7,098 results match your criteria Toxicity Local Anesthetics


Recent update on potential cytotoxicity, biocompatibility and preventive measures of biomaterials used in dentistry.

Biomater Sci 2021 May;9(9):3244-3283

Faculty, Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, 110062, India.

Dental treatment is provided for a wide variety of oral health problems like dental caries, periodontal diseases, periapical infections, replacement of missing teeth and orthodontic problems. Various biomaterials, like composite resins, amalgam, glass ionomer cement, acrylic resins, metal alloys, impression materials, bone grafts, membranes, local anaesthetics, etc., are used for dental applications. Read More

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Accidental systematic administration of 1 litre of cardioplegia solution during paediatric cardiac surgery.

Anaesth Rep 2021 Jan-Jun;9(1):76-80. Epub 2021 Apr 27.

Department of Congenital Cardiothoracic Anaesthesia Freeman Hospital Newcastle upon Tyne UK.

Cardioplegia is used to induce cardiac arrest in order to facilitate cardiac surgery in patients supported by cardiopulmonary bypass. It is administered directly into the coronary vessels after the heart has been isolated from the systemic circulation. We describe the case of a 9-year-old boy who mistakenly received 1 l of high strength St Thomas' Harefield cardioplegia solution delivered into the systemic circulation during cardiac surgery. Read More

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Current Methods to Investigate Nociception and Pain in Zebrafish.

Front Neurosci 2021 8;15:632634. Epub 2021 Apr 8.

German Federal Institute for Risk Assessment (BfR), German Centre for the Protection of Laboratory Animals (Bf3R), Berlin, Germany.

Pain is an unpleasant, negative emotion and its debilitating effects are complex to manage. Mammalian models have long dominated research on nociception and pain, but there is increasing evidence for comparable processes in fish. The need to improve existing pain models for drug research and the obligation for 3R refinement of fish procedures facilitated the development of numerous new assays of nociception and pain in fish. Read More

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Double-Blind, Randomized Clinical Trial Comparing One Percent Buffered Versus Two Percent Unbuffered Lidocaine Injections in Children.

Pediatr Dent 2021 Mar;43(2):88-94

Dr. Divaris is a professor, Division of Pediatric and Public Health, Adams School of Dentistry, all at the University of North Carolina at Chapel Hill, Chapel Hill, N.C., USA.

Buffered local anesthetics offer an alternative to conventional, unbuffered anesthetic formulations; however, evidence about their use in children is scant. The purpose of this study was to determine the anesthetic and physiologic differences associated with the use of buffered one percent and unbuffered two percent lidocaine (both with 1:100,000 epinephrine) in children. In this randomized, double-blinded, crossover study, 25 children ages 10 to 12 years old received two inferior alveolar never blocks, at least one week apart, randomized to alternating sequences of two drug formulations: (1) formula A-three mL buffered one percent lidocaine (i. Read More

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Local Anesthetic-Induced Central Nervous System Toxicity during Interscalene Brachial Plexus Block: A Case Series Study of Three Patients.

J Clin Med 2021 Mar 2;10(5). Epub 2021 Mar 2.

Department of Neurology, University Hospital Frankfurt, Goethe University, 60528 Frankfurt, Germany.

Local anesthetics are commonly administered by nuchal infiltration to provide a temporary interscalene brachial plexus block (ISB) in a surgical setting. Although less commonly reported, local anesthetics can induce central nervous system toxicity. In this case study, we present three patients with acute central nervous system toxicity induced by local anesthetics applied during ISB with emphasis on neurological symptoms, key neuroradiological findings and functional outcome. Read More

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Local anesthetic systemic toxicity: What nurses should know.

Nursing 2021 Apr;51(4):42-46

In York, Pa., Melissa A. Schneider is a clinical nurse educator at WellSpan York Hospital and an associate professor of nursing at York College of Pennsylvania, and Katrina A. Howard is a nurse manager at WellSpan York Hospital.

Abstract: Local or regional anesthetics are becoming more common pain management options for patients, especially considering concerns regarding opioid use disorders. Though mostly safe, these interventions may carry serious risks such as local anesthetic systemic toxicity (LAST). This article discusses LAST and the importance of recognizing its signs and symptoms. Read More

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Levobupivacaine-Loaded Liposome Associated with Thermogel for Prolonged Analgesia.

AAPS PharmSciTech 2021 Mar 14;22(3):104. Epub 2021 Mar 14.

Núcleo de Desenvolvimento Farmacêutico e Cosmético- NUDFAC, Departamento de Ciências Farmacêuticas, Universidade Federal de Pernambuco, Avenida Professor Artur de Sá, s/n, Cidade Universitária, Recife, Pernambuco, 50740-521, Brazil.

Pain is a phenomenon present in the majority of the population, affecting, among others, the elderly, overweight people, and especially recently operated patients, analgesia being necessary. In the specific case of relief of postoperative pain, different kinds of anesthetics are being used, among them bupivacaine, a widely used drug which promotes long-lasting analgesic effects. However, cardiotoxicity and neurotoxicity are related to its repetitive use. Read More

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Neurotoxic Effects of Local Anesthetics on Developing Motor Neurons in a Rat Model.

J Clin Med 2021 Feb 25;10(5). Epub 2021 Feb 25.

Department of Anesthesiology & Pain Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea.

Neurotoxic effects of local anesthetics (LAs) on developing motor neurons have not been documented. We investigated the neurotoxic effects of LAs on developing motor neurons in terms of cell viability, cytotoxicity, reactive oxygen species (ROS), and apoptosis. Embryonic spinal cord motor neurons were isolated from Sprague-Dawley rat fetuses and exposed to one of the three LAs-lidocaine, bupivacaine, or ropivacaine-at concentrations of 1, 10, 100, or 1000 µM. Read More

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February 2021

Cocaine Induces Cytoskeletal Changes in Cardiac Myocytes: Implications for Cardiac Morphology.

Int J Mol Sci 2021 Feb 24;22(5). Epub 2021 Feb 24.

School of Life Sciences, Pharmacy and Chemistry, Kingston University, Penrhyn Road, Kingston upon Thames, London, KT1 2EE, UK.

Cocaine is one of the most widely abused illicit drugs worldwide and has long been recognised as an agent of cardiac dysfunction in numerous cases of drug overdose. Cocaine has previously been shown to up-regulate cytoskeletal rearrangements and morphological changes in numerous tissues; however, previous literature observes such changes primarily in clinical case reports and addiction studies. An investigation into the fundamental cytoskeletal parameters of migration, adhesion and proliferation were studied to determine the cytoskeletal and cytotoxic basis of cocaine in cardiac cells. Read More

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February 2021

[Toxicity of Takifugu exascurusCollected from the Sea of Kumano].

Shokuhin Eiseigaku Zasshi 2021 ;62(1):28-32

Department of Agro-Food Science, Niigata Agro-Food University.

Marine pufferfish Takifugu exascurus is not approved for human consumption due to the lack of information on its toxicity. To clarify the toxicity of T. exascurus, ten live specimens were collected from the Sea of Kumano, Japan, and the toxicity and tetrodotoxin (TTX) concentration were determined using mouse bioassay and high performance liquid chromatography-fluorescence detection (HPLC-FLD), respectively. Read More

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Impact of intravenous lidocaine on clinical outcomes of patients with ARDS during COVID-19 pandemia (LidoCovid): A structured summary of a study protocol for a randomised controlled trial.

Trials 2021 Feb 11;22(1):131. Epub 2021 Feb 11.

Hôpital de Hautepierre, Service d'Anesthésie-Réanimation et Médecine Péri-Opératoire, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.

Objectives: The main objective of this study is to evaluate the effect of intravenous lidocaine on gas exchange and inflammation in acute respiratory distress syndrome due or not to Covid-19 pneumonia.

Trial Design: This is a prospective monocentric, randomized, quadruple-blinded and placebo-controlled superiority trial. This phase 3 clinical study is based on two parallel groups received either intravenous lidocaine 2% or intravenous NaCl 0. Read More

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February 2021

Quaternary Lidocaine Derivatives: Past, Present, and Future.

Drug Des Devel Ther 2021 14;15:195-207. Epub 2021 Jan 14.

Department of Anesthesiology, Laboratory of Anesthesia and Critical Care Medicine, Translational Neuroscience Centre, West China Hospital, Sichuan University, Chengdu, People's Republic of China.

Local anesthetics have the advantage of complete analgesia with fewer side effects compared to systemic analgesics. However, their clinical use is limited due to their short duration of action. Thus, local anesthetics with fast onset, long duration of action, selective nociceptive block, and low local and systemic toxicity are highly desirable. Read More

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January 2021

Updates in our understanding of local anaesthetic systemic toxicity: a narrative review.

Anaesthesia 2021 01;76 Suppl 1:27-39

Department of Anaesthesia, University of Illinois College of Medicine, Chicago, IL, USA.

Despite advances in clinical practice, local anaesthetic systemic toxicity continues to occur with the therapeutic use of local anaesthesia. Patterns of presentation have evolved over recent years due in part to the increasing use of ultrasound which has been demonstrated to reduce risk. Onset of toxicity is increasingly delayed, a greater proportion of clinical reports are secondary to fascial plane blocks, and cases are increasing where non-anaesthetist providers are involved. Read More

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January 2021

Fundamentals and innovations in regional anaesthesia for infants and children.

Anaesthesia 2021 Jan;76 Suppl 1:74-88

Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.

Regional anaesthesia in children has evolved rapidly in the last decade. Although it previously consisted of primarily neuraxial techniques, the practice now incorporates advanced peripheral nerve blocks, which were only recently described in adults. These novel blocks provide new avenues for providing opioid-sparing analgesia while minimising invasiveness, and perhaps risk, associated with older techniques. Read More

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January 2021

Local Anesthetics: A Century of Progress.

Authors:
John A Yagiela

Anesth Prog 2020 12;67(4):235-244

Section of Oral Biology, UCLA School of Dentistry, Los Angeles, California.

One century after the clinical introduction of cocaine, local anesthesia remains the most important method of pain control in dentistry. Many local anesthetics have been marketed since 1884, and it is likely that attempts to produce drugs that enhance anesthetic efficacy, reduce systemic and local toxicity, and increase nociceptive selectivity, will continue. In addition, new methods of drug administration have been and will be developed to achieve these goals. Read More

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December 2020

Pharmacokinetics of intraperitoneal and subcutaneous levobupivacaine in anesthetized rats.

J Anesth 2021 04 1;35(2):168-174. Epub 2021 Jan 1.

Department of Anesthesiology and Critical Care, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.

Background: We compared the pharmacokinetics of levobupivacaine when administered intraperitoneally, subcutaneously, and intravenously in an anesthetized rat model, to estimate the toxicity risk of a local anesthetic when absorbed from the peritoneum.

Methods: Thirty-two rats were anesthetized with sevoflurane. In Experiment 1, we administered 5. Read More

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Characterization of Device-Related Malfunction, Injury, and Death Associated with Using Elastomeric Pumps for Delivery of Local Anesthetics in the US Food and Drug Administration MAUDE Database.

Drug Healthc Patient Saf 2020 23;12:293-299. Epub 2020 Dec 23.

Pacira BioSciences, Inc., Parsippany, NJ, USA.

Purpose: To characterize medical device reports about elastomeric pumps delivering local anesthesia made to the US Food and Drug Administration Manufacturer and User Facility Device Experience (MAUDE) database.

Patients And Methods: We conducted a retrospective review of medical device reports submitted to MAUDE from January 2010 to July 2018. A systematic, computerized algorithm was used to identify records pertaining to elastomeric pumps using local anesthesia. Read More

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December 2020

Electrocorticographic description of the effects of anticonvulsant drugs used to treat lidocaine-induced seizures.

Brain Behav 2021 Feb 25;11(2):e01940. Epub 2020 Dec 25.

Laboratory of the Pharmacology and Toxicology of Natural Products, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil.

Introduction: Local anesthetics are widely used in clinical practice. While toxicity is rare, these drugs can cause potentially lethal seizures.

Objective: In the present study, we investigated the electrocorticographic (ECoG) and electromyographic patterns of seizures induced by acute lidocaine (LA) toxicity and treated with anticonvulsant drugs. Read More

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February 2021

Fentanyl-contaminated cocaine outbreak with laboratory confirmation in New York City in 2019.

Am J Emerg Med 2021 02 7;40:103-105. Epub 2020 Dec 7.

Division of Medical Toxicology, Ronald O. Perelman Department of Emergency Medicine, NYU Grossman School of Medicine, 455 1(st) Ave, Rm 124, New York, NY 10016, USA; Department of Health and Mental Hygiene, New York City Poison Control Center, 455 1(st) Ave, Rm 124, New York, NY, 10016, USA.

Background: Illicitly manufactured fentanyl and fentanyl analogues (IMFs) are being increasingly suspected in overdose deaths. However, few prior outbreaks have been reported thus far of patients with laboratory-confirmed IMF toxicity after reporting intent to use only nonopioid substances. Herein we report a case series of nine patients without opioid use disorder who presented to two urban emergency departments (EDs) with opioid toxicity after insufflating a substance they believed to be cocaine. Read More

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February 2021

Eastern Newt (Notophthalmus viridescens).

Wilderness Environ Med 2021 Mar 15;32(1):130-131. Epub 2020 Dec 15.

Division of Medical Toxicology, Department of Emergency Medicine, University of Virginia, Charlottesville, VA.

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A retrospective multicenter study comparing bupivacaine and ropivacaine in endoscopic ultrasound guided celiac plexus neurolysis.

Ann Palliat Med 2021 Feb 2;10(2):1755-1762. Epub 2020 Dec 2.

Department of Gastroenterology and Hepatology, Changhai Hospital, The Secondary Military Medical University, Shanghai, China.

Background: Endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) is widely practiced to palliate cancer pain in patients with inoperable abdominal malignancy. During CPN, the dehydrated alcohol is injected to ablate neural tissue and local anesthetics is to minimize the discomfort from alcohol injection. This study aims to compare the efficacy and safety of bupivacaine and ropivacaine in EUS-CPN. Read More

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February 2021

Levamisole-a Toxic Adulterant in Illicit Drug Preparations: a Review.

Ther Drug Monit 2021 04;43(2):221-228

NMS Labs, Horsham, Pennsylvania.

Abstract: Discovered in the 1960s, the common anthelminthic levamisole has seen widespread use in veterinary applications. Its use rapidly expanded thereafter to include human medical treatments for a variety of acute and chronic disorders. Because of reports of severe adverse effects, the US Food and Drug Administration withdrew levamisole's approval for human use in 2000; however, medical options outside the United States and illicit options worldwide allow continued accessibility to levamisole. Read More

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Antinociceptive effect of vapocoolant medium stream spray on hotplate latency in rat pups.

Paediatr Anaesth 2021 Mar 4;31(3):330-337. Epub 2021 Jan 4.

Department of Anesthesiology, Critical Care, and Pain Medicine, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA.

Background: Heel sticks account for most blood tests performed in neonates without analgesia because topical local anesthetics are ineffective on heel glabrous skin. We investigated the antinociceptive effect of an alternative topical analgesic, a vapocoolant spray, on hind paw glabrous skin of rat pups. The spray was applied by two methods: method 1 for 4 s at a distance of 8 cm and method 2 for 10 s at a distance of 18 cm. Read More

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Shifts in the neurobiological mechanisms motivating cocaine use with the development of an addiction-like phenotype in male rats.

Psychopharmacology (Berl) 2021 Mar 25;238(3):811-823. Epub 2020 Nov 25.

Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, PO Box 801402, Charlottesville, VA, 22904, USA.

Rationale: The development of addiction is accompanied by a shift in the mechanisms motivating cocaine use from nucleus accumbens (NAc) dopamine D receptor (DR) signaling to glutamate AMPA-kainate receptor (AMPA-R) signaling.

Objective: Here, we determined whether similar shifts occur for NAc-DR signaling and following systemic manipulation of DR, DR, and AMPA-R signaling.

Methods: Male rats were given short-access (20 infusions/day) or extended-access to cocaine (24 h/day, 96 infusions/day, 10 days). Read More

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Pharmacokinetics and Safety of INL-001 (Bupivacaine HCl) Implants Compared with Bupivacaine HCl Infiltration After Open Unilateral Inguinal Hernioplasty.

Adv Ther 2021 01 25;38(1):691-706. Epub 2020 Nov 25.

HD Research LLC, Houston, TX, USA.

Introduction: Surgical site infiltration with bupivacaine HCl results in short-lived analgesia for postsurgical pain and carries the risk of systemic bupivacaine toxicity due to accidental intravascular injection. INL-001 is a bupivacaine HCl collagen-matrix implant that provides extended delivery of bupivacaine directly at the site and avoids the risk of accidental injection. Here, we examine the pharmacokinetic (PK) and safety profile of INL-001 placement during unilateral open inguinal hernioplasty. Read More

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January 2021

Differences in aerosol flow rates between disposable and reusable atomizers used for airway topicalization: implications for local anesthetic toxicity.

Can J Anaesth 2021 Feb 18;68(2):270-271. Epub 2020 Nov 18.

Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, NS, Canada.

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February 2021

Amide-type local anesthetics may suppress tumor cell proliferation and sensitize Human Hepatocellular Carcinoma Cells to Cisplatin upregulation of expression and demethylation.

J Cancer 2020 23;11(24):7312-7319. Epub 2020 Oct 23.

Department of Anesthesiology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China.

It has been reported that local anesthetics are toxic to various types of cells. Furthermore, several local anesthetics have been confirmed to exert demethylation effects and regulate the proliferation of human cancer cells. Our previous findings suggest that lidocaine may exert potential antitumor activity and enhance the sensitivity of cisplatin to hepatocellular carcinoma and . Read More

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October 2020

Efficacy and safety of different doses of ropivacaine for laparoscopy-assisted infiltration analgesia in patients undergoing laparoscopic cholecystectomy: A prospective randomized control trial.

Medicine (Baltimore) 2020 Nov;99(46):e22540

Department of Anesthesia, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou.

Background: Wound infiltration analgesia provides effective postoperative pain control in patients undergoing laparoscopic cholecystectomy (LC). However, the efficacy and safety of wound infiltration with different doses of ropivacaine is not well defined. This study investigated the analgesic effects and pharmacokinetic profile of varying concentrations of ropivacaine at port sites under laparoscopy assistance. Read More

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November 2020

Ethnic Differences in Analgesic Efficacy and Safety of Liposomal Bupivacaine Among Asian and Caucasian Surgical Patients: A Retrospective Matched-Cohort Analysis.

Asian J Anesthesiol 2020 09 24;58(3):99-110. Epub 2020 Jul 24.

Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio.

Background: Extended-release local anesthetics allow for prolonged analgesia after a single administration. Although Asians demonstrate different pain thresholds than Caucasians, whether they have different postoperative local anesthetic analgesic effects has not been elucidated.

Objective: We aimed to compare the postoperative analgesic efficacy of liposomal bupivacaine on Asian and Caucasian adults, and the incidence of local anesthetic systemic toxicity (LAST) syndrome. Read More

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September 2020