Publications by authors named "Alon P Winnie"
Background: A decreased latency of onset of neural blockade has been noted when muscular exercise of the hand was performed after supraclavicular brachial plexus block using lidocaine. In this observational study, we examined the effect of repetitive muscle contraction of the hand on the speed of onset of interscalene brachial plexus block (ISB) using bupivacaine.
Methods: Forty patients were enrolled, all of whom received an ISB as one component of their anesthetic management for elective arthroscopic shoulder surgery.
Article Synopsis
- The study investigates how clinically relevant levels of bupivacaine and levobupivacaine affect norepinephrine release from cardiac nerves, which is crucial for heart function.
- Results showed that both anesthetics significantly reduced norepinephrine release and heart contractions, with their effects being comparable to tetrodotoxin, a known nerve blocker.
- The findings suggest that these local anesthetics can impair cardiac sympathetic transmission, which may contribute to their cardiotoxic effects in clinical settings.
Background And Objectives: Buprenorphine added to local anesthetic solutions for supraclavicular block was found to triple postoperative analgesia duration in a previous study when compared with local anesthetic block alone. That study, however, did not control for potentially confounding factors, such as the possibility that buprenorphine was affecting analgesia through intramuscular absorption or via a spinal mechanism. To specifically delineate the role of buprenorphine in peripherally mediated opioid analgesia, the present study controlled for these 2 factors.
View Article and Find Full Text PDFThe treatment of intractable pain with currently available therapeutic regimens is often unsatisfactory due to tolerance and untoward complications. Studies in our laboratory have suggested that the transplantation of adrenal medullary tissue into the spinal subarachnoid space can significantly reduce pain in animal models, most likely via release of opioid peptides and catecholamines. The current study was an initial attempt to assess the potential for adrenal medullary transplants in the spinal subarachnoid space to alleviate pain in humans.
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