7,326 results match your criteria Toxicity Local Anesthetics

Sudden quadriparesis after non-overdose local anesthesia.

Int J Emerg Med 2022 May 17;15(1):19. Epub 2022 May 17.

Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.

Background: A well-known anesthetic, lidocaine is the most widely used local anesthetic. Local anesthetic systemic toxicity (LAST) is a life-threatening event with common and prominent presentations of central nervous system (CNS) toxicity and cardiovascular toxicity. The most frequent and prominent early warning signs and symptoms of LAST are central nervous system symptoms. Read More

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[Prevention of adverse events following the use of local anesthetics in traumatology and orthopedics].

Khirurgiia (Mosk) 2022 (4):75-79

Pirogov Russian National Research Medical University, Moscow, Russia.

The article analyzes the frequency of development of adverse toxic reactions when using local anesthetics in the practice of an orthopedic traumatologist; based on the conclusions of commission forensic medical examinations conducted in the framework of criminal proceedings on the death of patients, the features of the onset of LAST syndrome are studied, which significantly increases the medical risk for the patient and the legal risk for the doctor. An analytical study of scientific publications on the possibilities of using the local anesthetic Articaine-Binergia 20 mg/ml in the daily work of both polyclinic and inpatient doctors to ensure the safety of medical activities was conducted. Read More

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Ultrasound-guided pediatric nerve blocks in the emergency department: an evidence-based update.

Pediatr Emerg Med Pract 2022 May 2;19(5):1-32. Epub 2022 May 2.

Associate Professor of Emergency Medicine, David Geffen School of Medicine at UCLA; Harbor-UCLA Medical Center, Torrance, CA.

Analgesia in pediatric patients is critical for minimizing discomfort and maximizing satisfaction for both the patients and their caregivers. In the last decade, ultrasound has been shown to be effective in improving the safety and efficacy of regional anesthesia. This issue discusses materials, methods, and monitoring for pediatric patients undergoing nerve blocks in the emergency department, including both ultrasound-guided and landmark approaches. Read More

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Local Anesthetic Plasma Concentrations as a Valuable Tool to Confirm the Diagnosis of Local Anesthetic Systemic Toxicity? A Report of 10 Years of Experience.

Pharmaceutics 2022 Mar 26;14(4). Epub 2022 Mar 26.

Laboratoire de Pharmacologie Clinique, Service de Pharmacologie Clinique, APHM, INSERM, Institut Neurosciences Système, UMR 1106, Aix Marseille Université, 13005 Marseille, France.

Background: Local anesthetic systemic toxicity (LAST) has been reported as a serious complication of local anesthetic (LA) peripheral injection. The signs and symptoms of LAST are highly variable, and the challenge remains to confirm its diagnosis. In this context, the determination of LA plasma concentration appears as a valuable tool to confirm LAST diagnosis. Read More

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Pediatric lower limb peripheral nerve blocks: Indications, effectiveness, and the incidence of adverse events.

Paediatr Anaesth 2022 Apr 22. Epub 2022 Apr 22.

Department of Paediatric Anaesthesia and Pain Management, Royal Children's Hospital, Melbourne, Victoria, Australia.

Aim: While the proportion of pediatric anesthetics with regional anesthesia in pediatric patients has steadily increased, there are only a few series that describe the use of lower limb peripheral nerve blocks in children. Our aim was to describe the indications, anesthetic approach, and complications associated with lower limb blocks in children undergoing orthopedic surgery in a center with a large caseload of complex patients.

Methods: In a retrospective analysis of prospectively collected data, we reviewed children who had a peripheral nerve block for orthopedic surgery placed between January 2016 and January 2021 at the Royal Children's Hospital Melbourne. Read More

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Pharmacodynamics, toxicology and toxicokinetics of ropivacaine oil delivery depot.

BMC Anesthesiol 2022 04 21;22(1):113. Epub 2022 Apr 21.

Department of Pharmacology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, 76 Yanta West Road, Xi`an, 710061, Shaanxi, China.

Background: Ropivacaine oil delivery depot (RODD) can be used to treat postoperative incision pain. The aim was to study pharmacodynamics, toxicity and toxicokinetics of RODD.

Methods: The base research of RODD were conducted. Read More

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Cocaine: An Updated Overview on Chemistry, Detection, Biokinetics, and Pharmacotoxicological Aspects including Abuse Pattern.

Toxins (Basel) 2022 Apr 13;14(4). Epub 2022 Apr 13.

UCIBIO-Applied Molecular Biosciences Unit, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal.

Cocaine is one of the most consumed stimulants throughout the world, as official sources report. It is a naturally occurring sympathomimetic tropane alkaloid derived from the leaves of , which has been used by South American locals for millennia. Cocaine can usually be found in two forms, cocaine hydrochloride, a white powder, or 'crack' cocaine, the free base. Read More

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Tetrodotoxin levels in lab-reared Rough-Skinned Newts (Taricha granulosa) after 3 years and comparison to wild-caught juveniles.

Toxicon 2022 Jul 11;213:7-12. Epub 2022 Apr 11.

Department of Biology, Utah State University, 5305 Old Main Hill, Logan UT 84322, USA.

The origin and biogenesis of tetrodotoxin (TTX) is one of the most interesting and perplexing questions remaining for TTX researchers. Newts can possess extreme quantities of TTX and are one of the most well-studied of all TTX-bearing organisms, yet seemingly conflicting results between studies on closely related species continues to generate debate. In this study, eggs from 12 female newts (Taricha granulosa) were reared in captivity and the metamorphosed juveniles were fed a TTX-free diet for 3 years. Read More

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Chemical Ecology of the North American Newt Genera Taricha and Notophthalmus.

Prog Chem Org Nat Prod 2022 ;118:101-130

Graduate School of Agricultural Science & Frontier Research Institute for Interdisciplinary Sciences, Tohoku University, 468-1 Aramaki-Aza-Aoba, Aoba-ku, Sendai, Miyagi, 980-8572, Japan.

The North American newt genera Taricha and Notophthalmus (order Caudata) are well known for the combination of potent toxicity, aposematic coloration, and striking defense postures that protects these animals from predation. This suite of traits is centered around the neurotoxin tetrodotoxin, which causes paralysis and death in metazoans by disrupting the initiation and propagation of electrical signals in the nerves and muscles. Tetrodotoxin defends newts from predation across multiple life history stages and its role in generating arms-race coevolution between Taricha newts and garter snake (genus Thamnophis) predators is well studied. Read More

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LncRNA SNHG12 ameliorates bupivacaine-induced neurotoxicity by sponging miR-497-5p to upregulate NLRX1.

Lijie Sun Ru Yuan

Hum Exp Toxicol 2022 Jan-Dec;41:9603271221089001

Department of Anesthesiology, Changzhou Wujin People's Hospital Affiliated to Jiangsu University, Changzhou, China.

Long non-coding RNA (lncRNA) small nucleolar RNA host gene 12 (SNHG12) has been reported to participate in the regulation of various nervous system disorders. Bupivacaine (BV), a commonly used local anesthetic, could generate neurotoxicity in neurons. This work intended to investigate the role and specific mechanism of SNHG12 in BV-induced neurotoxicity. Read More

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Efficacy of intravenous versus intraperitoneal lidocaine for postoperative analgesia in laparoscopic cholecystectomy: a randomized, double-blind, placebo-controlled trial.

Minerva Anestesiol 2022 Apr 5. Epub 2022 Apr 5.

Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand -

Background: Laparoscopic cholecystectomy (LC) has become the gold standard for gallbladder removal due to the low degree of invasiveness. However, postoperative pain still persists. Local anesthetics provide analgesia, reduce opioid consumption, and accelerate the return of bowel activity with a rare incidence of toxicity. Read More

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Effects of nalbuphine on the cardiotoxicity of ropivacaine in rats.

Fundam Clin Pharmacol 2022 Apr 4. Epub 2022 Apr 4.

Department of Anesthesia, Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China.

When combined with nalbuphine, local anesthetics show a longer duration of nerve block without increasing complications. However, no evidence is available concerning the effect of nalbuphine on the cardiotoxicity of local anesthetics. The objective of this work is to investigate whether nalbuphine pretreatment can increase the lethal dose threshold of ropivacaine in rats. Read More

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Comparison of plasma levobupivacaine concentrations with and without epinephrine following erector spinae plane block for breast cancer surgery: a randomized controlled trial.

BMC Anesthesiol 2022 03 29;22(1):86. Epub 2022 Mar 29.

Department of Anesthesiology, School of Medicine, Toho University, Tokyo, Japan.

Background: The erector spinae plane (ESP) block requires a large volume of local anesthetic to provide effective analgesia, which has the potential to cause local anesthetic systemic toxicity (LAST). Adjunctive epinephrine slows the entry of local anesthetic into the plasma and decreases its toxic effect on vulnerable tissues. We compared plasma levobupivacaine concentrations with and without epinephrine after ESP blocks for breast cancer surgery. Read More

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Molecular Characterization of a New Tetrodotoxin-Binding Protein, Peroxiredoxin-1, from .

Int J Mol Sci 2022 Mar 12;23(6). Epub 2022 Mar 12.

Fisheries Research Institute of Fujian, Key Laboratory of Cultivation and High-Value Utilization of Marine Organisms in Fujian Province, Xiamen 361013, China.

Pufferfish are considered a culinary delicacy but require careful preparation to avoid ingestion of the highly toxic tetrodotoxin (TTX), which accumulates in certain tissues. In this study, the tissue distribution of peroxiredoxin-1 from was investigated. The peroxiredoxin-1 protein was obtained by in vitro recombinant expression and purification. Read More

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Lidocaine Infusion for the Treatment of Headache Associated With Subarachnoid Hemorrhage: A Case Report.

A A Pract 2022 Mar 23;16(3):e01576. Epub 2022 Mar 23.

From the Department of Anesthesiology, University of Kansas School of Medicine - Wichita, Wichita, Kansas.

Headache after subarachnoid hemorrhage and corresponding craniotomy with aneurysm clipping can be severe and difficult to treat. Currently accepted analgesic therapies are often ineffective at treating the pain without incurring unacceptable side effects. We present an innovative approach wherein intravenous lidocaine infusions were used to successfully treat 2 patients with hyperalgesia refractory to traditional analgesic therapies. Read More

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Practice advisory on the prevention and management of complications of pediatric regional anesthesia.

J Clin Anesth 2022 Aug 18;79:110725. Epub 2022 Mar 18.

Giorgio Ivani, MD, Department of Anesthesiology, Regina Margherita Children's Hospital, Turin, Italy.

Study Objectives: To develop evidence-based recommendations for prevention and management of infections, bleeding, and local anesthetic toxicity in children undergoing regional anesthesia.

Design: A joint committee of the European Society of Regional Anesthesia and Pain Therapy (ESRA) and the American Society of Regional Anesthesia and Pain Medicine (ASRA) studied electronic literature databases of pediatric regional anesthesia to construct evidence-based recommendations.

Main Results: For epidural anesthesia lumbar or thoracic placement is preferred. Read More

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Local Anesthetics, Local Anesthetic Systemic Toxicity (LAST), and Liposomal Bupivacaine.

Clin Sports Med 2022 Apr;41(2):303-315

Department of Anesthesiology and Critical Care, Hospital of the University of Pennsylvania, 3400 Spruce Street, Suite 680 Dulles, Philadelphia, PA 19104, USA. Electronic address:

Local anesthetics have played a vital role in the multimodal analgesia approach to patient care by decreasing the use of perioperative opioids, enhancing patient satisfaction, decreasing the incidence of postoperative nausea and vomiting, decreasing the length of hospital stay, and reducing the risk of chronic postsurgical pain. The opioid-reduced anesthetic management for perioperative analgesia has been largely successful with the use of local anesthetics during procedures such as peripheral nerve blocks and neuraxial analgesia. It is important that practitioners who use local anesthetics are aware of the risk factors, presentation, and management of local anesthetic systemic toxicity (LAST). Read More

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Light activated pulsatile drug delivery for prolonged peripheral nerve block.

Biomaterials 2022 04 3;283:121453. Epub 2022 Mar 3.

Department of Chemical and Environmental Engineering. University of Zaragoza, Campus Río Ebro-Edificio I+D, C/ Poeta Mariano Esquillor S/N, 50018, Zaragoza, Spain; Instituto de Nanociencia y Materiales de Aragón (INMA), CSIC-Universidad de Zaragoza, Zaragoza, 50009, Spain; Networking Research Center on Bioengineering, Biomaterials and Nanomedicine, CIBER-BBN, 28029, Madrid, Spain; Aragon Health Research Institute (IIS Aragon), 50009, Zaragoza, Spain.

Regional anesthesia is widely used in peripheral nerve block and in neuraxial anesthesia to reduce anesthetics systemic side effects and shorten recovery times. However, when applied as a single injection (e.g. Read More

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P53 and taurine upregulated gene 1 promotes the repair of the DeoxyriboNucleic Acid damage induced by bupivacaine in murine primary sensory neurons.

Bioengineered 2022 03;13(3):7439-7456

Department of Anesthesiology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China.

The research aimed to explore the biological role of p53 protein and long non-coding RNA (lncRNA) taurine upregulated gene 1 (TUG1) in bupivacaine (bup)-induced neurotoxicity. Our work treated dorsal root ganglion (DRG) cells with bup, detected cell viability through CCK-8, apoptosis through TUNEL assays, DeoxyriboNucleic Acid (DNA) damage through γ-H2AX protein and comet assay, including p53 mRNA, protein and TUG1 expression through q-PCR and western blot, furthermore, cell viability and DNA damage were determined after the silencing of p53 and TUG1, biological information and TUG1 FISH combined with p53 protein immunofluorescence (IF) was performed to determine the cellular localization of these molecule. experiments, we explored the impact of intrathecal injection of bup on p53 mRNA and protein, TUG1, γ-H2AX protein expression. Read More

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Use of Physiologically Based Kinetic Modeling-Facilitated Reverse Dosimetry to Predict In Vivo Acute Toxicity of Tetrodotoxin in Rodents.

Toxicol Sci 2022 04;187(1):127-138

Division of Toxicology, Wageningen University, 6708 WE Wageningen, The Netherlands.

In this study, the ability of a new in vitro/in silico quantitative in vitro-in vivo extrapolation (QIVIVE) methodology was assessed to predict the in vivo neurotoxicity of tetrodotoxin (TTX) in rodents. In vitro concentration-response data of TTX obtained in a multielectrode array assay with primary rat neonatal cortical cells and in an effect study with mouse neuro-2a cells were quantitatively extrapolated into in vivo dose-response data, using newly developed physiologically based kinetic (PBK) models for TTX in rats and mice. Incorporating a kidney compartment accounting for active renal excretion in the PBK models proved to be essential for its performance. Read More

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Local Differences in the Toxin Amount and Composition of Tetrodotoxin and Related Compounds in Pufferfish () and Toxic Goby () Juveniles.

Toxins (Basel) 2022 02 18;14(2). Epub 2022 Feb 18.

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

Tetrodotoxin (TTX)-bearing fish ingest TTX from their preys through the food chain and accumulate TTX in their bodies. Although a wide variety of TTX-bearing organisms have been reported, the missing link in the TTX supply chain has not been elucidated completely. Here, we investigated the composition of TTX and 5,6,11-trideoxyTTX in juveniles of the pufferfish, , and toxic goby, , using LC-MS/MS, to resolve the missing link in the TTX supply chain. Read More

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February 2022

Concentrations of Tetrodotoxin (TTX) and Its Analogue 4,9-Anhydro TTX in Different Tissues of the Silver-Cheeked Pufferfish (, Gmelin, 1789) Caught in the South-Eastern Mediterranean Sea, Lebanon.

Toxins (Basel) 2022 02 8;14(2). Epub 2022 Feb 8.

Laboratory of Plankton and Shellfish Toxicity, Institute of Oceanography and Fisheries, Šetalište Ivana Meštrovića 63, 21000 Split, Croatia.

Pufferfishes are among the best-known marine organisms that accumulate marine biotoxins such as Tetrodotoxin (TTX). In the Mediterranean Sea, the silver-cheeked toadfish is the most reported TTX-bearer, causing many fatal and non-fatal cases. In Lebanon, no previous studies have measured TTX levels although the possibility of TTX-poisoning is high since is caught in different sizes and can be mistaken with other small fishes. Read More

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February 2022

Evaluation of the Efficacy, Biocompatibility, and Permeation of Bupivacaine-Loaded Poly(epsilon-caprolactone) Nano-Capsules as an Anesthetic.

J Biomed Nanotechnol 2022 Jan;18(1):268-276

Pharmaceutical Chemistry Department, College of Pharmacy, King Saud University, Riyadh, 11451, Saudi Arabia.

In this study bupivacaine (BVC) was encapsulated in Nano-capsules of poly--caprolactone (PCL) and its cytotoxicity in HaCaT (MTT) cells, its permeability in the oesophageal epithelium of pigs, as well as its anesthetic effect in the incision model of rat's hind paw (electronic von Frey anesthesiometer) were evaluated. BVC and epinephrine-associated bupivacaine (BVC-Epi) have been compared to BVC-Nano and it was demonstrated that BVC-Nano had high physicochemical properties and remained stable for 120 days; also, encapsulation of bupivacaine did not affect its toxicity to HaCaT cells, but epinephrine reduced its toxicity. Although both methods of combination with epinephrine and encapsulation in nanocapsules resulted in an extended time of anesthesia, the efficacy of epinephrine was more favorable. Read More

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January 2022

Efficacy of lipid emulsion therapy in treating cardiotoxicity from diphenhydramine ingestion: a review and analysis of case reports.

Clin Toxicol (Phila) 2022 May 16;60(5):550-558. Epub 2022 Feb 16.

Department of Emergency Medicine, Division of Medical Toxicology, Boston Children's Hospital, Boston, MA, USA.

Introduction: Lipid emulsion therapy (LET) has been most thoroughly studied to reverse local anesthetic systemic toxicity (LAST). Case reports suggest that LET can successfully rescue cardiovascular collapse from bupropion, amitriptyline, and propranolol. The efficacy of LET against refractory hypotension and dysrhythmias from diphenhydramine, a commonly ingested lipophilic cardiotoxic agent, is less well described. Read More

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HIV-1 Tat and cocaine coexposure impacts piRNAs to affect astrocyte energy metabolism.

Epigenomics 2022 03 16;14(5):261-278. Epub 2022 Feb 16.

Department of Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy, Texas A&M University Health Science Center, Kingsville, TX 78363, USA.

To understand the effect of HIV infection and cocaine exposure on piRNA expression in human primary astrocytes. We used small RNA sequencing analysis to investigate the impacts of HIV-1 Tat and cocaine coexposure on the expression of piRNAs in human primary astrocytes. We identified 27,700 piRNAs and analyzed them by small RNA next-generation sequencing. Read More

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Ropivacaine-loaded, hydroxypropyl chitin thermo-sensitive hydrogel combined with hyaluronan: an injectable, sustained-release system for providing long-lasting local anesthesia in rats.

Reg Anesth Pain Med 2022 04 15;47(4):234-241. Epub 2022 Feb 15.

Key Laboratory of Biomedical Polymers of Ministry of Education and Department of Chemistry, Wuhan University, Wuhan, Hubei, China

Background And Objective: Ropivacaine hydrochloride is a commonly used local anesthetic in clinics. However, local injection or continuous infusion of ropivacaine has been associated with several disadvantages. Accordingly, it is important to develop a new controlled release system for local administration of ropivacaine to achieve a prolong anesthetic effect, improve efficacy, and minimize the side effects. Read More

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Toxic Relationships and Arms-Race Coevolution Revisited.

Annu Rev Anim Biosci 2022 02;10:63-80

Department of Ecology and Evolutionary Biology, University of California, Los Angeles, California, USA; email:

Toxin evolution in animals is one of the most fascinating and complex subjects of scientific inquiry today. Gaining an understanding of toxins poses a multifaceted challenge given the diverse modes of acquisition, evolutionary adaptations, and abiotic components that affect toxin phenotypes. Here, we highlight some of the main genetic and ecological factors that influence toxin evolution and discuss the role of antagonistic interactions and coevolutionary dynamics in shaping the direction and extent of toxicity and resistance in animals. Read More

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February 2022

A Systematic Review on Nerve-Related Adverse Effects following Mandibular Nerve Block Anesthesia.

Int J Environ Res Public Health 2022 01 31;19(3). Epub 2022 Jan 31.

Department of Clinical Specialistic and Dental Sciences, Università Politecnica delle Marche, Via Tronto 10/A, 60126 Ancona, Italy.

Inferior alveolar nerve (IAN) block injections are commonly used in clinical practice, but they are not free from complications. The aim of the present systematic review is to assess the nerve-related adverse effects of IAN block anesthesia. A structured and systematic search was performed on the major electronic databases (PubMed, Cochrane Library, Web of Science, Scopus and CINAHL) for studies published in English until 30 September 2021. Read More

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January 2022

QX-OH/Levobupivacaine: A Structurally Novel, Potent Local Anesthetic Produces Fast-Onset and Long-Lasting Regional Anesthesia in Rats.

J Pain Res 2022 4;15:331-340. Epub 2022 Feb 4.

Laboratory of Anesthesia and Critical Care Medicine, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.

Purpose: Local anesthetics (LAs) are an important alternative for postoperative analgesia; however, the short duration of LAs limits their use. Thus, we previously developed LL-1, a mixture of QX-OH and levobupivacaine (LB) that produces regional anesthesia for more than 10 h in rats. The aim of this study is to investigate the long-acting mechanism of LL-1 in vivo and in vitro. Read More

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February 2022

Bupivacaine for Root Canal Treatment - Practitioner Behaviors and Patient Perspectives: Survey Studies.

Local Reg Anesth 2022 3;15:11-21. Epub 2022 Feb 3.

Department of Endodontics, New York University College of Dentistry, New York, NY, USA.

Introduction And Objectives: Local anesthesia is essential in dentistry in providing intraoperative analgesia and anesthesia. However, knowledge related to its use for management of post-operative pain is limited. Perioperative pain management is especially important for root canal treatment (ie, endodontic therapy), performed by endodontists. Read More

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February 2022