Pharmacokinetics and protein binding of bupivacaine were studied after caudal injection 2.5 mg/kg in 13 ASA PS 1 infants (1-6 months age) scheduled for elective hernia repair. Blood was sampled at frequent intervals from 5 min to 600 all but one patients. Additional samples taken 720 840 five Bupivacaine concentration measured using gas chromatography. Protein ultrafiltration. Peak serum concentrations ranged between 0.55 1.93 micrograms/ml. The time reach the peak 10 60 min. Terminal...

Aims Propofol is a widely used i.v. anaesthetic agent. However, its binding properties to blood components have not been fully studied. Methods We studied the of propofol erythrocytes, human serum and isolated proteins. Because bound ultrafiltration equilibrium dialysis membranes, we co‐binding technique with dextran coated charcoal erythrocytes. Results free fraction in was 1.2–1.7% at total concentrations ranging from 2.80 179 μm (0.5 32 μg ml −1 ). Fifty percent erythrocytes 48% proteins,...

The enantiomers of a racemic drug generally differ in their pharmacokinetic and/or pharmacodynamic properties. Because bupivacaine is mixture two optical isomers known to exert different toxic properties on isolated nerve preparations, we decided use an rabbit heart model with constant coronary inflow compare the myocardial uptake kinetics R(+)-, S(-)-enantiomers and bupivacaine. increase QRS duration was also measured, concentration-effect relationship analyzed for three drugs. exhibited...

Background The analgesic effect of perioperative low doses intravenous lidocaine has been demonstrated after abdominal surgery. This study aimed to evaluate whether a continuous low-dose infusion reduced postoperative pain and modified nociceptive threshold total hip arthroplasty. Methods Sixty patients participated in this randomized double-blinded study. Patients received 1% (lidocaine group) with 1.5 mg/kg bolus 10 min followed by mg . kg h or saline (control group). These regimens were...

In Brief BACKGROUND: There is great variability in the need for morphine postoperative period. We performed a pharmacokinetic–pharmacodynamic study considering potential effect of two main metabolites morphine. METHODS: Fifty patients with moderate to severe pain received as an IV titration, followed by IM administration postoperatively. The plasma concentration morphine, morphine-6-glucuronide (M-6-G), morphine-3-glucuronide (M-3-G), and intensity were measured at frequent intervals....

Background Nerve blocks provide analgesia after surgery. The authors tested whether nerve have antiinflammatory effects. Methods Patients had combined sciatic (single-shot) and continuous femoral block (48 h) (block group) or morphine patient-controlled total knee arthroplasty. Pain at rest upon movement was monitored 1 (D1), 4 (D4), 7 days (D7) (M1) 3 months (M3) Knee inflammation evaluated (skin temperature, circumference) before surgery D1, D4, D7, M1, M3. Plasma cytokine concentrations...

Postoperative pain after laparoscopic surgery is less than laparotomy, and patients may benefit from an intraperitoneal injection of local anesthetic. Thirty-seven ASA physical status I or II received in double-blinded fashion 20 mL 0.9% saline solution (placebo), ropivacaine 0.25% (Rop 0.25%), 0.75% 0.75%) immediately trocar placement at the end surgery. We measured morphine consumption until h Plasma concentrations were measured. The three groups comparable for shoulder pain, parietal...

Background Numerous local anesthetics have an asymmetric tetrahedron carbon, which confers stereoselective differences between the isomers. The authors attempted to quantify depressant effect of racemic bupivacaine, levobupivacaine, and ropivacaine on myocardial ventricular conduction contractility. Methods studied pharmacokinetics (outflow concentration) pharmacodynamics (QRS widening) three drugs infused in isolated rabbit heart preparation. All data were fitted simultaneously with use...

Postoperative pain after laparoscopic surgery is less than laparotomy, and patients may benefit from an intraperitoneal injection of local anesthetic. Thirty-seven ASA physical status I or II received in double-blinded fashion 20 mL 0.9% saline solution (placebo), ropivacaine 0.25% (Rop 0.25%), 0.75% 0.75%) immediately trocar placement at the end surgery. We measured morphine consumption until h Plasma concentrations were measured. The three groups comparable for shoulder pain, parietal...

Received from the Anesthesia Intensive Care Department, COCHIN Universitary Hospital, Paris, France.LUMBAR plexus blockade is used for intraoperative and postoperative analgesia. Its performance sometimes difficult, procedure carries risk of vascular, dural, or epidural puncture. 1,2These concerns, particularly intravascular injection, has recently led many to use ropivacaine. This choice based both on its long duration action because it believed be less cardiotoxic than bupivacaine. 3To...

Background Continuous epidural infusion of bupivacaine is widely practiced for postoperative pain relief in pediatric patients. However, may induce adverse effects infants (convulsions or cardiac arrhythmias), likely because decreased hepatic clearance and serum protein binding capacity. The authors wanted to examine the complex relations between age, alpha-1 acid glycoprotein (AAG) concentration, unbound total concentrations receiving epidurally 2 days. Methods Twenty-two aged 1-7 months...

The pharmacokinetics of morphine was studied in six patients whom a radiologic localization an insulinoma to be performed under general anesthesia. Sampling done the peripheral artery, mesenteric vein five patients, hepatic vein, and as well urine. Hepatic blood flow estimated by indocyanine green infusion technique at end procedure. Morphine terminal half-life 92 ± 9 minutes, total body clearance 1260 ml · min−1, extraction ratio 0.65 0.11. No concentration gradient observed between artery...

Abstract This article presents the results of a survey three major multidisciplinary journals (Nature, Proceedings National Academy Science, Science). Fifty articles involving experiments necessitating agreement an ethics committee were searched in each to June 30th 2023. Because PNAs announced that Statistical Review Committee was created and working since September 2023, further set 50 retrieved analyzed from 2024 January 1st. The following items checked articles: explicit statement...

Neurogenic inflammation may participate in postoperative inflammatory pain. We evaluated, the rat, influence of a short and prolonged sciatic nerve block on carrageenan-induced inflammation, time course which be compared to inflammation. A catheter was placed right injected with 0.5% bupivacaine epinephrine (0.2 mL): one injection Short Block Group, four injections performed at 90-min intervals Prolonged Group. In all groups, two hind paws were then carrageenan. The development evaluated...

The study was designed to compare the effects of equimolar concentrations racemic bupivacaine, levobupivacaine, and ropivacaine on ventricular conduction, anisotropy, duration homogeneity refractoriness, wavelengths, provide a potency ratio for conduction velocity.Isolated frozen rabbit hearts (which leave thin layer surviving epicardial muscle) were treated with 0.1, 1, 10 mum or ropivacaine. Left longitudinal transverse velocities, anisotropic ratio, minimum pacing cycle length, use...

Background: Common practice in intubation without muscle relaxant is to inject the opioid drug prior hypnotic drug. Because remifentanil reaches adequate cerebral concentration more rapidly than does propofol, we tested hypothesis that injection of after propofol might lead better intubating conditions. Methods: Thirty ASA I–II patients scheduled for elective surgery and with no anticipated difficult were enrolled study. Five minutes midazolam 30 µg kg −1 , randomized into two groups: group...

Binding parameters of R(+)- and S(-)-bupivacaine were determined for human serum proteins, alpha-1-acid glycoprotein (AAG) albumin (HSA), using ultrafiltration. estimated according to the Scatchard model law mass action nonlinear regression. A sigmoid (cooperativity) term was added when needed. Both enantiomers exhibited a two site binding profile solution containing AAG HSA at physiological concentrations. At concentrations lower than 40 microM (concentrations encountered in clinical...