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Stomatologiia (Mosk) 2020 ;99(2):11-16

First Moscow State Medical University named after I.M. Sechenov (Sechenov University), Moscow, Russia.

Novel anaesthetic formulation LHT-15-32 was studied. The experimental study involved 66 white mice, 15 Rana radibunda frogs and 50 male Sprague Dawley rats. Its acute intravenous and subcutaneous toxicity was determined in mice. Read More

Biochim Biophys Acta Biomembr 2020 May 13;1862(9):183351. Epub 2020 May 13.

College of Chemistry and Chemical Engineering, Shanghai University of Engineering Science, Shanghai 201620, China.

To understand the intrinsic influence of a drug on lipid membranes is of critical importance in pharmacological science. Herein, we report fluorescence microscopy analysis of the interaction between the local anesthetic tetracaine (TTC) and planar supported lipid bilayers (SLBs), as model membranes. Our results show that TTC increases lipid chain mobility, destabilizes the SLBs and remarkably induces membrane disruption and solubilization. Read More

J Pharm Biomed Anal 2020 Apr 29;187:113335. Epub 2020 Apr 29.

U.R.I.To.N - Unit of Research of University of Florence, Florence, Italy; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy. Electronic address:

Local anaesthetics (LAs) are commonly used in surgery, especially in dentistry. They cause a transitory inhibition of nerve signal due to the blockade of the voltage-gated sodium channels. LAs are administrated alone or with vasoconstriction agents, such as adrenaline. Read More

J Clin Orthop Trauma 2020 May-Jun;11(3):417-421. Epub 2020 Feb 26.

Academic Team of Musculoskeletal Surgery, Leicester General Hospital, Leicester, Leicestershire, UK.

The use of regional anaesthesia in foot and ankle surgery is becoming well recognised, particularly in patients who prefer to stay awake during the procedure and for better post-operative analgesia. Its use is ideal for patients with multiple co-morbidities, in whom general anaesthesia (GA) otherwise would could be challenging. The procedures performed with landmark/anatomical guidance alone carry a relatively higher risk of complications, risk of inadvertant injection into the intarvascualr space leadinf to local anaesthetic toxicity, the majority of which complications are caused by incorrect placement of the needle. Read More

Adv Pharmacol Pharm Sci 2020 4;2020:5794187. Epub 2020 Jan 4.

Department of Orthopaedic Surgery, Loma Linda University, 11406 Loma Linda Drive, Suite 218, Loma Linda, CA 92354, USA.

Objective: The purpose of this study is to determine whether (1) liposomal bupivacaine is chondrotoxic; (2) the chondrotoxicity of liposomal bupivacaine differs from standard bupivacaine; and (3) chondrotoxic effects are time dependent.

Materials And Methods: We obtained 72 10 mm articular cartilage plugs from 12 fresh bovine distal femoral knee joints and exposed them to either saline, 0.5% bupivacaine, or liposomal bupivacaine for either 30 or 90 minutes. Read More

Naunyn Schmiedebergs Arch Pharmacol 2020 May 5. Epub 2020 May 5.

Department of Physiological Sciences, Piracicaba Dental School, University of Campinas - UNICAMP, Avenida Limeira, 901, Piracicaba, SP, 13414-903, Brazil.

Articaine (ATC) is one of the most widely used local anesthetics in dentistry. Despite its safety, local toxicity has been reported. This study aimed to develop an ATC-2- hydroxypropyl-β-cyclodextrin inclusion complex (ATC HPβCD) and to assess its toxicity in vitro. Read More

J Perianesth Nurs 2020 Apr 22. Epub 2020 Apr 22.

Institute of Learning, Leadership and Development (iLEAD), Christiana Care Health System, Newark, DE.

Purpose: Local anesthetics are used for procedures in various settings. Although complications related to local anesthetic use is rare, adverse events do occur. A significant knowledge deficit was identified regarding local anesthetic systemic toxicity (LAST) signs, symptoms, and treatment. Read More

Restor Neurol Neurosci 2020 ;38(2):173-183

Research Service, Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, IL, USA.

Background: Local anesthetic toxicity has been well-documented to cause neuronal injury, death, and dysfunction, particularly in a susceptible nerve.

Objective: To determine whether select local anesthetics affect neuron survival and/or functional recovery of an injured nerve.

Methods: This report describes 6 separate experiments that test immediate or delayed application of local anesthetics in 3 nerve injury models. Read More

Reg Anesth Pain Med 2020 05 1;45(5):394. Epub 2020 Mar 1.

Anaesthesia, James Cook University Hospital, Middlesbrough, UK

Anaesthesist 2020 May;69(5):301-313

Klinik für Anästhesie und Intensivtherapie, Philipps Universität Marburg, Marburg, Deutschland.

For decades local anesthetics have proven to be safe and effective drugs in the clinical practice, crucially promoting the enormous achievements in regional anesthesia. Meanwhile, it is a well-known fact that local anesthetics are much more than just "simple" sodium channel blockers. They also interact with numerous other ion channels and subcellular structures, enhancing nerve blockade and resulting in systemic "alternative" effects, which can sometimes even be clinically used. Read More

Biomed Res Int 2020 31;2020:1283214. Epub 2020 Jan 31.

Department of Radiology, Zhuhai Hospital Affiliated with Jinan University, Zhuhai 519000, Guangdong Province, China.

Bupivacaine, a common local anesthetic, causes serious nerve injury, especially in diabetic patients, as high glucose has been reported to enhance bupivacaine-induced neurotoxicity. However, the key regulator for synergism remains unknown. To our surprise, the expression of repair protein Ku70 is suppressed, while the high-glucose environment induces DNA oxidative damage in neurons. Read More

Int J Obstet Anesth 2020 May 23;42:109-111. Epub 2019 Dec 23.

Division of Obstetric, Gynecologic, and Fetal Anesthesia, Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins Hospital, Baltimore, USA. Electronic address:

A 32-year-old G2P1 woman presented for induction of labor at term. Her past medical history included polysubstance use disorder and methadone maintenance, scant prenatal care, morbid obesity, and intimate partner violence. Her induction was progressing smoothly until the acute onset of altered mental status near to the time of delivery, several minutes after a clinician-administered epidural local anesthetic bolus for significant pain. Read More

Int Braz J Urol 2020 Mar-Apr;46(2):302-305

Department of Urology, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon.

An Bras Dermatol 2020 Jan - Feb;95(1):82-90. Epub 2019 Dec 18.

Dermatology Service, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.

Local anesthetics are essential medications for the conduction of dermatological procedures. They stop the depolarization of nerve fibers and are divided into two main categories, the amide and ester types. Systemic toxicity with reflex on the central nervous and cardiovascular systems is their most feared adverse reactions, and the anaphylactic reaction is the most concerning one. Read More

Am J Emerg Med 2020 Jan 8. Epub 2020 Jan 8.

Division of Medical Toxicology, Department of Emergency Medicine, University of Pittsburgh School of Medicine, USA; Pittsburgh Poison Center, Pittsburgh, PA, USA.

Background: Local anesthetic systemic toxicity characteristically occurs after inadvertent intravascular injection of local anesthetics; however, it is unclear if similar symptoms arise after intrathecal adminstration. Intrathecal use of local anesthetics for chronic pain is increasing and carries a potential risk of toxicity. Experience with the presenting symptoms and appropriate treatment for intrathecal local anesthetic toxicity is limited. Read More

Open Med (Wars) 2019 17;14:953-958. Epub 2019 Dec 17.

Clinic of Rheumatology, Orthopaedic Traumatology and Reconstructive Surgery, Faculty of Medicine, Vilnius University, Siltnamiu 29, Vilnius, LT-04130, Vilnius, Lithuania.

Background: Cardiac arrest related to nerve blockade using a local anaesthetic is a rare event. We report a case of bupivacaine severe cardiovascular toxicity following cervical paravertebral nerve block.

Case Presentation: A 44-year-old female was admitted to Republican Vilnius University Hospital, with symptoms of sustained severe pain in her neck that radiated to both arms. Read More

Postgrad Med 2020 Jan 3;132(1):28-36. Epub 2020 Jan 3.

Mid America PolyClinic, Overland Park, KS, USA.

Interest in and use of topical analgesics has been increasing, presumably due to their potential utility for relief of acute and chronic pain. Topically applied agents with analgesic properties can target peripheral nociceptive pathways while minimizing absorption into the plasma that leads to potential systemic adverse effects.Clinical trials have found 5% lidocaine patches to be effective and well tolerated for the treatment of post-herpetic neuralgia (PHN) with a minimal risk of toxicity or drug-drug interactions. Read More

Chemosphere 2020 May 23;246:125703. Epub 2019 Dec 23.

Shanghai Key Lab for Urban Ecological Processes and Eco-Restoration, Tiantong National Field Observation Station for Forest Ecosystem, School of Ecological and Environmental Sciences, East China Normal University, Shanghai, 200241, China; Institute of Eco-Chongming (IEC), No.20 Cuiniao Road, ChenJiazhen, Shanghai, 202162, China. Electronic address:

Coking wastewater is highly toxic and refractory industrial wastewater, and is thus extremely challenging to treat. Currently, most treatment technologies focus on degrading carbonaceous pollutants, while insufficient attention is placed on ammonium nitrogen (NH-N), the most important nitrogenous contaminant in coking wastewater and with a high biological toxicity. In the current study, we developed an integrated electrochemical system comprising two three-dimensional electrochemical reactors (3DERs), two three-dimensional biofilm electrode reactors (3DBERs) and one three-dimensional biofilm electrode reactor for denitrification (3DBER-De) to treat coking wastewater rich in NH-N. Read More

Acta Med Okayama 2019 Dec;73(6):543-546

Department of Anesthesiology and Resuscitology, Okayama University Hospital, Okayama 700-8558, Japan.

We here report that a 71-year-old Japanese woman with a history of anaphylaxis induced by muscle relaxants had local anesthetic systemic toxicity (LAST) following an abdominal surgery under general anesthesia with combined spinal-epidural anesthesia without muscle relaxants. The total dosages of local anesthetics reached 0.67 mg/kg of ropivacaine and 11. Read More

J Photochem Photobiol B 2020 Jan 18;202:111716. Epub 2019 Nov 18.

Department of Anesthesiology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, Xinjiang, China. Electronic address:

Though anesthetic drug delivery system and drug vehicles is generally applied for pain relief, there are have many difficulties and issues due to its short duration carrier and low biocompatibility, effectiveness at the conditions of inflammation at acidic pH. To resolve this issue, we have designed and developed the dual (pH and temperature) responsive bio-nanomaterial to improve the efficiency anesthetic drug delivery system. Chitosan is a unique class of biomaterials that is widely used in medical devices. Read More

Toxicon 2020 Jan 25;173:57-61. Epub 2019 Nov 25.

Department of Marine Science and Resources, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan.

Planocerid flatworms and the related species (Platyhelminthes: polycladida) are known as tetrodotoxin (TTX)-bearing organisms, and they contribute to toxification of marine organisms at higher trophic levels, such as pufferfish and sea slugs. However, little is known of their biology or ecology. In this study, we therefore investigated the occurrence and toxicity of two sympatric planocerids, Planocera multitentaculata and Planocera reticulata, in intertidal zones of the central region of mainland Honshu, Japanese Islands. Read More

Mar Drugs 2019 Nov 21;17(12). Epub 2019 Nov 21.

Graduate School of Agricultural Science, Tohoku University, 468-1 Aramaki-Aza-Aoba, Aoba-ku, Sendai 980-8572, Japan.

Paralytic shellfish toxins (PSTs) are the major neurotoxic contaminants of edible bivalves in Japan. Tetrodotoxin (TTX) was recently detected in bivalve shellfish around the world, drawing widespread attention. In Japan, high levels of TTX were reported in the digestive gland of the scallop, , in 1993; however, no new data have emerged since then. Read More

J Neurochem 2019 Nov 23:e14924. Epub 2019 Nov 23.

Department of Anesthesiology, General Hospital of Ning Xia Medical University, Yin Chuan, China.

Local anesthetics can cause severe toxicity when absorbed systemically. Rapid intravenous administration of lipid emulsion (LE) is the standard of care for severe local anesthetic systemic toxicity which can cause cardiovascular and central nervous system (CNS) injury. The biological mechanism by which LE alleviates CNS toxicity remains unknown and understudied. Read More

BMC Pharmacol Toxicol 2019 11 21;20(1):70. Epub 2019 Nov 21.

Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, Shangcai village, Nanbaixiang town, Ouhai District, Wenzhou City, 325000, Zhejiang Province, China.

Background: Dexmedetomidine was proved to mitigate bupivacaine-induced cardiotoxicity but mechanism of this ability is still unclear. This study was designed to investigate the direct effects of dexmedetomidine on cardiotoxicity induced by bupivacaine on Langendorff rat heart preparation and the role of alpha 2 adrenoceptors in this process was explored.

Methods: Hearts of rat were isolated, mounted on a Langendorff system. Read More

Acta Clin Croat 2019 Jun;58(Suppl 1):53-61

1Department of Anesthesiology, Resustitation, Intensive Medicine and Pain Management, Faculty of Medicine, "Josip JurajStrossmayer" University, Osijek, Croatia; 2Department of Health Studies, University of Zadar, Zadar, Croatia; 3Department of Anesthesiology, Reanimatology and Intensive Care Medicine, Zadar General Hospital, Zadar, Croatia; 4Department of Anesthesiology and Perioperative Medicine, School of Medicine, University of Missouri, Columbia, USA; 5School of Medicine, University of Rijeka, Rijeka, Croatia; 6Clinic of Anesthesiology and Intensive Care Medicine, Clinical Hospital Centre Rijeka, Rijeka, Croatia; 7Clinic of Neurology, Clinical Hospital Centre Rijeka, Rijeka, Croatia.

The objective of this clinical update, based on recently published literature, was to discuss incidence and characteristics of the most relevant clinical adverse effects associated with local anesthetic and steroid use in regional anesthesia and treatment of acute or chronic pain. A comprehensive review of the English-language medical literature search utilizing PubMed, Ovid Medline® and Google Scholar from 2015 to 2018 was performed. This narrative review provides anesthesia practitioners with updated evidences on complications and contraindications of local anesthetic and steroid use with emphasis on current points of view regarding prevention, early diagnosis and treatment of adverse events. Read More

Curr Pain Headache Rep 2019 Nov 14;23(12):89. Epub 2019 Nov 14.

Department of Anesthesiology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, 19107, USA.

Purpose Of Review: The purpose of this review is to provide a summary of the perioperative studies that have examined transdermal lidocaine (lidocaine patch) as an analgesic and put the evidence in context of the likely overall benefit of transdermal lidocaine in the perioperative period.

Recent Findings: Several randomized controlled trials have been published in the past 4 years that concluded transdermal lidocaine can reduce acute pain associated with laparoscopic trocar or cannula insertion. Transdermal lidocaine may reduce short-term pain after surgery in selected surgery types and has a low risk of toxicity but its overall clinical utility in the perioperative setting is questionable. Read More

Pharm Res 2019 Nov 8;36(12):179. Epub 2019 Nov 8.

Laboratory for Biomaterials and Drug Delivery, Boston Children's Hospital, Harvard Medical School, 300 Longwood Ave, Enders Building, Room 361, Boston, Massachusetts, 02115, USA.

Purpose: It is unknown whether there are sex differences in response to free or encapsulated local anesthetics.

Methods: We examined nerve block duration and toxicity following peripheral nerve blockade in male and female rats. We studied the local anesthetic bupivacaine (free or encapsulated) as well as tetrodotoxin, which acts on a different site of the same voltage-gated channel. Read More

J Surg Res 2020 Mar 1;247:406-412. Epub 2019 Nov 1.

Department of Surgery, South Auckland Clinical Campus, The University of Auckland, Auckland, New Zealand; Department of Surgery, Middlemore Hospital, Counties Manukau District Health Board, Auckland, New Zealand.

Background: Multimodal analgesic regimes are required to treat pain. Intraperitoneal (IP) agents, such as local anesthetics (LAs), have been shown to reduce pain after abdominal surgery. Other IP analgesics have been tested in several randomized control trials (RCTs), but no reviews or guidelines have evaluated their use. Read More

Cochrane Database Syst Rev 2019 10 7;2019(10). Epub 2019 Oct 7.

Tufts University School of Medicine, Pain Research, Education and Policy (PREP) Program, Department of Public Health and Community Medicine, Boston, Massachusetts, USA.

Background: Lidocaine, mexiletine, tocainide, and flecainide are local anesthetics which give an analgesic effect when administered orally or parenterally. Early reports described the use of intravenous lidocaine or procaine to relieve cancer and postoperative pain. Interest reappeared decades later when patient series and clinical trials reported that parenteral lidocaine and its oral analogs tocainide, mexiletine, and flecainide relieved neuropathic pain in some patients. Read More

Pediatr Clin North Am 2019 12;66(6):1135-1147

Division of Adolescent Medicine, Department of Pediatrics, Milton S. Hershey Medical Center, Penn State Hershey Children's Hospital, Hershey, PA 17033, USA. Electronic address:

Cocaine use by adolescents and young adults continues to be a significant public health issue and the cause of medical and psychological morbidity and mortality. Although use rates are lower than those seen with alcohol, tobacco, and other illicit substances such as marijuana, cocaine is highly addictive and presents significant acute and long-term medical and psychological effects. This article reviews the epidemiology of cocaine use among adolescents and young adults, discusses the pharmacology and neurobiology of cocaine use and dependence, provides information regarding acute intoxication and systemic effects seen with more chronic use, and describes current assessment and treatment approaches. Read More

Toxicol Lett 2020 Jan 28;318:104-113. Epub 2019 Oct 28.

Department of Anesthesiology, Zhujiang Hospital, Southern Medical University, No. 253 Middle Gongye Street, Guangzhou, Guangdong Province, 510282, China. Electronic address:

Background: Bupivacaine (BP) is commonly used as a local anaesthetic(LA) in the clinic, but it can also cause neurotoxicity, especially in patients with diabetes. Previous studies have found that high-glucose environments can aggravate BP-induced DNA damage in nerve cells. Ku70 is subunit of the DNA damage repair enzyme DNA-PK. Read More

Reg Anesth Pain Med 2019 Oct 25. Epub 2019 Oct 25.

Anesthesiology & Perioperative Medicine, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

Peripheral nerve blocks have a unique role in postcesarean delivery multimodal analgesia regimens. In this review article, options for peripheral nerve blocks for cesarean delivery analgesia will be reviewed, specifically paravertebral, transversus abdominis plane, quadratus lumborum, iliohypogastric and ilioinguinal, erector spinae, and continuous wound infiltration blocks. Anatomy, existing literature evidence, and specific areas in need of future research will be assessed. Read More

Zhong Nan Da Xue Xue Bao Yi Xue Ban 2019 Sep;44(9):985-989

Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha 410008, China.

Objective: To investigate the effect of SB203580, a p38MAPK specific inhibitor, on ropivacaine-induced cytotoxicity in PC12 cells.
 Methods: PC12 cells were divided into three groups: the normal group (Group N), cells were cultured for 48 h; the ropivacaine group (Group R), cells were cultured with 15 mmol/L ropivacaine hydrochloride for 48 h; the ropivacaine+SB203580 group (Group R+S), cells were cultured with 15 mmol/L ropivacaine hydrochloride plus 10 μmol/L SB203580 for 48 h. The cell survival rates were detected by MTT assay. Read More

Transl Vis Sci Technol 2019 Sep 17;8(5):28. Epub 2019 Oct 17.

Kohane Lab for Biomaterials and Drug Delivery, Department of Anesthesia, Perioperative and Pain Medicine, Division of Critical Care, Boston Children's Hospital, Boston, MA, USA.

Purpose: Topical corneal local anesthetics are short acting and may impair corneal healing. In this study we compared corneal anesthesia and toxicity of topically applied -ethyl lidocaine (QX-314) versus the conventional local anesthetic, proparacaine (PPC).

Methods: Various concentrations of QX-314 and 15 mM (0. Read More

Paediatr Drugs 2019 Dec;21(6):439-449

Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.

Regional anesthesia provides effective anesthesia and pain relief in infants with age-specific data attesting to safety and efficacy. Regional anesthesia decreases exposure to opioids and general anesthetic agents and associated adverse drug effects, suppresses the stress response, and provides better hemodynamic stability compared to general anesthesia. Regional anesthesia can prevent long-term behavioral responses to pain. Read More

Toxicol In Vitro 2020 Apr 15;64:104634. Epub 2019 Oct 15.

Division of Pharmacology and Toxicology, College of Pharmacy, The University of Texas, Austin, TX 78712, United States of America. Electronic address:

In vivo and in vitro animal models are used to investigate the toxicological modes of action of a substance as surrogates for humans since it is not ethical to conduct certain experiments in humans. The toxic actions of many compounds are manifested in specific organs, known as target organs of toxicity. Thus, in vitro systems that use cells derived from that target organ are best used to understand toxicological mechanisms. Read More

Ecotoxicol Environ Saf 2019 Dec 12;186:109772. Epub 2019 Oct 12.

Department of Dermatology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China; Key Laboratory of Dermatology, Ministry of Education, Hefei, Anhui, China. Electronic address:

Trichloroethylene (TCE) is a common organic solvent which can cause TCE hypersensitivity syndrome (THS) in exposure workers. THS is an adverse skin disorder with severe inflammatory kidney damage. Complement C3a receptor (C3aR) acts as a specific receptor for the key complement cleavage product C3a and involves multiple inflammatory responses, but the role of C3aR in TCE induced kidney inflammatory injury remains unknown. Read More

Drugs Aging 2020 01;37(1):1-9

Department of Anesthesiology, University of Illinois Hospital, 1740 W. Taylor St, Suite 3200W, Chicago, IL, 606012, USA.

This article provides a concise overview of local anesthetic systemic toxicity, its history, mechanisms, risk factors, prevention, clinical presentation, and treatment, with a special emphasis on issues specific to the geriatric population. The authors used MEDLINE, Scopus, and Google Scholar to search for original research articles (human and animal studies), registries data, case reports, review articles, and pertinent online publications using the combinations of the following search terms: local anesthetics, local anesthetic systemic toxicity, intralipid, lipid emulsion, Exparel, ultrasound-guidance, regional anesthesia, lidocaine, bupivacaine, ropivacaine, cocaine, procaine, tetracaine, levobupivacaine, liposomal bupivacaine, lignocaine. Local anesthetic systemic toxicity continues to occur despite the use of putatively less cardiotoxic formulations of local anesthetics and more common use of ultrasound guidance. Read More

Local Reg Anesth 2019 27;12:99-102. Epub 2019 Sep 27.

Department of Anesthesiology, New York Presbytarian Brooklyn Methodist Hospital, New York, NY, USA.

We report a case of a 41-year-old male with anticipated difficult airway undergoing a repair of a bilateral radial fracture under bilateral sequential brachial plexus block. Anesthesiologists are reluctant to perform bilateral blocks because of the fear of complications like diaphragmatic paralysis, local anesthetic (LA) toxicity, and pneumothorax. We advise that with the correct application of LA pharmacokinetics, careful patient selection and usage of ultrasound, bilateral blocks can be done safely. Read More

Exp Ther Med 2019 Oct 1;18(4):2648-2652. Epub 2019 Aug 1.

Department of Anesthesiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310006, P.R. China.

Local anesthetic of ropivacaine was demonstrated to reduce the postoperative pain in elderly patients. This study investigated the pharmacokinetics of ropivacaine at different concentrations in elderly patients subjected to fascia iliaca compartment block. Forty patients with femoral neck fracture at American Society of Anesthesiologists (ASA) I-II status, undergoing fascia iliaca compartment block (FICB) were randomized to two groups receiving 0. Read More

Drug Des Devel Ther 2019 18;13:3307-3319. Epub 2019 Sep 18.

Department of Anesthesiology, Jinan Central Hospital Affiliated to Shandong University, Ji'nan, Shandong Province 250013, People's Republic of China.

Purpose: Hyaluronic acid-poly(ethylene glycol)-distearoyl phosphoethanolamine (HA-PEG-DSPE) modified and tocopheryl polyethylene glycol 1000 succinate (TPGS) contained nanostructured lipid carriers (NLCs) were prepared loading ropivacaine and dexmedetomidine to improve the topical anesthetic analgesic anesthesia efficiency.

Methods: NLCs were prepared by the solvent diffusion method. The average particle size, zeta potential, release behavior, and cytotoxicity of the NLCs were tested. Read More

Toxicon 2019 Dec 21;170:77-84. Epub 2019 Sep 21.

Utah State University, Uintah Basin, Vernal, UT, USA. Electronic address:

The natural history and pharmacology of tetrodotoxin (TTX) has long intrigued biologists. This toxin has a remarkable distribution that spans two domains of life (Bacteria and Eukarya). Within Eukaryotes, TTX has only been identified in animals but is known to be present in over five-dozen species of phylogenetically distant Metazoans. Read More

Can J Surg 2019 10;62(5):356-357

From the Department of Cardiac Surgery, Montreal Heart Institute and Université de Montréal, Montreal, Que. (Carrier); and the Department of Medicine, Montreal Heart Institute and Université de Montréal, Montreal, Que. (Giraldeau, Parent, Ducharme).

Summary: Cardiac toxicity from recreational drug use remains difficult to establish. We report the cases of 3 young patients who were hospitalized for cardiogenic shock. All were bridged to transplantation with implantation of a left ventricular assist device (LVAD). Read More

Reg Anesth Pain Med 2019 Sep 6. Epub 2019 Sep 6.

Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.

Background: Variation in clinical practice is often considered unwarranted when it does not reflect patient preference or evidence-based medicine. Complications from regional anesthesia such as nerve injury and systemic toxicity are dose dependent. It is currently unclear if there is significant variation with the dosing of local anesthetics (LA) in the context of the modern practice of peripheral regional anesthesia. Read More

Neurotoxicology 2019 12 5;75:70-77. Epub 2019 Sep 5.

Department of Forensic Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.

Chronic abuse of psychoactive drugs including cocaine causes addiction, dependence, and brain disorders through the alteration of neuronal plasticity. Mitochondrial fission and fusion, collectively called as mitochondrial dynamics, participates in not only the maintenance of neuronal homeostasis but also reorganization of neuronal circuits. The purpose of this study is to examine effects of direct and repeated exposure of cocaine on mitochondrial dynamics in neuronal cells in vitro. Read More

Am J Emerg Med 2019 11 24;37(11):2119.e1-2119.e2. Epub 2019 Aug 24.

Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, NY, USA.

This is the case of a 23-year-old female with a past medical history of ADHD and Depression who was evaluated in the emergency department for perioral cyanosis and hypoxia after application of the eutectic mixture of lidocaine and prilocaine (EMLA) local anesthetic prior to a laser-assisted hair removal procedure. This report illustrates a case of methemoglobinemia which is a rare but significant complication of topical anesthetic use. Read More

Int J Environ Res Public Health 2019 08 28;16(17). Epub 2019 Aug 28.

Water Conservancy Project & Civil Engineering College, Tibet Agriculture & Animal Husbandry University, Linzhi 860000, China.

The ecotoxicity of psychiatric pharmaceuticals to aquatic organisms is being increasingly recognized. However, current ecological studies focus on the effects of individual psychiatric pharmaceuticals, with little attention being given to their combined effects. In this study, the interactive effects of two psychiatric pharmaceuticals, sertraline (SER) and diphenhydramine (DPH), on bioconcentration and biochemical and behavioral responses were investigated in crucian carp () after seven days of exposure. Read More

AORN J 2019 09;110(3):263-272

Advances in anesthesia techniques and guidance imaging have made regional anesthetics effective both for pain management and as a primary anesthesia modality for patients undergoing operative and other invasive procedures. Patients can receive regional anesthesia in most areas of the body, including the upper and lower extremities and torso. It is critical that perioperative nurses are familiar with regional anesthetic options and understand them well enough to support their patients in the preoperative, intraoperative, and postoperative phases of surgical care. Read More

Plast Reconstr Surg 2019 09;144(3):783-795

Chicago, Ill.; Boston, Mass.; Seattle, Wash.; and Melbourne, Victoria, Australia From the Department of Anesthesiology, University of Illinois College of Medicine; Research and Development Service, Jesse Brown Veterans Affairs Medical Center; the Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital; the Virginia Mason Medical Center; the University of Washington; the Department of Anaesthesia and Acute Pain Medicine, St. Vincent's Hospital Melbourne; and the Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne.

Background: The objective of this narrative review of local anesthetic systemic toxicity is to provide an update on its prevention, diagnosis, and management.

Methods: The authors used a MEDLINE search of human studies, animal studies, and case reports and summarize findings following the American Society of Regional Anesthesia and Pain Medicine practice advisories on local anesthetic systemic toxicity.

Results: Between March of 2014 and November of 2016, there were 47 cases of systemic toxicity described. Read More

Hernia 2019 12 19;23(6):1071-1080. Epub 2019 Aug 19.

Lotus Clinical Research, LLC, Pasadena, CA, USA.

Purpose: Currently available local anesthetics have not demonstrated sufficient analgesia beyond 12-24 h postoperatively. The purpose of the study was to assess the safety and efficacy of HTX-011 (bupivacaine and meloxicam in Biochronomer polymer technology), a long-acting investigational anesthetic, in reducing both postoperative pain over 72 h and postoperative opioid use compared to bupivacaine hydrochloride (HCl).

Methods: A phase 3, randomized, double-blind, active-controlled multi-center study (EPOCH 2; NCT03237481) in subjects undergoing unilateral open inguinal herniorrhaphy with mesh placement was performed. Read More