Pharmacokinetics of levobupivacaine 0.5% after superficial or combined (deep and superficial) cervical plexus block in patients undergoing minimally invasive parathyroidectomy

Pintarič, Tatjana Stopar; Koželj, Gordana; Stanovnik, Lovro; Casati, Andrea; Hočevar, Marko; Jankovič, Vesna Novak

doi:10.1016/j.jclinane.2008.01.007

Cited by 8 publications

(5 citation statements)

References 20 publications

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“…142 Cervical plexus blocks with bupivacaine (80–115 mg) or levobupivacaine (125 mg dose) result in peak plasma levels of ~1–2µg/mL 140 and 0.4–0.8 µg/mL, 143 respectively. Brachial plexus blocks with ropivacaine, dose ~250 mg, resulted in plasma levels of 2.6–3.3µg/mL 144 while the same local anesthetic used for femoral nerve block (0.75%, 225 mg) 43 or TAP block (150 mg) 145 resulted in peak plasma levels of ~1.5 and 2 µg/mL, respectively.…”

Section: Resultsmentioning

confidence: 99%

Preventive Analgesia by Local Anesthetics

Barreveld

Witte

Chahal³

et al. 2013

Anesthesia &Amp; Analgesia

140

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The use of local anesthetics to reduce acute postoperative pain has a long history, but recent reports have not been systematically reviewed. In addition, the need to include only those clinical studies that meet minimum standards for randomization and blinding must be adhered to. In this review we have applied stringent clinical study design standards to identify publications on the use of perioperative local anesthetics. We first examined several types of peripheral nerve blocks, covering a variety of surgical procedures, and second, for effects of intentionally administered IV local anesthetic (lidocaine) for suppression of postoperative pain. Thirdly, we have examined publications in which vascular concentrations of local anesthetics were measured at different times after peripheral nerve block procedures, noting the incidence when those levels reached ones achieved during intentional IV administration. Importantly, the very large number of studies using neuraxial blockade techniques (epidural, spinal) has not been included in this review but will be dealt with separately in a later review. The overall results showed a strongly positive effect of local anesthetics, by either route, for suppressing postoperative pain scores and analgesic (opiate) consumption. In only a few situations were the effects equivocal. Enhanced effectiveness with the addition of adjuvants was not uniformly apparent. The differential benefits between drug delivery before, during, or immediately after a surgical procedure are not obvious, and a general conclusion is that the significant antihyperalgesic effects occur when the local anesthetic is present during the acute postoperative period, and its presence during surgery is not essential for this action.

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Section: Resultsmentioning

confidence: 99%

Preventive Analgesia by Local Anesthetics

Barreveld

Witte

Chahal³

et al. 2013

Anesthesia &Amp; Analgesia

140

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“…The recommended dosage for performing surficial CPB is 0.35 mL/kg 0.5% levobupivacaine. Pintaric et al [10] investigated pharmacokinetic profile of 0.35 mL/kg of 0.5% levobupivacaine during superficial and combined (deep and superficial) cervical plexus block (CPB) in patients undergoing minimally invasive parathyroidectomy. They measured levobupivacaine plasma concertation 5,10,15,20,30,45 and 60 minutes after administration and found that the median (range) time required to reach the maximal concentrations was 30 minutes (20-30 min) in group superficial and 20 minutes (15-30 min) in group combined (P = 0.45).…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Guided Cervical Plexus Block for Parathyroidectomy-Out First Experiences

Stojanović

Tošković²,

Mojsic³

et al. 2023

ijirms

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Ultrasound guided Cervical Plexus Block (CPB) is a technique that has been applied in parathyroid surgery. Main advantages of ultrasound technique include a direct view of nerves; local anaesthetic (LA) spreading during injection; reduced volume of LA; blood vessels and other structures injury is significantly reduced. It is especially useful in patients with serious comorbidities, in which possible peri-operative consequences and risks of general anaesthesia can be avoided. Based on our first results of the presented cases, we can say that superficial CPB is a safe and simple procedure in order to provide perioperative analgesia in parathyroid surgery.

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“…También aporta ventajas sobre el bloqueo del plexo braquial a nivel interescalénico, la anestesia epidural cervical tiene menor tasa de fallos, la dosis total de anestésico local requerida es menor, precisa una única punción sin provocación de parestesias o movimientos musculares mediante neuroestimulación, es más fácil el mantenimiento de un catéter para analgesia postoperatoria, y no necesita complementarse con anestesia general para mejorar la calidad (6,7). Del mismo modo se puede utilizar en pacientes con intubación endotraqueal difícil, cirugías de tiroides y paratiroides, cirugía de mama, cirugía de carotidea, cirugía cardiaca sin circulación extracorpórea o en pacientes en que se prevean arritmias cardíacas (8)(9)(10).…”

Section: Nota Clínicaunclassified

Anestesia y analgesia epidural cervical para cirugía de miembro superior

Izquierdo¹,

Aranguren²,

Ugaz³

et al. 2019

Rev. Soc. Esp. Dolor.

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Introduction: Cervical epidural anesthesia has been successfully used for various types of surgical procedures involving upper limb surgery, thoracic wall surgery, carotid artery surgery and neck dissections, keeping the patient conscious, with less blood loss and a surgical fi eld more bloodless, also presents lower failure rate, lower total dose of local anesthesia and maintenance of postoperative analgesia through a catheter. Objective: To describe anesthetic management and postoperative analgesia in a patient scheduled for hand surgery, using a cervical epidural technique. Methods and results: We present the case of a patient who underwent osteosynthesis of the fi fth fi nger of the right hand, and whose anesthetic technique was cervical epidural with catheter, using 0.25 % bupivacaine plus lidocaine without epinephrine 2 %, continuing with postoperative epidural analgesia by catheter in which uses morphine 5 mg, bupivacaine 50 mg and 90 cc sodium chloride in an elastomer pump at 0.5 cc/h. Conclusions: Cervical epidural anesthesia is an effective and safe technique for upper limb surgery, allowing continuous postoperative analgesia.

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Pharmacokinetics of levobupivacaine 0.5% after superficial or combined (deep and superficial) cervical plexus block in patients undergoing minimally invasive parathyroidectomy

Cited by 8 publications

References 20 publications

Preventive Analgesia by Local Anesthetics

Preventive Analgesia by Local Anesthetics

Ultrasound Guided Cervical Plexus Block for Parathyroidectomy-Out First Experiences

Anestesia y analgesia epidural cervical para cirugía de miembro superior

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