Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Sep 2017
Observational StudySerum Bupivacaine Concentration After Periarticular Injection With a Mixture of Liposomal Bupivacaine and Bupivacaine HCl During Total Knee Arthroplasty.
A relatively new technique to reduce postoperative pain for total knee arthroplasty is to inject a mixture of 266 mg of liposomal bupivacaine and 125 mg of 0.25% bupivacaine HCl with epinephrine 1:300,000 around the knee joint at the time of surgery. Currently, no publications report serum bupivacaine concentrations over time after periarticular injection of liposomal mixed with free bupivacaine. This information is important to ensure safe serum bupivacaine concentrations are maintained especially when considering supplemental or rescue peripheral nerve blocks. ⋯ Total serum concentrations of bupivacaine after periarticular administration of liposomal bupivacaine mixed with bupivacaine HCl remained below the described toxicity threshold (2.5 μg/mL) within the first 48 hours, and no patients demonstrated signs or symptoms of toxicity. However, peak serum concentration time was not achieved within the 48-hour interval. Additional studies are needed to describe the course of serum bupivacaine levels after 48 hours and to ascertain the risk of toxicity when combining this method of periarticular injection with peripheral nerve blocks.
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Reg Anesth Pain Med · Sep 2017
Comparative StudyAntioxidation Role of Different Lateral Stellate Ganglion Block in Isoproterenol-Induced Acute Myocardial Ischemia in Rats.
To determine whether stellate ganglion block (SGB) treatment exerts protective effects against isoproterenol (ISO)-induced acute myocardial ischemia (AMI) due to its antioxidant effects, we aimed to evaluate the protective effects of different lateral SGB agents on the tissue antioxidant status in ISO-induced AMI in male Sprague-Dawley rats. ⋯ These findings suggest that SGB could have antioxidative effects against AMI, and the protective effect of right SGB was more effective than that of left SGB. Thus, the right SGB could be an effective and safe method of local anesthesia to protect against cardiac damage due to oxidative stress.