The Effect of pH Adjustment of 0.5% Bupivacaine on the Latency of Epidural Anesthesia

Stevens, Rosemary; Schubert, Armin; Spitzer, L.; Chester, W. L.; Brandon, David; Grueter, Jean A.; Clayton, Beth Ann

doi:10.1097/00132582-199007000-00057

Cited by 6 publications

(5 citation statements)

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“…Significant reductions in onset time have been claimed for extradural mepivacaine [28], lignocaine [22], bupivacaine [24] and chloroprocaine [64,75]. All investigators do not agree with these findings, however, especially with respect to bupivacaine [76]. It is difficult to reconcile such differences, but they may be explained at least partly by use of different end-points (e.g.…”

Section: Alkalinization (Ph Adjustment)mentioning

confidence: 99%

Extradural, Spinal or Combined Block for Obstetric Surgical Anaesthesia

Carrie

1990

British Journal of Anaesthesia

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One of the outstanding features of obstetric surgical procedures carried out under regional anaesthesia is that the patients are seldom given premedication, peroperative sedation or light general anaesthesia which might mask any deficiencies in the local anaesthetic block. Before delivery this is in the interests of the fetus, which may be affected by any drugs given to the mother. For procedures carried out after delivery, sedation or anaesthesia interferes with the mother's enjoyment of her new baby, and may even jeopardize her safety if her respiratory protective reflexes are depressed. This is in contrast with other branches of anaesthesia in which regional techniques are popular-especially orthopaedics, where supplementary sedation or anaesthesia is commonplace. It is in obstetric anaesthesia, therefore, that the differences between extradural and spinal block may be most apparent, and in choosing between them it is necessary that the anaesthetist understands the relative merits of the two techniques. In accordance with popular usage, "anaesthesia" is used in this article, rather than "analgesia", although much of the time only freedom from pain is implied. In addition, " subarachnoid" and " intrathecal" are used synonymously with "spinal". FACTORS AFFECTING THE CHOICE BETWEEN EXTRADURAL AND SPINAL ANAESTHESIA General factors affecting the choice between extradural and spinal anaesthesia always include the expertise of the anaesthetist and the availability of suitable drugs and equipment. Historically, spinal anaesthesia antedated extradural KEY WORDS Anaesthesia, obstetric. Anaesthetic techniques: extradural. spinal.

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Section: Alkalinization (Ph Adjustment)mentioning

confidence: 99%

Extradural, Spinal or Combined Block for Obstetric Surgical Anaesthesia

Carrie

1990

British Journal of Anaesthesia

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“…After over 500.000 applications of procaine infusions according to the described regime in our hospital and outpatient department, we have not observed one case with long-term or severe side effects. No case was registered with a serious allergic emergency situation, which underlines the observations of Becke concerning the huge therapeutic safety of Procaine Procaine concentration due to the addition of sodium bicarbonate [84] and an accelerated initial effect were also observed in animal studies [85,86]. The continuous application of Procaine-Base by the use of a medical pump demonstrated impressive results in many severe cases of pain and inflammation [87][88][89].…”

Section: How Safe Is the Procaine-base-infusion And Which Side Effects Appear?mentioning

confidence: 60%

Procaine and Procaine-Base-Infusion: A Review of the Safety and Fields of Application after Twenty Years of Use

Urm¹,

Oettmeier²,

Nazlıkul³

2018

Clin Res Open Access

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The highly-dosed infusion with Procaine-HCl with sodium-bicarbonate as additive was firstly published twenty years ago. The method advanced to a routine in many centers for pain treatment, rehabilitation and natural medicine. The aim of the procedure is the systemic use of the various pharmacological features of Procaine, especially to inhibit pain and inflammation, for vasodilatation, anti-oxidation and to harmonize the vegetative nervous system. The addition of sodium-bicarbonate balances the common latent pH-decrease in the periphery. The degradation products of Procaine, diethylaminoethanol (DEAE) and para-amino benzoic acid (PABA), have a systemic effect. For the safety of the patients after 500.000 applications: the procaine-infusion is safe. To improve the success rate of the method of the classic Procaine-Base-infusion should be realized an acid-base-diagnostic.

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“…Alkalinization of local anaesthetics with sodium bicarbonate has been evaluated in a number of studies to establish the effect of the pH adjustment on potency (DiFazio et al. , 1986; Stevens et al. , 1989; Ackerman et al.…”

Section: Discussionmentioning

confidence: 99%

Effect of alkalinization on the local analgesic efficacy of ketamine in the abaxial sesamoid nerve block in horses

López‐Sanromán

Cruz

Santos

et al. 2003

Vet Pharm & Therapeutics

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The objective of this study was to determine the effects of the alkalinization on the local analgesic efficacy of 1% ketamine in the abaxial sesamoid nerve block in horses. Thirty-six mature healthy horses were randomly assigned to four groups for the following treatments; an abaxial sesamoid block with 5 mL of saline solution (control saline); an abaxial sesamoid block with 5 mL of a solution containing 1% ketamine (KETs 1%); an abaxial sesamoid block with 5 mL of a solution containing saline solution and 0.5 mEq of sodium bicarbonate (control bicarbonate); and an abaxial sesamoid block with 5 mL of a solution containing 1% ketamine and 0.5 mEq of sodium bicarbonate (KETb 1%). All blocks were performed in one randomly selected front leg. To determine analgesia, hoof withdrawal from thermal stimulus from radiant heat lamp was assessed. Before each block, the hoof withdrawal reflex latency (HWRL) (time between lamp illumination and withdrawal of the hoof) was determined; after the block, local analgesic effects were determined using the heat lamp at 2 and 5 min after the injection and then every 5 min for 1 h. In KETs 1% group, there were significant increases in HWRL between basal values and values from 2 to 10 min after an abaxial sesamoid block. In KETb 1% group, significant increases in HWRL was collected between the basal value and values from 2 to 25 min following an abaxial sesamoid block. In KETs 1% group, of the nine horses, four had an abaxial sesamoid block that was unsuccessful. However, in KETb 1% group, only one of the nine horses had an abaxial sesamoid nerve block that was unsuccessful. The alkalinization of a 1% ketamine solution produced a more consistent and persistent local analgesia in horses when compared with 1% ketamine solution alone.

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The Effect of pH Adjustment of 0.5% Bupivacaine on the Latency of Epidural Anesthesia

Cited by 6 publications

References 0 publications

Extradural, Spinal or Combined Block for Obstetric Surgical Anaesthesia

Extradural, Spinal or Combined Block for Obstetric Surgical Anaesthesia

Procaine and Procaine-Base-Infusion: A Review of the Safety and Fields of Application after Twenty Years of Use

Effect of alkalinization on the local analgesic efficacy of ketamine in the abaxial sesamoid nerve block in horses

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