Bupivacaine

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J. Bannister - One of the best experts on this subject based on the ideXlab platform.

  • Extradural S(-)-Bupivacaine: comparison with racemic RS-Bupivacaine.
    British journal of anaesthesia, 1998
    Co-Authors: C. R. Cox, K. A. Faccenda, Charlotte Gilhooly, J. Bannister, N. B. Scott, L. M. M. Morrison
    Abstract:

    Bupivacaine has a chiral centre and is currently available as a racemic mixture of its two enantiomers: R(+)-Bupivacaine and S(-)-Bupivacaine. Preclinical studies have demonstrated that there is enantiomer selectivity of action with the bulk of central nervous system and cardiovascular toxicity residing with the R(+) isomer. The aim of this study was to compare the clinical efficacy and safety of S(-)-Bupivacaine with racemic RS-Bupivacaine for extradural anaesthesia. We studied 88 patients undergoing elective lower limb surgery under lumbar extradural anaesthesia who received 15 ml of 0.5% or 0.75% S(-)-Bupivacaine, or 0.5% RS-Bupivacaine in a randomized, double-blind study. There was no difference in onset time, maximum spread of sensory block or intensity of motor block between the three groups. Duration of sensory block was significantly longer for 0.75% S(-)-Bupivacaine. We conclude that S(-)-Bupivacaine has similar local anaesthetic characteristics to RS-Bupivacaine when used for extradural anaesthesia.

  • -)-Bupivacaine: comparison with racemic RS-Bupivacaine†
    1998
    Co-Authors: C. R. Cox, K. A. Faccenda, Charlotte Gilhooly, J. Bannister, N. B. Scott, L. M. M. Morrison
    Abstract:

    Summary Bupivacaine has a chiral centre and is currently available as a racemic mixture of its two enanti- omers: R(� )-Bupivacaine and S(� )-Bupivacaine. Preclinical studies have demonstrated that there is enantiomer selectivity of action with the bulk of central nervous system and cardiovascular toxicity residing with the R(� ) isomer. The aim of this study was to compare the clinical efficacy and safety of S(� )-Bupivacaine with racemic RS-Bupivacaine for extradural anaesthesia. We studied 88 patients undergoing elective lower limb surgery under lumbar extradural anaesthe- sia who received 15 ml of 0.5% or 0.75% S(� )-Bupivacaine, or 0.5% RS-Bupivacaine in a randomized, double-blind study. There was no difference in onset time, maximum spread of sensory block or intensity of motor block between the three groups. Duration of sensory block was significantly longer for 0.75% S(� )- Bupivacaine. We conclude that S(� )-Bupivacaine has similar local anaesthetic characteristics to RS-Bupivacaine when used for extradural anaes- thesia. (Br. J. Anaesth. 1998; 80: 289-293)

  • Comparison of S(-)-Bupivacaine with racemic (RS)-Bupivacaine in supraclavicular brachial plexus block.
    British journal of anaesthesia, 1998
    Co-Authors: C. R. Cox, N. B. Scott, M. R. Checketts, N. Mackenzie, J. Bannister
    Abstract:

    Bupivacaine is used widely as a local anaesthetic but has potential for severe cardiovascular and central nervous system (CNS) toxicity. It has an asymmetric carbon atom giving it a chiral centre, and the commercial preparation is a racemic mixture of its two enantiomers: dextro or R(+)-Bupivacaine and levo or S(-)-Bupivacaine. Preclinical studies have demonstrated reduced cardiotoxicity and CNS toxicity for S(-)-Bupivacaine. In this study we have compared the clinical efficacy of S(-)-Bupivacaine with racemic RS-Bupivacaine for supraclavicular brachial plexus block in 75 patients undergoing elective hand surgery. Patients received 0.4 ml kg-1 of either 0.25% or 0.5% S(-)-Bupivacaine or 0.5% RS-Bupivacaine in a randomized, double-blind study. Clinical assessments of sensory and motor block were performed at regular intervals. There were no significant differences in onset time, dermatomal spread or duration of both sensory and motor block between the three groups (the power of the study was 81% to detect a 4-h difference in duration). Duration of sensory block was prolonged with wide interpatient variation: 892 (SD 250) min, 1039 (317) min and 896 (284) min for 0.25% S(-)-Bupivacaine, 0.5% S(-)-Bupivacaine and 0.5% RS-Bupivacaine, respectively. There were no differences in the overall success rate of the technique. We conclude that S(-)-Bupivacaine was suitable for local anaesthetic use in brachial plexus block anaesthesia.

C. R. Cox - One of the best experts on this subject based on the ideXlab platform.

  • Extradural S(-)-Bupivacaine: comparison with racemic RS-Bupivacaine.
    British journal of anaesthesia, 1998
    Co-Authors: C. R. Cox, K. A. Faccenda, Charlotte Gilhooly, J. Bannister, N. B. Scott, L. M. M. Morrison
    Abstract:

    Bupivacaine has a chiral centre and is currently available as a racemic mixture of its two enantiomers: R(+)-Bupivacaine and S(-)-Bupivacaine. Preclinical studies have demonstrated that there is enantiomer selectivity of action with the bulk of central nervous system and cardiovascular toxicity residing with the R(+) isomer. The aim of this study was to compare the clinical efficacy and safety of S(-)-Bupivacaine with racemic RS-Bupivacaine for extradural anaesthesia. We studied 88 patients undergoing elective lower limb surgery under lumbar extradural anaesthesia who received 15 ml of 0.5% or 0.75% S(-)-Bupivacaine, or 0.5% RS-Bupivacaine in a randomized, double-blind study. There was no difference in onset time, maximum spread of sensory block or intensity of motor block between the three groups. Duration of sensory block was significantly longer for 0.75% S(-)-Bupivacaine. We conclude that S(-)-Bupivacaine has similar local anaesthetic characteristics to RS-Bupivacaine when used for extradural anaesthesia.

  • -)-Bupivacaine: comparison with racemic RS-Bupivacaine†
    1998
    Co-Authors: C. R. Cox, K. A. Faccenda, Charlotte Gilhooly, J. Bannister, N. B. Scott, L. M. M. Morrison
    Abstract:

    Summary Bupivacaine has a chiral centre and is currently available as a racemic mixture of its two enanti- omers: R(� )-Bupivacaine and S(� )-Bupivacaine. Preclinical studies have demonstrated that there is enantiomer selectivity of action with the bulk of central nervous system and cardiovascular toxicity residing with the R(� ) isomer. The aim of this study was to compare the clinical efficacy and safety of S(� )-Bupivacaine with racemic RS-Bupivacaine for extradural anaesthesia. We studied 88 patients undergoing elective lower limb surgery under lumbar extradural anaesthe- sia who received 15 ml of 0.5% or 0.75% S(� )-Bupivacaine, or 0.5% RS-Bupivacaine in a randomized, double-blind study. There was no difference in onset time, maximum spread of sensory block or intensity of motor block between the three groups. Duration of sensory block was significantly longer for 0.75% S(� )- Bupivacaine. We conclude that S(� )-Bupivacaine has similar local anaesthetic characteristics to RS-Bupivacaine when used for extradural anaes- thesia. (Br. J. Anaesth. 1998; 80: 289-293)

  • Comparison of S(-)-Bupivacaine with racemic (RS)-Bupivacaine in supraclavicular brachial plexus block.
    British journal of anaesthesia, 1998
    Co-Authors: C. R. Cox, N. B. Scott, M. R. Checketts, N. Mackenzie, J. Bannister
    Abstract:

    Bupivacaine is used widely as a local anaesthetic but has potential for severe cardiovascular and central nervous system (CNS) toxicity. It has an asymmetric carbon atom giving it a chiral centre, and the commercial preparation is a racemic mixture of its two enantiomers: dextro or R(+)-Bupivacaine and levo or S(-)-Bupivacaine. Preclinical studies have demonstrated reduced cardiotoxicity and CNS toxicity for S(-)-Bupivacaine. In this study we have compared the clinical efficacy of S(-)-Bupivacaine with racemic RS-Bupivacaine for supraclavicular brachial plexus block in 75 patients undergoing elective hand surgery. Patients received 0.4 ml kg-1 of either 0.25% or 0.5% S(-)-Bupivacaine or 0.5% RS-Bupivacaine in a randomized, double-blind study. Clinical assessments of sensory and motor block were performed at regular intervals. There were no significant differences in onset time, dermatomal spread or duration of both sensory and motor block between the three groups (the power of the study was 81% to detect a 4-h difference in duration). Duration of sensory block was prolonged with wide interpatient variation: 892 (SD 250) min, 1039 (317) min and 896 (284) min for 0.25% S(-)-Bupivacaine, 0.5% S(-)-Bupivacaine and 0.5% RS-Bupivacaine, respectively. There were no differences in the overall success rate of the technique. We conclude that S(-)-Bupivacaine was suitable for local anaesthetic use in brachial plexus block anaesthesia.

Mohamed-rida Alsaden - One of the best experts on this subject based on the ideXlab platform.

  • A randomized-controlled trial comparing liposomal Bupivacaine, plain Bupivacaine, and the mixture of liposomal Bupivacaine and plain Bupivacaine in transversus abdominus plane block for postoperative analgesia for open abdominal hysterectomies
    Canadian Journal of Anesthesia Journal canadien d'anesthésie, 2021
    Co-Authors: Christina W. Fidkowski, Nandak Choksi, Mohamed-rida Alsaden
    Abstract:

    Purpose Transversus abdominus plane (TAP) blocks are widely used for postoperative analgesia for abdominal surgical procedures. The purpose of this study was to compare the analgesic efficacy of plain Bupivacaine, liposomal Bupivacaine, and the mixture of plain Bupivacaine with liposomal Bupivacaine when used in a TAP block. Methods This study was a single centre, prospective, patient-, observer-, and surgeon-blinded, randomized-controlled trial in which 90 patients undergoing an open abdominal hysterectomy with a midline incision were randomized to receive a TAP block with plain Bupivacaine (group Bupivacaine), liposomal Bupivacaine (group liposomal), or a mixture of liposomal Bupivacaine and plain Bupivacaine (group mixture). Primary outcomes included time to the first rescue opioid analgesic and total opioid consumption during the first 72 postoperative hours. Secondary outcomes included pain scores, patient satisfaction, incidence of hemodynamic instability, presence of local anesthetic systemic toxicity, and length of hospital stay. Results The median [interquartile range] time to first opioid was 51 [28–66] min in group Bupivacaine, 63 [44–102] min in group liposomal, and 51 [24–84] min in group mixture ( P = 0.20). The median [interquartile range] total opioid consumption in the first 72 postoperative hours was 208 [155–270] mg in group Bupivacaine, 203 [153–283] mg in group liposomal, and 202 [116–325] mg in group mixture ( P = 0.92). There were no significant differences in secondary outcomes between groups. Conclusions In this small study at risk of being under-powered, the mixture of liposomal Bupivacaine with plain Bupivacaine for TAP block did not improve analgesia compared with either liposomal Bupivacaine or plain Bupivacaine on their own. Trial registration www.clinicaltrials.gov (NCT03250507); registered 5 April 2017. Objectif Les blocs des muscles du plan transverse de l’abdomen (blocs TAP) sont fréquemment utilisés pour l’analgésie postopératoire après une intervention chirurgicale abdominale. L’objectif de cette étude était de comparer l’efficacité analgésique de la bupivacaïne simple, de la bupivacaïne liposomale, et du mélange de bupivacaïne simple et bupivacaïne liposomale lorsque utilisés dans un bloc TAP. Méthode Cette étude randomisée contrôlée monocentrique, prospective, à l’insu de la patiente, de l’observateur et du chirurgien a recruté 90 patientes subissant une hystérectomie abdominale par laparotomie via une incision de la ligne médiane, qui ont été randomisées pour recevoir un bloc TAP réalisé avec de la bupivacaïne simple (groupe bupivacaïne), de la bupivacaïne liposomale (groupe liposomale), ou un mélange de bupivacaïne liposomale et de bupivacaïne simple (groupe mélange). Les critères d’évaluation principaux comprenaient le délai jusqu’à l’administration du premier analgésique opioïde de sauvetage et la consommation totale d’opioïdes pendant les 72 premières heures postopératoires. Les critères secondaires incluaient les scores de douleur, la satisfaction des patientes, l’incidence d’instabilité hémodynamique, la présence de toxicité systémique de l’anesthésique local, et la durée du séjour à l’hôpital. Résultats Le délai médian [écart interquartile] jusqu’à la première administration d’opioïde était de 51 [28-66] min dans le groupe bupivacaïne, 63 [44-102] min dans le groupe liposomale, et 51 [24-84] min dans le groupe mélange ( P = 0,20). La consommation médiane totale d’opioïdes [écart interquartile] au cours des premières 72 heures postopératoires était de 208 [155-270] mg dans le groupe bupivacaïne, 203 [153-283] mg dans le groupe liposomale, et 202 [116-325] mg dans le groupe mélange ( P = 0,92). Aucune différence intergroupe significative n’a été observée dans les critères d’évaluation secondaires. Conclusion Dans cette petite étude manquant potentiellement de puissance, le mélange de bupivacaïne liposomale et bupivacaïne simple pour le bloc TAP n’a pas amélioré l’analgésie par rapport à la bupivacaïne liposomale ou à la bupivacaïne simple administrées seules. Enregistrement de l’étude www.clinicaltrials.gov (NCT03250507); enregistrée le 5 avril 2017.

  • A randomized-controlled trial comparing liposomal Bupivacaine, plain Bupivacaine, and the mixture of liposomal Bupivacaine and plain Bupivacaine in transversus abdominus plane block for postoperative analgesia for open abdominal hysterectomies.
    Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2021
    Co-Authors: Christina W. Fidkowski, Nandak Choksi, Mohamed-rida Alsaden
    Abstract:

    PURPOSE Transversus abdominus plane (TAP) blocks are widely used for postoperative analgesia for abdominal surgical procedures. The purpose of this study was to compare the analgesic efficacy of plain Bupivacaine, liposomal Bupivacaine, and the mixture of plain Bupivacaine with liposomal Bupivacaine when used in a TAP block. METHODS This study was a single centre, prospective, patient-, observer-, and surgeon-blinded, randomized-controlled trial in which 90 patients undergoing an open abdominal hysterectomy with a midline incision were randomized to receive a TAP block with plain Bupivacaine (group Bupivacaine), liposomal Bupivacaine (group liposomal), or a mixture of liposomal Bupivacaine and plain Bupivacaine (group mixture). Primary outcomes included time to the first rescue opioid analgesic and total opioid consumption during the first 72 postoperative hours. Secondary outcomes included pain scores, patient satisfaction, incidence of hemodynamic instability, presence of local anesthetic systemic toxicity, and length of hospital stay. RESULTS The median [interquartile range] time to first opioid was 51 [28-66] min in group Bupivacaine, 63 [44-102] min in group liposomal, and 51 [24-84] min in group mixture (P = 0.20). The median [interquartile range] total opioid consumption in the first 72 postoperative hours was 208 [155-270] mg in group Bupivacaine, 203 [153-283] mg in group liposomal, and 202 [116-325] mg in group mixture (P = 0.92). There were no significant differences in secondary outcomes between groups. CONCLUSIONS In this small study at risk of being under-powered, the mixture of liposomal Bupivacaine with plain Bupivacaine for TAP block did not improve analgesia compared with either liposomal Bupivacaine or plain Bupivacaine on their own. TRIAL REGISTRATION www.clinicaltrials.gov (NCT03250507); registered 5 April 2017.

N. B. Scott - One of the best experts on this subject based on the ideXlab platform.

  • Extradural S(-)-Bupivacaine: comparison with racemic RS-Bupivacaine.
    British journal of anaesthesia, 1998
    Co-Authors: C. R. Cox, K. A. Faccenda, Charlotte Gilhooly, J. Bannister, N. B. Scott, L. M. M. Morrison
    Abstract:

    Bupivacaine has a chiral centre and is currently available as a racemic mixture of its two enantiomers: R(+)-Bupivacaine and S(-)-Bupivacaine. Preclinical studies have demonstrated that there is enantiomer selectivity of action with the bulk of central nervous system and cardiovascular toxicity residing with the R(+) isomer. The aim of this study was to compare the clinical efficacy and safety of S(-)-Bupivacaine with racemic RS-Bupivacaine for extradural anaesthesia. We studied 88 patients undergoing elective lower limb surgery under lumbar extradural anaesthesia who received 15 ml of 0.5% or 0.75% S(-)-Bupivacaine, or 0.5% RS-Bupivacaine in a randomized, double-blind study. There was no difference in onset time, maximum spread of sensory block or intensity of motor block between the three groups. Duration of sensory block was significantly longer for 0.75% S(-)-Bupivacaine. We conclude that S(-)-Bupivacaine has similar local anaesthetic characteristics to RS-Bupivacaine when used for extradural anaesthesia.

  • -)-Bupivacaine: comparison with racemic RS-Bupivacaine†
    1998
    Co-Authors: C. R. Cox, K. A. Faccenda, Charlotte Gilhooly, J. Bannister, N. B. Scott, L. M. M. Morrison
    Abstract:

    Summary Bupivacaine has a chiral centre and is currently available as a racemic mixture of its two enanti- omers: R(� )-Bupivacaine and S(� )-Bupivacaine. Preclinical studies have demonstrated that there is enantiomer selectivity of action with the bulk of central nervous system and cardiovascular toxicity residing with the R(� ) isomer. The aim of this study was to compare the clinical efficacy and safety of S(� )-Bupivacaine with racemic RS-Bupivacaine for extradural anaesthesia. We studied 88 patients undergoing elective lower limb surgery under lumbar extradural anaesthe- sia who received 15 ml of 0.5% or 0.75% S(� )-Bupivacaine, or 0.5% RS-Bupivacaine in a randomized, double-blind study. There was no difference in onset time, maximum spread of sensory block or intensity of motor block between the three groups. Duration of sensory block was significantly longer for 0.75% S(� )- Bupivacaine. We conclude that S(� )-Bupivacaine has similar local anaesthetic characteristics to RS-Bupivacaine when used for extradural anaes- thesia. (Br. J. Anaesth. 1998; 80: 289-293)

  • Comparison of S(-)-Bupivacaine with racemic (RS)-Bupivacaine in supraclavicular brachial plexus block.
    British journal of anaesthesia, 1998
    Co-Authors: C. R. Cox, N. B. Scott, M. R. Checketts, N. Mackenzie, J. Bannister
    Abstract:

    Bupivacaine is used widely as a local anaesthetic but has potential for severe cardiovascular and central nervous system (CNS) toxicity. It has an asymmetric carbon atom giving it a chiral centre, and the commercial preparation is a racemic mixture of its two enantiomers: dextro or R(+)-Bupivacaine and levo or S(-)-Bupivacaine. Preclinical studies have demonstrated reduced cardiotoxicity and CNS toxicity for S(-)-Bupivacaine. In this study we have compared the clinical efficacy of S(-)-Bupivacaine with racemic RS-Bupivacaine for supraclavicular brachial plexus block in 75 patients undergoing elective hand surgery. Patients received 0.4 ml kg-1 of either 0.25% or 0.5% S(-)-Bupivacaine or 0.5% RS-Bupivacaine in a randomized, double-blind study. Clinical assessments of sensory and motor block were performed at regular intervals. There were no significant differences in onset time, dermatomal spread or duration of both sensory and motor block between the three groups (the power of the study was 81% to detect a 4-h difference in duration). Duration of sensory block was prolonged with wide interpatient variation: 892 (SD 250) min, 1039 (317) min and 896 (284) min for 0.25% S(-)-Bupivacaine, 0.5% S(-)-Bupivacaine and 0.5% RS-Bupivacaine, respectively. There were no differences in the overall success rate of the technique. We conclude that S(-)-Bupivacaine was suitable for local anaesthetic use in brachial plexus block anaesthesia.

L. M. M. Morrison - One of the best experts on this subject based on the ideXlab platform.

  • Extradural S(-)-Bupivacaine: comparison with racemic RS-Bupivacaine.
    British journal of anaesthesia, 1998
    Co-Authors: C. R. Cox, K. A. Faccenda, Charlotte Gilhooly, J. Bannister, N. B. Scott, L. M. M. Morrison
    Abstract:

    Bupivacaine has a chiral centre and is currently available as a racemic mixture of its two enantiomers: R(+)-Bupivacaine and S(-)-Bupivacaine. Preclinical studies have demonstrated that there is enantiomer selectivity of action with the bulk of central nervous system and cardiovascular toxicity residing with the R(+) isomer. The aim of this study was to compare the clinical efficacy and safety of S(-)-Bupivacaine with racemic RS-Bupivacaine for extradural anaesthesia. We studied 88 patients undergoing elective lower limb surgery under lumbar extradural anaesthesia who received 15 ml of 0.5% or 0.75% S(-)-Bupivacaine, or 0.5% RS-Bupivacaine in a randomized, double-blind study. There was no difference in onset time, maximum spread of sensory block or intensity of motor block between the three groups. Duration of sensory block was significantly longer for 0.75% S(-)-Bupivacaine. We conclude that S(-)-Bupivacaine has similar local anaesthetic characteristics to RS-Bupivacaine when used for extradural anaesthesia.

  • -)-Bupivacaine: comparison with racemic RS-Bupivacaine†
    1998
    Co-Authors: C. R. Cox, K. A. Faccenda, Charlotte Gilhooly, J. Bannister, N. B. Scott, L. M. M. Morrison
    Abstract:

    Summary Bupivacaine has a chiral centre and is currently available as a racemic mixture of its two enanti- omers: R(� )-Bupivacaine and S(� )-Bupivacaine. Preclinical studies have demonstrated that there is enantiomer selectivity of action with the bulk of central nervous system and cardiovascular toxicity residing with the R(� ) isomer. The aim of this study was to compare the clinical efficacy and safety of S(� )-Bupivacaine with racemic RS-Bupivacaine for extradural anaesthesia. We studied 88 patients undergoing elective lower limb surgery under lumbar extradural anaesthe- sia who received 15 ml of 0.5% or 0.75% S(� )-Bupivacaine, or 0.5% RS-Bupivacaine in a randomized, double-blind study. There was no difference in onset time, maximum spread of sensory block or intensity of motor block between the three groups. Duration of sensory block was significantly longer for 0.75% S(� )- Bupivacaine. We conclude that S(� )-Bupivacaine has similar local anaesthetic characteristics to RS-Bupivacaine when used for extradural anaes- thesia. (Br. J. Anaesth. 1998; 80: 289-293)

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