Local anesthesia with mepivacaine is used for vaginal deliveries and for minor surgeries of the vagina and perineum as repair of an episiotomy or perineal laceration. Neonatal intoxication caused by local anesthesia with mepivacaine for maternal episiotomy has been rarely reported. We present a case of a term female infant with unexplained cardiorespiratory distress and several neurologic findings, including seizures, one hour after birth. Electrocardiogram showed a second-degree atrioventricular block and a left-bundle branch block. Blood measures in the patient revealed a high mepivacaine level following local anesthesia for maternal episiotomy. Because of the increasing practice of local anesthesia, high awareness for neonatal intoxication and further research in safe elimination therapy in neonates is needed.
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http://dx.doi.org/10.1155/2019/4013564 | DOI Listing |
Int Urogynecol J
January 2025
Department of Urology, Hasheminejad Kidney Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Introduction And Hypothesis: This study was aimed at evaluating the therapeutic effects of a modified intravesical botulinum toxin injection technique (fewer injection sites under local anesthesia), in comparison with the conventional technique for patients with idiopathic detrusor overactivity, considering the urodynamic parameters.
Methods: In this double-blinded randomized clinical trial, 78 adult females with idiopathic detrusor overactivity were divided into two groups: conventional and modified groups. In the conventional method, patients received intradetrusor botulinum toxin injection at 20 sites under general or spinal anesthesia in a trigone-sparing fashion.
Curr Pain Headache Rep
January 2025
Department of Anesthesiology, Perioperative, and Pain Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.
Purpose Of Review: The rhomboid intercostal and subserratus plane (RISS) block is an effective, safer alternative for managing postoperative acute pain following abdominal surgeries. The RISS block offers several advantages over traditional approaches, including reduced incidence of puncture-related complications, lower rates of systemic opioid consumption, and more consistent analgesic coverage of lower thoracic dermatomes.
Recent Findings: Despite a favorable safety profile, the RISS block carries potential risks, such as pneumothorax and local anesthetic systemic toxicity, particularly when long-acting anesthetics such as bupivacaine or ropivacaine are used.
J Anesth Analg Crit Care
January 2025
Department of Emergency Surgery and Trauma, Anesthesia and Intensive Care Unit, Bufalini Hospital, Azienda Unità Sanitaria Locale (AUSL) Della Romagna, Cesena, Italy.
Patients admitted to intensive care unit (ICU) after non-traumatic subarachnoid hemorrhage (SAH) represent a group with distinctive characteristics and few data are available on long-term outcome in this population. We conducted a single-center retrospective study in an Italian intensive care unit. All patients with non-traumatic SAH (ICD-9-CM Diagnosis Code 430) admitted to ICU were included.
View Article and Find Full Text PDFTrials
January 2025
Department of Neurology, Universitätsmedizin Greifswald, Fleischmannstraße 6, Greifswald, 17489, Germany.
Background: Postoperative delirium (POD) is the most common neurological adverse event among elderly patients undergoing surgery. POD is associated with an increased risk for postoperative complications, long-term cognitive decline, an increase in morbidity and mortality as well as extended hospital stays. Delirium prevention and treatment options are currently limited.
View Article and Find Full Text PDFArch Orthop Trauma Surg
January 2025
Medical University of Graz, Graz, Austria.
Background: The role of local infiltration anesthesia (LIA) in knee surgery is significant. LIA can be more potent than a nerve block, but without the downsides. A wide range of agents are used for LIA, including some off-label medications such as dexmedetomidine and ropivacaine.
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