We administered 0.5% bupivacaine 30 ml either with or without adrenaline 5 micrograms ml-1 randomly to 16 healthy outpatients, to determine the efficacy of local and intra-articular local anaesthesia for knee arthroscopy and whether or not adrenaline should be added to intra-articular bupivacaine. Bupivacaine concentrations were measured in plasma obtained 15, 30, 45 and 60 min after intra-articular injection. Patients receiving bupivacaine with adrenaline had significantly smaller plasma concentrations of bupivacaine at all times than did patients receiving plain bupivacaine. The maximal concentrations of bupivacaine in the plain group (median 515 ng ml-1, range 46-875 ng ml-1) were greater than those in the adrenaline group (median 33 ng ml-1, range 7-125 ng ml-1) (P = 0.001). All patients found the anaesthetic satisfactory. We conclude that intra-articular/local anaesthesia is satisfactory for outpatient arthroscopic surgery, and that adrenaline should probably be added to bupivacaine before intra-articular injection.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1093/bja/65.4.537 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Comparison of Pharmacokinetics of Long-Acting Local Analgesics: CPL-01, a Novel Extended-Release Ropivacaine, Demonstrates Consistent and Predictable Exposure Compared with Liposomal Bupivacaine.
Clin Drug Investig
January 2025
Cali Biosciences, US, LLC, San Diego, CA, USA.
Background And Objective: There is a significant medical need for improved long-acting local anesthetics to decrease postsurgical pain and reduce postoperative opioid use. While ropivacaine is considered a safer local anesthetic than bupivacaine, no long-acting ropivacaine formulation is currently marketed. Available formulations of bupivacaine show inconsistent pharmacokinetics (PK) among different surgical models, and inconsistency in PK may lead to a reluctance to use the medication owing to fear of local anesthetic systemic toxicity (LAST) or unreliable efficacy.
View Article and Find Full Text PDFThe Effects of Synthetic Polymers on the Release Patterns of Bupivacaine Hydrochloride from Sodium Hyaluronate Hydrogels.
Biomedicines
December 2024
Department of Physical Chemistry and Biophysics, Faculty of Pharmacy, Wroclaw Medical University, ul. Borowska 211A, 55-556 Wrocław, Poland.
Background: Using hydrogels for the controlled release of drugs is beneficial for patients, who then receive the proper dose of the medicinal substance. In addition, the formulation can provide more consistent drug absorption while reducing the frequency of dosing.
Objectives: The aim of this investigation is to propose a novel HA (sodium hyaluronate)-based hydrogel for intra-articular injection doped with synthetic polymers and incorporated with bupivacaine hydrochloride (Bu) as a local anesthetic.
Effects of epidural dexmedetomidine on patient-controlled epidural analgesia after total knee arthroplasty: a single-center, prospective, double-blind, randomized controlled study.
J Int Med Res
January 2025
Department of Anesthesiology and Pain Medicine, Saint Vincent's Hospital, College of Medicine, Catholic University of Korea, Suwon, Korea.
Objective: To evaluate the impact of adding epidural dexmedetomidine to low-concentration patient-controlled epidural analgesia (PCEA) on pain control and side effects in total knee arthroplasty (TKA).
Methods: In this double-blind study, American Society of Anesthesiologists I to II patients undergoing TKA were assigned to receive 0.125% bupivacaine + fentanyl 4 µg/mL (group R) or 0.
The Potency of Cytotoxic Mechanisms of Local Anesthetics in Human Chondrocyte Cells.
Int J Mol Sci
December 2024
Department of Biochemistry, National Defense Medical Center, Taipei 114, Taiwan.
Local anesthetics are commonly used in various clinical settings for both prevention and symptom relief. Numerous clinical studies have demonstrated that intra-articular injections of local anesthetics achieve high success rates in orthopedic practices. However, several widely used local anesthetics, including bupivacaine, lidocaine, and ropivacaine, have been shown to exhibit toxicity to chondrocytes, with the underlying mechanisms of chondrotoxicity remaining poorly understood.
View Article and Find Full Text PDFEffect of Position-Based Dosing Strategy for Metaraminol on Neonatal Acid-Base Status During Elective Caesarean Delivery: A Noninferiority Randomised Controlled Trial.
Drug Des Devel Ther
December 2024
Department of Anaesthesiology, Peking University People's Hospital, Peking, People's Republic of China.
Background: The 15° left tilt position during caesarean delivery has been recommended by guidelines for many years, but recent studies have questioned the clinical benefit of left tilt position. We hypothesize that using a higher starting dose of metaraminol in the supine position will result in a non-inferior umbilical arterial pH, compared to the 15° left tilt position.
Methods: Healthy women undergoing elective caesarean delivery were randomized to the supine position (n = 62) or 15° left tilt position (n = 62) after spinal anaesthesia (0.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!