Background: Liposomal bupivacaine (Exparel®) is a sustained-release formulation of bupivacaine for use in surgical infiltration anaesthesia. We analysed the histological nerve toxicity and clinical effectiveness of perineural Exparel® alone or with added dexamethasone in a mouse model.
Methods: We assigned 98 mice receiving a perineural sciatic nerve injection into seven groups: sham (n=14, perineural saline), B (n=14, perineural bupivacaine), BDIP (n=14, perineural bupivacaine + intraperitoneal dexamethasone), BDPN (n=14, perineural bupivacaine + perineural dexamethasone), E (n=14, perineural Exparel®), EDIP (n=14, perineural Exparel® + intraperitoneal dexamethasone), and EDPN (n=14, perineural Exparel® + perineural dexamethasone). The duration of thermoalgesic and motor block was evaluated in 49 mice (seven mice randomly selected by group) every 30 min until recovery. Mice were killed for sciatic nerve histological assessment at 14 or 28 days.
Results: The median duration of motor block was 90, 120, 120, 120, 180, and 180 min and the duration of thermoalgesic block was 240, 300, 360, 360, 360, and 420 min for groups B, BDIP, BDPN, E, EDIP, and EDPN, respectively. The B group mice showed mild neural inflammation at 14 days and the E group mice showed mild neural inflammation at 28 days. Addition (intraperitoneal or perineural) of dexamethasone reduced neural inflammation induced by bupivacaine, whereas only perineural dexamethasone reduced neural inflammation induced by Exparel®.
Conclusions: Perineural or systemic dexamethasone had a protective effect against the neural inflammation induced by bupivacaine, and perineural dexamethasone attenuated delayed inflammation induced by perineural Exparel®.
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http://dx.doi.org/10.1016/j.bja.2020.04.091 | DOI Listing |
Clin Transl Oncol
November 2024
Department of Plastic, Reconstructive and Aesthetic Surgery, Marmara University School of Medicine, Istanbul, Türkiye.
Purpose: To examine the impact of the worst patterns of invasion (WPOI) on survival outcomes and possible implications for adjuvant treatment decisions in squamous cell oral cavity cancer patients.
Methods: The loco-regional progression-free survival (LRPFS) and the distant metastasis-free survival (DMFS) were calculated for 162 patients. Univariate and multivariate analyses were done according to prognostic predictors of stage (early/T1-2 or N0; locally advanced /T3-4 or N +), grade, depth of invasion, WPOI, perineural (PNI), and lymphovascular (LVI) invasion and margin status.
Cancer Imaging
March 2024
Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
Background: Cutaneous squamous cell carcinoma (CSCC) has a propensity for perineural spread (PNS) which is associated with poorer treatment outcomes. Immunotherapy is the new standard of care treatment for advanced CSCC resulting in durable responses. PNS is not captured by traditional response assessment criteria used in clinical trials, e.
View Article and Find Full Text PDFRadiol Oncol
December 2023
Centre of Radiotherapy, National Institute of Oncology, Budapest, Hungary.
Background: The aim of the study was to dosimetrically compare interstitial high-dose-rate (HDR) brachytherapy (BT) and modern external beam radiotherapy modalities, as volumetric modulated arc therapy (VMAT) and stereotactic radiotherapy with Cyberknife (CK) of tumours of the tongue and floor of the mouth in terms of dose to the critical organs.
Patients And Methods: In National Institute of Oncology, Budapest, between March 2013 and August 2022 twenty patients (11 male/9 female) with stage T1-3N0M0 tongue (n = 14) and floor of mouth (n = 6) tumours received postoperative radiotherapy because of close/positive surgical margin and/or lymphovascular and/or perineural invasion. High-dose-rate interstitial brachytherapy applying flexible plastic catheters with a total dose of 15 × 3 Gy was used for treatment.
Background Marjolin's ulcer or scar carcinoma is a rare disease arising from the conversion of chronic scar into malignancy. Studies show Marjolin's ulcer squamous cell carcinoma has more chances of lymph nodal metastasis and is more aggressive with a worse survival rate. To date, no established guidelines exist for managing regional lymph nodes in cases of Marjolin's ulcer with clinically N0 nodes.
View Article and Find Full Text PDFZhonghua Zhong Liu Za Zhi
February 2022
Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
To analyze the efficacy of sinonasal adenoid cystic carcinoma (ACC) with perineural invasion (PNI), and explore the prognostic value of PNI on sinonasal adenoid cystic carcinoma. The clinical data of 105 patients with sinonasal ACC admitted to Cancer Hospital, Chinese Academy of Medical Sciences from January 2000 to December 2016 were retrospectively reviewed. All patients were restaged according to American Joint Committee on Cancer 8th edition.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!