Block

Singh¹,

Verma²,

Pathania³

et al. 2017

Ann. Int. Med. Den. Res.

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Background: To study the effect of magnesium sulphate as an adjuvant to Bupivacaine and Ropivacaine in ultrasound guided interscalene block in patients scheduled for orthopedic surgeries around the shoulder. Methods: Sixty patients (20-60 years) posted for elective orthopedic surgeries around the shoulder under interscalene brachial plexus block were divided into two Groups B and R in a randomized fashion. In group B (n = 30), 20 ml 0.5% bupivacaine plus 150 mg (3 ml of 50:1 solution) magnesium sulfate and in group R (n = 30), 20 ml 0.5% Ropivacaine plus 150 mg (3 ml of 50:1 solution) magnesium sulfate was administered in ultrasound guided interscalene block. After performance of the block it was evaluated for its onset time and duration of sensory and motor block every 3 min up to 30 min and subsequently hourly intervals up to 24hr. The time of first analgesic demand (VAS>4), total analgesic need, hemodynamic stability and side effects were recorded during the study. Results: The duration of sensory and motor block and the time to first analgesic demand was significantly longer (P<0.05) in Group B. In addition the total need for rescue analgesics in the post-operative period was also significantly lower (P<0.05) in this group compared to Group R. Intraoperative hemodynamics was comparable and no appreciable side effect was noted in the study. Conclusion: This study demonstrates that the addition of magnesium sulfate to Bupivacaine when compared to Ropivacaine in interscalene brachial plexus block provides enhanced sensory and motor block duration, prolonged duration of analgesia and decreased total postoperative analgesic needs with no side effects, hence could be a more rational combination.

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“…Smaller differences were observed in experiments on animals in vitro. From the toxicity point of view, the (R)-(−)-enantiomer exhibits higher toxicity [24,34].…”

Section: Prilocainementioning

confidence: 99%

“…The impact of stereochemistry on the activity of anesthetics in general has been addressed in several past reviews [ 21 , 22 , 23 ]. In 2006, Tomin et al specifically discussed the activity of local anesthetics with respect to their stereochemical arrangement [ 24 ]. The presented overview focused on local anesthetics, which, due to their different stereochemistry, have different local anesthetic activities, pharmacokinetic properties, and toxicity [ 25 , 26 , 27 ].…”

Section: Mechanism Of the Action Of Local Anestheticsmentioning

confidence: 99%

“…In the case of bupivacaine and ropivacaine, ( S ) enantiomers showed a (−) rotation, while enantiomers ( R ) showed a (+) rotation. Due to the small structural change in the case of mepivacaine in comparison with these local anesthetics, different designations of rotation appear in many works, thus not allowing generalizations on individual stereoisomers in relation to their local anesthetic activity [ 24 , 34 , 81 , 82 ].…”

Section: Stereoselectivity In the Pharmacokinetics Of Local Anesthmentioning

confidence: 99%

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Chiral Aspects of Local Anesthetics

et al. 2020

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Thanks to the progress made in chemical technology (particularly in the methodologies of stereoselective syntheses and analyses) along with regulatory measures, the number of new chiral drugs registered in the form of pure enantiomers has increased over the past decade. In addition, the pharmacological and pharmacokinetic properties of the individual enantiomers of already-introduced racemic drugs are being re-examined. The use of the pure enantiomer of a drug that has been used to date in the form of a racemate is called a “chiral switch”. A re-examination of the properties of the pure enantiomers of racemates has taken place for local anesthetics, which represent a group of drugs which have long been used. Differences in (R) and (S)-enantiomers were found in terms of pharmacodynamic and pharmacokinetic activity as well as in toxicity. Levobupivacaine and robivacaine were introduced into practice as pure (S)-(−)-enantiomers, exhibiting more favorable properties than their (R)-(+)-stereoisomers or racemates. This overview focuses on the influence of chirality on the pharmacological and toxicological activity of local anesthetics as well as on individual HPLC and capillary electrophoresis (CE) methods used for enantioseparation and the pharmacokinetic study of individual local anesthetics with a chiral center.

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Differences in Local Anesthetic Effects of Optically Active Isomers of local Anesthetic Compounds

Cited by 6 publications

References 9 publications

Erektör spina plan bloğunun perkütan nefrolitotomi cerrahisi maliyetine etkisi

Erektör spina plan bloğunun perkütan nefrolitotomi cerrahisi maliyetine etkisi

Comparative Evaluation of Magnesium as an Adjuvant To 0.5% Bupivacaine and 0.5% Ropivacaine In Ultrasound Guided Interscalene Brachial Plexus Block

Chiral Aspects of Local Anesthetics

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