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British Journal of Anaesthesia Feb 1985
Topics: Anesthesia, Epidural; Anesthesia, Obstetrical; Bupivacaine; Cesarean Section; Female; Humans; Pregnancy
PubMed: 3970807
DOI: No ID Found -
Annals of the Royal College of Surgeons... Nov 1989
Topics: Adult; Bupivacaine; Humans; Male; Pain, Postoperative; Penis
PubMed: 2604353
DOI: No ID Found -
British Journal of Anaesthesia Sep 1991Mepivacaine and bupivacaine are used clinically as racemic mixtures of enantiomers. In these studies the enantiomers of each agent were administered separately to sheep...
Mepivacaine and bupivacaine are used clinically as racemic mixtures of enantiomers. In these studies the enantiomers of each agent were administered separately to sheep by i.v. bolus injection on separate occasions. Enantioselective disposition was deemed if the R:S ratio of the relevant pharmacokinetic parameter differed significantly from unity. Both enantiomers of both agents were cleared principally by the liver; urinary excretion of unmetabolized agents accounted for less than 2% of the doses. For R(-)-and S(+)-mepivacaine, respective mean (SEM) values of parameters were: total body clearance 1.20 (0.29) litre min-1 and 0.97 (0.20) litre min-1 (ns); total volume of distribution 144 (39) litre and 80 (21) litre (P less than 0.05); slow half-life 120 (40) min and 84 (22) min (ns); mean hepatic extraction ratio 0.50 (0.14) and 0.52 (0.09) (ns); mean hepatic clearance 0.75 (0.23) litre min-1 and 0.75 (0.18) litre min-1 (ns). For R(+)- and S(-)-bupivacaine, respective values were: total body clearance 0.77 (0.33) litre min-1 and 0.53 (0.26) litre min-1 (P less than 0.05); total volume of distribution 40 (10) litre and 43 (10) litre (ns); slow half-life 57 (10) min and 104 (21) min (P less than 0.05); mean hepatic extraction ratio 0.46 (0.15) and 0.29 (0.13) (P less than 0.05); mean hepatic clearance 0.85 (0.31) litre min-1 and 0.54 (0.26) litre min-1 (P less than 0.05). Thus there was enantioselective distribution of mepivacaine and enantioselective clearance of bupivacaine, but the magnitude of the effect was relatively small.
Topics: Animals; Bupivacaine; Cardiac Output; Female; Half-Life; Heart Atria; Injections; Liver; Mepivacaine; Metabolic Clearance Rate; Sheep; Stereoisomerism
PubMed: 1911009
DOI: 10.1093/bja/67.3.239 -
BioMed Research International 2014The aim of the study was to compare the sensory, motor, and neuroophthalmological effects of isobaric levobupivacaine and bupivacaine when intrathecally administered. (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
The aim of the study was to compare the sensory, motor, and neuroophthalmological effects of isobaric levobupivacaine and bupivacaine when intrathecally administered.
MATERIALS AND METHODS
A prospective, double-blind, randomized study with 60 ASA grade I-II patients aged 18-65 years awaiting knee arthroscopy under spinal anesthesia. Patients received 12.5 mg of isobaric bupivacaine or levobupivacaine. Several features were recorded.
RESULTS
No significant intergroup differences were observed for ASA classification, time to micturate, demographic data, surgery duration, and patient/surgeon satisfaction. Similar hemodynamic parameters and sensory/motor blockade duration were found for both groups. There were no neuroophthalmological effects in either group. Sensory (P = 0.018) and motor blockade onset (P = 0.003) was faster in the bupivacaine group. T6 (T2-T12) and T3 (T2-T12) were the highest sensory block levels for the levobupivacaine and bupivacaine groups, respectively (P = 0.008). It took less time to regain maximum motor blockade in the bupivacaine group (P = 0.014), and the levobupivacaine group required use of analgesia earlier (P = 0.025).
CONCLUSIONS
Isobaric bupivacaine and levobupivacaine are analogous and well-tolerated anesthetics for knee arthroscopy. However, for bupivacaine, sensory and motor blockade onset was faster, and greater sensory blockade with a longer postoperative painless period was achieved.
Topics: Adolescent; Adult; Aged; Anesthesia, Spinal; Arthroscopy; Bupivacaine; Humans; Knee; Levobupivacaine; Middle Aged
PubMed: 24701571
DOI: 10.1155/2014/349034 -
International Journal of Obstetric... Aug 2014Following maternal administration, local anesthetics pass into breast milk. In the present study, we aimed to compare the passage of levobupivacaine and bupivacaine into... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Following maternal administration, local anesthetics pass into breast milk. In the present study, we aimed to compare the passage of levobupivacaine and bupivacaine into breast milk following epidural anesthesia for cesarean delivery.
METHODS
A total of 20 women undergoing elective cesarean delivery under epidural anesthesia were randomized to receive either 0.5% levobupivacaine or 0.5% racemic bupivacaine via an epidural catheter. Immediately before and 30min, 1h, 2h, 6h, 12h and 24h after administration of epidural local anesthetic, maternal blood and breast milk samples were taken simultaneously. Drug concentrations in plasma and milk were determined via high-performance liquid chromatography. The infant's drug exposure was determined by calculating milk/plasma ratios of levobupivacaine and bupivacaine.
RESULTS
Both levobupivacaine and bupivacaine were detected in breast milk 30min after epidural administration. Concentrations of both agents showed constant and similar decreases in milk and plasma and were nearly undetectable at 24h. The milk/plasma ratios were 0.34±0.13 for levobupivacaine and 0.37±0.14 for bupivacaine.
CONCLUSIONS
Both levobupivacaine and bupivacaine pass into breast milk following epidural administration. The concentration of both drugs was approximately three times lower in breast milk than in maternal plasma.
Topics: Adolescent; Adult; Anesthesia, Epidural; Anesthesia, Obstetrical; Anesthetics, Local; Bupivacaine; Cesarean Section; Double-Blind Method; Female; Humans; Infant, Newborn; Levobupivacaine; Milk, Human; Pregnancy; Prospective Studies; Young Adult
PubMed: 24953218
DOI: 10.1016/j.ijoa.2014.03.005 -
British Journal of Anaesthesia May 1997We have compared the incidence of CNS symptoms and changes in echocardiography and electrophysiology during i.v. infusions of ropivacaine, bupivacaine and placebo. Acute... (Clinical Trial)
Clinical Trial Comparative Study Randomized Controlled Trial
We have compared the incidence of CNS symptoms and changes in echocardiography and electrophysiology during i.v. infusions of ropivacaine, bupivacaine and placebo. Acute tolerance of i.v. infusion of 10 mg min-1 was studied in a crossover, randomized, double-blind study in 12 volunteers previously acquainted with the CNS effects of lignocaine. The maximum tolerated dose for CNS symptoms was higher after ropivacaine in nine of 12 subjects and higher after bupivacaine in three subjects. The 95% confidence limits for the difference in mean dose between ropivacaine and bupivacaine were -30 and 7 mg. The maximum tolerated unbound arterial plasma concentration was twice as high after ropivacaine (P < 0.001). Muscular twitching occurred more frequently after bupivacaine (P < 0.05). The time to disappearance of all symptoms was shorter after ropivacaine (P < 0.05). A threshold for CNS toxicity was apparent at a mean free plasma concentration of approximately 0.6 mg litre-1 for ropivacaine and 0.3 mg litre-1 for bupivacaine. Bupivacaine increased QRS width during sinus rhythm compared with placebo (P < 0.001) and ropivacaine (P < 0.01). Bupivacaine reduced both left ventricular systolic and diastolic function compared with placebo (P < 0.05 and P < 0.01, respectively), while ropivacaine reduced only systolic function (P < 0.01).
Topics: Adult; Amides; Anesthetics, Local; Bupivacaine; Central Nervous System Diseases; Cross-Over Studies; Double-Blind Method; Drug Administration Schedule; Electrocardiography; Hemodynamics; Humans; Infusions, Intravenous; Male; Ropivacaine; Ventricular Function, Left
PubMed: 9175963
DOI: 10.1093/bja/78.5.507 -
British Journal of Anaesthesia Apr 1979
Topics: Adolescent; Adult; Aged; Anesthesia, Epidural; Bupivacaine; Humans; Middle Aged
PubMed: 465263
DOI: 10.1093/bja/51.4.384 -
Medical Science Monitor : International... Dec 2013Hypotension is the most common problem with spinal anesthesia. This prospective study aimed to compare normotensive and hypertensive patients with respect to the... (Comparative Study)
Comparative Study
BACKGROUND
Hypotension is the most common problem with spinal anesthesia. This prospective study aimed to compare normotensive and hypertensive patients with respect to the hemodynamic effects of spinal anesthesia performed with hyperbaric bupivacaine.
MATERIAL AND METHODS
Sixty patients who were scheduled to undergo various elective operations under spinal anesthesia were included into the study. The patients were separated into 2 groups: hypertensive patients constituted Group H (n=30) and normotensive patients constituted Group N (n=30). After fluid loading, spinal anesthesia was performed with 3.5 ml 0.5% hyperbaric bupivacaine. Demographic characteristics and incidence of hypotension and bradycardia were compared. Systolic (SBP), diastolic (DBP), and mean blood pressures (MBP) and heart rate (HR) were also compared before and after spinal anesthesia.
RESULTS
There was no significant difference between the groups with respect to demographic characteristics, maximal height of sensory block, incidences of hypotension and bradycardia, and the amount of fluids infused (p>0.05). In the hypertensive patient group, the SBP, DBP, and MBP values were significantly higher than in the normotensive patient group at all measurement times (p<0.05). Comparison within the groups did not reveal any significant differences in either group compared to the basal values (p>0.05). There were no significant differences in HR between or within groups (p>0.05).
CONCLUSIONS
There was no significant difference between normotensive and hypertensive patients in the incidences of hypotension caused by spinal anesthesia with 0.5% hyperbaric bupivacaine.
Topics: Adult; Anesthesia, Spinal; Blood Pressure; Bupivacaine; Elective Surgical Procedures; Heart Rate; Humans; Hypertension; Middle Aged; Prospective Studies; Statistics, Nonparametric
PubMed: 24304744
DOI: 10.12659/MSM.889412 -
Anaesthesia Aug 1984
Topics: Anesthesia, Conduction; Anesthesia, Obstetrical; Bupivacaine; Female; Humans; Pregnancy
PubMed: 6476329
DOI: 10.1111/j.1365-2044.1984.tb06556.x -
The Journal of International Medical... Apr 2014To compare two intrathecal anaesthetics, bupivacaine and levobupivacaine, for their effects on motor and sensory blockade and haemodynamics in patients aged ≥ 65 years... (Comparative Study)
Comparative Study Randomized Controlled Trial
OBJECTIVES
To compare two intrathecal anaesthetics, bupivacaine and levobupivacaine, for their effects on motor and sensory blockade and haemodynamics in patients aged ≥ 65 years undergoing transurethral resection of the prostate (TUR-P) or transurethral resection of the urinary bladder (TUR-M).
METHODS
Patients scheduled to undergo TUR-P or TUR-M were randomized to receive either 3 ml (15 mg) 0.5% isobaric levobupivacaine (group L) or 3 ml (15 mg) of 0.5% hyperbaric bupivacaine (group B) for spinal anaesthesia. The onset time, maximum level and time to reach the maximum level of sensory and motor blockade were recorded. Changes to haemodynamic parameters were also recorded.
RESULTS
The study randomized 100 patients: 57 to group L and 43 to group B. Levobupivacaine did not cause any significant changes in haemodynamic parameters, including systolic blood pressure, and showed a similar sensory block onset time compared with bupivacaine, but it had a significantly longer motor block onset time compared with bupivacaine.
CONCLUSION
These current findings suggest that levobupivacaine can be used as a substitute for bupivacaine for spinal anaesthesia in elderly patients ≥ 65 years of age undergoing elective TUR-P or TUR-M operations.
Topics: Aged; Aging; Anesthesia, Spinal; Anesthetics, Local; Blood Pressure; Bupivacaine; Female; Humans; In Vitro Techniques; Injections, Spinal; Levobupivacaine; Male; Nerve Block; Prostate; Transurethral Resection of Prostate; Urinary Bladder
PubMed: 24595149
DOI: 10.1177/0300060513496737