Search Our Scientific Publications & Authors

A A Pract 2019 Jan 16. Epub 2019 Jan 16.

Department of Anesthesiology, University of Illinois Hospital and Health Sciences System, Chicago, Illinois.

Local anesthetic toxicity is a rare but serious complication of local anesthetic administration. Although lidocaine has a safety profile superior to other amide local anesthetics, we report a case of cardiac arrest after intranasal injection of lidocaine. The case involves a 22-year-old healthy woman who experienced pulseless electrical activity shortly after a submucosal injection of 2. Read More

Reg Anesth Pain Med 2019 Jan 11. Epub 2019 Jan 11.

Department of Anesthesiology, University of Utah Hospital, Salt Lake City, Utah, USA.

Background And Objectives: A common analgesic technique for total knee arthroplasty (TKA) is to inject local anesthetic into the periarticular tissue during surgery, known as local infiltration analgesia (LIA). Since the solution used typically contains a large amount of local anesthetic, concerns arise about exceeding the maximum dosage when adding a peripheral nerve block. Little research exists that addresses serum ropivacaine concentrations following LIA combined with peripheral nerve block. Read More

Medicina (Kaunas) 2018 Dec 25;55(1). Epub 2018 Dec 25.

Department of Emergency Medicine, Marmara University Faculty of Medicine, Istanbul 34916, Turkey.

: Although there are several hypotheses about the mechanism of action, intravenous lipid emulsion (ILE) therapy has been shown to be effective in the treatment of toxicities due to local anaesthetics and many lipophilic drugs. In this study, we had hypothesized that ILE therapy might also be effective in preventing mortality and cardiorespiratory depressant effects due to propofol intoxication. : Twenty-eight Sprague-Dawley adult rats were randomly divided into four groups. Read More

Toxicol Lett 2019 Mar 17;303:9-15. Epub 2018 Dec 17.

University of Health Sciences, Dept. of Medical CBRN Defense, 06010, Etlik, Ankara, Turkey.

Sulfur mustard (SM) was responsible for more than 80% of all documented chemical casualties during the Great War. Recent literature on clinic picture of SM exposure remained so limited with the sporadic cases who were accidentally exposed to SM especially either in Western Europe or China. We reported a Syrian family of four who became victims of chemical terrorism due to SM exposure and we described the detailed clinical course of the family including the medical history, initial symptomatology, clinical examination, hematological data, and initial treatment in the first 48 hours after exposure at Kilis State Hospital, Turkey. Read More

Paediatr Anaesth 2019 Feb 31;29(2):169-174. Epub 2018 Dec 31.

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

Background: Surgical wound infiltration with local anesthetics is common as part of multimodal analgesia and enhanced recovery pathways in pediatric surgical patients. Liposomal bupivacaine can provide up to 92 hours of pain relief, and was approved by the U.S Food and Drug Administration for local infiltration in adults. Read More

Aquat Toxicol 2019 Jan 24;206:114-122. Epub 2018 Oct 24.

Centre for Sustainable Tropical Fisheries and Aquaculture, James Cook University, Townsville, Queensland, 4811, Australia; Department of Ecology, Environment and Evolution, La Trobe University, Melbourne, 3086, Vic. Australia.

Tetrodotoxin is a potent non-proteinaceous neurotoxin, which is commonly found in the marine environment. Synthesised by bacteria, tetrodotoxin has been isolated from the tissues of several genera including pufferfish, salamanders and octopus. Believed to provide a defensive function, the independent evolution of tetrodotoxin sequestration is poorly understood in most species. Read More

Mar Drugs 2018 Nov 16;16(11). Epub 2018 Nov 16.

Centre for Environment, Fisheries and Aquaculture Science (Cefas), Barrack Road, Weymouth, Dorset DT4 8UB, UK.

The marine nemertean originates from the Pacific Ocean but in recent years has been discovered in northern Europe. The species has been associated with high levels of the marine neurotoxin Tetrodotoxin, traditionally associated with Pufferfish Poisoning. This study reports the first discovery of two organisms of in the UK, showing the geographical extent of this species is wider than originally described. Read More

Ecotoxicol Environ Saf 2019 Mar 13;169:112-119. Epub 2018 Nov 13.

Department of Biology, University of Naples Federico II, Via Cinthia, Edificio 7, 80126 Naples, Italy. Electronic address:

The recent discovery of illicit drugs in the aquatic environment has raised concerns about the possible effects on the aquatic fauna, because of the pharmacological activity of these substances. Cocaine is an illicit drug widespread in surface waters since it is the third most widely used drug in North America, Western and Central Europe, and the second in Latin America and the Caribbean. The aim of this study was to evaluate the influence of environmental concentrations of cocaine on the gills of the European eel (Anguilla anguilla). Read More

Pharmaceutics 2018 Nov 14;10(4). Epub 2018 Nov 14.

Biochemistry and Tissue Biology Department, Institute of Biology, University of Campinas, Campinas 13083-862, SP, Brazil.

Dibucaine (DBC) is among the more potent long-acting local anesthetics (LA), and it is also one of the most toxic. Over the last decades, solid lipid nanoparticles (SLN) have been developed as promising carriers for drug delivery. In this study, SLN formulations were prepared with the aim of prolonging DBC release and reducing its toxicity. Read More

J Anesth 2019 Feb 11;33(1):1-8. Epub 2018 Nov 11.

Systemic toxicity from local anesthetics can occur in any of the wide range of situations in which these agents are used. This practical guide is created to generate a shared awareness of the prevention, diagnosis, and treatment of local anesthetic systemic toxicity among all medical professionals who perform nerve blocks. Systemic toxicity of local anesthetic is induced by an increase of its protein-unbound plasma concentration. Read More

Chem Biol Interact 2019 Jan 25;297:95-108. Epub 2018 Oct 25.

Neuropsychopharmacology and Toxicology Program, College of Pharmacy, Kangwon National University, Chunchon, 24341, Republic of Korea. Electronic address:

We investigated whether protein kinase Cδ (PKCδ) mediates cocaine-induced hepatotoxicity in mice. Cocaine treatment (60 mg/kg, i.p. Read More

ACS Nano 2018 Nov 19. Epub 2018 Nov 19.

Laboratory for Biomaterials and Drug Delivery, Department of Anesthesiology , Boston Children's Hospital, Harvard Medical School , Boston , Massachusetts 02115 , United States.

Intravenous regional anesthesia (IVRA; Bier block) is commonly used to anesthetize an extremity for surgery. Limitations of the procedure include pain from the required tourniquet, the toxicity that can occur from systemic release of local anesthetics, and the lack of postoperative pain relief. We hypothesized that the nanoencapsulation of the local anesthetic would prolong local anesthesia and enhance safety. Read More

J Emerg Med 2019 01 17;56(1):107-108. Epub 2018 Oct 17.

Department of Anaesthesia, Pain and Palliative Medicine, Radboud University Medical Center, Helicopter Emergency Medical Service, Lifeliner 3, Nijmegen, the Netherlands.

Lasers Surg Med 2019 Jan 15;51(1):88-94. Epub 2018 Oct 15.

Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts.

Objective: Lidocaine acts as a local anesthetic by blocking transmembrane sodium channel permeability, but also induces the synthesis of heat shock proteins and sensitizes cells to hyperthermia. A previous study reported two cases of deep focal skin ulceration at points corresponding to depot local lidocaine injection sites after treatment with non-ablative fractional resurfacing and it was hypothesized that lidocaine had focally sensitized keratinocytes to the thermal damage of laser treatment. The objective of this study was to investigate whether lidocaine potentiates hyperthermia damage to both normal and cancerous skin cells using an in vitro model. Read More

Pharm Res 2018 Oct 10;35(12):229. Epub 2018 Oct 10.

Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas - Unicamp, P.O. Box - 6109, CEP, Campinas, SP, 13083-862, Brazil.

Purpose: Etidocaine (EDC) is a long lasting local anesthetic, which alleged toxicity has restricted its clinical use. Liposomes can prolong the analgesia time and reduce the toxicity of local anesthetics. Ionic gradient liposomes (IGL) have been proposed to increase the upload and prolong the drug release, from liposomes. Read More

Pharmacology 2018 26;102(5-6):307-315. Epub 2018 Sep 26.

Graduate Institute of Basic Medicine, New Taipei City,

Background: Ropivacaine, a long-acting amide local anesthetic agent, has been demonstrated to inhibit glutamatergic transmission. Glutamate neurotoxicity plays a pivotal role in the pathogenesis of brain disorders. The purpose of this study is to investigate the neuroprotective effect of ropivacaine against brain damage induced by kainic acid (KA), an analogue of glutamate. Read More

Br J Anaesth 2018 Oct 8;121(4):822-841. Epub 2018 Aug 8.

Department of Anesthesiology and Pain Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada. Electronic address:

Recent reports of local-anaesthetic (LA)-induced myotoxicity after peripheral nerve blocks have increased the interest in this less commonly known complication. Basic science evidence investigating LA-induced myotoxicity seems to demonstrate a pattern, but findings from human studies vary. This systematic review summarises the existing myotoxicity evidence and empirically examines its implications. Read More

Proc Natl Acad Sci U S A 2018 10 18;115(40):E9479-E9488. Epub 2018 Sep 18.

Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029;

GABAR-dependent activation of G protein-gated inwardly rectifying potassium channels (GIRK or K3) provides a well-known source of inhibition in the brain, but the details on how this important inhibitory pathway affects neural circuits are lacking. We used sorting nexin 27 (SNX27), an endosomal adaptor protein that associates with GIRK2c and GIRK3 subunits, to probe the role of GIRK channels in reward circuits. A conditional knockout of SNX27 in both substantia nigra pars compacta and ventral tegmental area (VTA) dopamine neurons leads to markedly smaller GABAR- and dopamine DR-activated GIRK currents, as well as to suprasensitivity to cocaine-induced locomotor sensitization. Read More

Biochem Biophys Res Commun 2018 Oct 7;504(2):513-518. Epub 2018 Sep 7.

Department of Anesthesiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266003, China. Electronic address:

Ropivacaine is one of the commonly used local anesthetics in medical and dental care. However, preclinical and observational studies indicate that ropivacaine could have substantial side effects including neurotoxicity, which has raised concern regarding the safety of this drug. In the present study, we investigated the effects of clinically relevant doses of ropivacaine on mitochondrial biogenesis and function in neuronal cells. Read More

Anaesthesia 2018 Nov 5;73(11):1361-1367. Epub 2018 Sep 5.

Department of Anaesthesiology, Nordsjaellands Hospital, University of Copenhagen, Hillerød, Denmark.

The volume-duration relationship using low concentrations of ropivacaine for peripheral nerve blocks is unknown, even though low concentrations of ropivacaine are increasingly used clinically. We investigated the effect of ropivacaine 0.2% on common peroneal nerve block duration. Read More

Equine Vet J 2018 Sep 4. Epub 2018 Sep 4.

K.L. Maddy Equine Analytical Chemistry Laboratory, School of Veterinary Medicine, University of California, Davis, California, USA.

Background: The use of intra-articular (IA) local anaesthetics has proven to be an effective means to treat post-operative pain. The effects of local anaesthetics on equine chondrocytes are mixed with some studies reporting chondrodestruction and others no adverse effects. A liposomal formulation of bupivacaine is used in people and dogs by intra- and peri-articular administration to provide up to 72 h of analgesia. Read More

J Vasc Interv Radiol 2018 09;29(9):1315-1317

Department of Anesthesiology, Saint Louis University School of Medicine, 3635 Vista Blvd., St. Louis, MO 63110.

J Natl Med Assoc 2018 Dec 3;110(6):624-634. Epub 2018 May 3.

Department of Oral Biology/Pharmacology, Dental College of Georgia, Augusta University Augusta, GA 30912-1128, USA. Electronic address:

The growing global availability of the stimulant shrub, khat, has aroused widespread concern. This paper is a review of possible adverse interactions between khat and conventional drugs. Khat chewing has been shown to reduce the bioavailabilities of orally co-administered antibiotics, ampicillin, amoxicillin, cephradine and tetracyclineHCl, and the antimalarial drug, chloroquine. Read More

Reprod Biomed Online 2018 09 17;37(3):269-278. Epub 2018 Aug 17.

Centro de Estudios Biomédicos, Biotecnológicos, Ambientales y de Diagnóstico (CEBBAD), Universidad Maimónides, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina. Electronic address:

Research Question: Recent evidence suggests that cocaine administration in animal models can trigger non-genetic inheritance of addiction traits from father to offspring, affecting development and behaviour. Is chronic cocaine intake involved in alterations of epigenetic homeostasis in the testis?

Design: Epigenetic marks and mediators in testis and isolated germ cells of adult mice treated with cocaine (10 mg/kg) or vehicle (sterile saline solution) were evaluated in an intermittent binge protocol: three intraperitoneal injections, 1 h apart, one day on/off for 13 days, collecting tissue 24 h after the last binge administration (day 14).

Results: It was shown that chronic cocaine intake in mice disrupts testicular epigenetic homeostasis, increasing global methylated cytosine levels in DNA from germ cells and sperm. Read More

Oxid Med Cell Longev 2018 8;2018:4967318. Epub 2018 Jul 8.

Laboratory for Corneal Tissue Engineering, College of Marine Life Sciences, Ocean University of China, Yushan Road No. 5, Qingdao 266003, China.

The introduction of intracameral anaesthesia by injection of lidocaine has become popular in cataract surgery for its inherent potency, rapid onset, tissue penetration, and efficiency. However, intracameral lidocaine causes corneal thickening, opacification, and corneal endothelial cell loss. Herein, we investigated the effects of lidocaine combined with sodium ferulate, an antioxidant with antiapoptotic and anti-inflammatory properties, on lidocaine-induced damage of corneal endothelia with experiment of morphological changes and cell viability of cultured human corneal endothelial cells and investigation of corneal endothelial cell density and central corneal thickness of cat eyes. Read More

Pain Res Treat 2018 15;2018:5710169. Epub 2018 Jul 15.

Department of Anesthesiology, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, USA.

Objective: Peripheral nerve blocks for postoperative analgesia have improved block success, but analgesia efficacy has been limited by the short duration of traditional local anesthetics. The results of randomized trials comparing liposome bupivacaine with conventional local anesthetic formulations (e.g. Read More

J Int Med Res 2018 Nov 15;46(11):4437-4446. Epub 2018 Aug 15.

1 Anesthesiology Department, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.

Objective: The transversus abdominis plane (TAP) block ameliorates visual analogue scale scores and decreases morphine requirements, but its role remains unclear. Patients of advanced age are susceptible to local anesthetic intoxication. We aimed to identify an optimal concentration that can be used in enhanced recovery after surgery (ERAS) without compromising analgesic efficacy. Read More

Iowa Orthop J 2018 ;38:107-112

Department of Orthopaedic Surgery, University of Missouri, Columbia.

Background: This study was conducted to evaluate the effects of commonly used injection medication combinations on supraspinatus tenocyte cell viability and tissue metabolism.

Methods: Twenty adult dogs underwent ultrasound guided injection of the canine equivalent of the subacromial space, based on random assignment to one of four treatment groups (n=5/group): normal saline, 1.0% lidocaine/methylprednisolone, 1. Read More

Bioorg Med Chem 2018 08 30;26(14):4088-4099. Epub 2018 Jun 30.

School of Food Science and Technology, Jiangnan University, Wuxi 214122, China; College of Food Science and Technology, Bohai University; Food Safety Key Lab of Liaoning Province; National & Local Joint Engineering Research Center of Storage, Processing and Safety Control Technology for Fresh Agricultural and Aquatic Products, Jinzhou, Liaoning 121013, China. Electronic address:

Pseudomonas fluorescens, a Gram-negative psychrotrophic bacteria, is the main microorganism causing spoilage of chilled raw milk and aquatic products. Quorum sensing (QS) widely exists in bacteria to monitor their population densities and regulate numerous physiological activities, such as the secretion of siderophores, swarming motility and biofilm formation. Thus, searching for quorum sensing inhibitors (QSIs) may be another promising way to control the deterioration of food caused by P. Read More

Biomaterials 2018 Oct 27;181:378-391. Epub 2018 Jul 27.

Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, 130022, PR China.

Local anesthetics are a class of drugs, which have wide applications in the treatment of acute and chronic pain. However, their analgesic effects only last for a few hours because of their short half-life, which is insufficient for clinical application, especially for long-term surgery or postoperative analgesia. Herein, an injectable hydrogel/microsphere (GEL/MS) composite co-encapsulating bupivacaine (BUP) and dexmedetomidine (DEX) was developed for effective sustained analgesia. Read More

J Toxicol Sci 2018 ;43(8):493-506

Research Division, Chugai Pharmaceutical Co., Ltd.

We used motion field imaging to characterize the conduction and contraction of a sheet of cardiomyocytes derived from human induced pluripotent stem cells (hiPS-CMs). A hiPS-CMs sheet of 2.8 mm × 2. Read More

Reg Anesth Pain Med 2018 08;43(6):648-649

Department of Anaesthesia and Acute Pain Medicine St Vincent's Hospital Melbourne Melbourne, Australia.

Br J Anaesth 2018 Aug;121(2):469-475

División de Anestesiología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

Background: Transversus abdominis plane block is increasingly used for post-Caesarean section analgesia. Cases of toxicity and the limited pharmacokinetic information during pregnancy motivated this study. The objective of the study was to characterise and compare the pharmacokinetics of levobupivacaine with epinephrine in tranversus abdominis plane block, in post-Caesarean section patients and healthy volunteers. Read More

BMJ Case Rep 2018 Jul 19;2018. Epub 2018 Jul 19.

Department of Internal Medicine, Griffin Hospital, Derby, Connecticut, USA.

Acute oesophageal necrosis (AON), also known as 'black oesophagus', is a rare condition characterised by the necrosis of the oesophagus usually involving the distal part. It has been associated with various conditions, and the pathogenesis is thought to involve hypovolaemia combined with decreased function of oesophageal protective mucosal barriers and may be compounded by the effect of gastric secretions on oesophageal mucosa. The hallmark of this condition is characteristic circumferential black discolouration of the distal oesophagus that may extend proximally. Read More

Spectrochim Acta A Mol Biomol Spectrosc 2018 Dec 6;205:55-65. Epub 2018 Jul 6.

Mar Baselios Institute of Technology, Anchal 691306, Kerala, India. Electronic address:

The drug action of ester type local anesthetic (LA) procaine hydrochloride (PRC HCl) is activated by blocking Na ion flow when it binds to the ion channel in the ligand gated sodium ion channel protein. Büchi's model, explains binding action of ester type LA drug with receptor in terms of charge transfer, dipole-dipole, hydrogen bonding and van der Waals interactions through lipophilic, ester and hydrophilic moieties. The present work investigates molecular structural and vibrational spectral features of para amino benzoate group, ester part and tertiary amino group respectively belonging to lipophilic, ester and hydrophilic moieties, accountable for the binding of drug to sodium channel. Read More

Curr Opin Anaesthesiol 2018 Oct;31(5):649-655

Department of Anaesthesia and Acute Pain Medicine, St. Vincent's Hospital, Melbourne, Victoria Parade, Fitzroy.

Purpose Of Review: Ultrasound guidance has become the accepted standard of practice for peripheral regional anesthesia. Despite evidence supporting the efficacy of ultrasound-guided regional anesthesia, its impact on patient safety has been less clear.

Recent Findings: Evidence has been consistent that ultrasound guidance reduces the incidence of vascular injury, local anesthetic systemic toxicity, pneumothorax and phrenic nerve block. Read More

Biomed Pharmacother 2018 Oct 11;106:510-522. Epub 2018 Jul 11.

Safety Pharmacology/Toxicology Consultant, Fairfield, CT, 06825, United States. Electronic address:

Background: RSD921, the R,R enantiomer of the kappa (k) agonist PD117,302, lacks significant activity on opioid receptors.

Methods: The pharmacological and toxicological actions were studied with reference to cardiovascular, cardiac, antiarrhythmic, toxic and local anaesthetic activity.

Results: In rats, dogs and baboons, RSD921 dose-dependently reduced blood pressure and heart rate. Read More

Mol Pain 2018 Jan-Dec;14:1744806918783478. Epub 2018 Jun 29.

1 Department of Neurophysiology, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan.

Background Chronic pain is a persistent unpleasant sensation that produces pathological synaptic plasticity in the central nervous system. Both human imaging study and animal studies consistently demonstrate that the anterior cingulate cortex is a critical cortical area for nociceptive and chronic pain processing. Thus far, the mechanisms of excitatory synaptic transmission and plasticity have been well characterized in the anterior cingulate cortex for various models of chronic pain. Read More

Anesth Prog 2018 ;65(2):119-123

PGY2 General Practice Chief Resident, NYU Lutheran, Brooklyn, New York.

Adverse reactions to local anesthetics are usually a reaction to epinephrine, vasovagal syncope, or overdose toxicity. Allergic reactions to local anesthetics are often attributed to additives such as metabisulfite or methylparaben. True allergic reactions to amide local anesthetics are extremely rare but have been documented. Read More

Bratisl Lek Listy 2018;119(6):373-378

Objective: Organophosphates including malathion can be ingested, inhaled, or absorbed through the skin, but it may be a maximum of acute toxicity when administered by oral intake. Intravenous lipid emulsion (ILE) treatment is used as a new treatment method in cases of systemic toxicity caused by local anesthetics. This study was aimed to examine the potential treatment effect of intravenous lipid emulsion on rat liver tissue in the toxicity of malathion. Read More

J Forensic Sci 2019 Jan 25;64(1):149-153. Epub 2018 Jun 25.

Michigan Medicine Department of Pathology/Wayne County Medical Examiner's Office, 1300 E Warren Ave, Detroit, MI, 48207.

Acetyl fentanyl (N-[1-phenethylpiperidin-4-yl]-N-phenylacetamide) is a potent opioid analgesic with no medicinal uses. We report deaths between 2016 and 2017 at the Medical Examiner's Office in Detroit, MI where acetyl fentanyl was found in the decedent's blood and compare them to previously published deaths between 2015 and 2016. The recent cases (cohort B) had a mean acetyl fentanyl concentration of 0. Read More

Theranostics 2018 23;8(12):3331-3347. Epub 2018 May 23.

Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, P. R. China.

Peripheral nerve blockade (PNB) is a conventional strategy for the management of acute postoperative pain. However, the short duration of the associated analgesia and the potential systemic toxicity due to the low molecular weights of local anesthetics limit their application. An forming injectable Gel-microsphere (Gel-MS) system consisting of PLGA-PEG-PLGA Gel (Gel) and Gel-immobilized bupivacaine-loaded microsphere (MS/BUP) was prepared for precision-guided long-acting analgesia. Read More

Reg Anesth Pain Med 2018 Nov;43(8):838-843

Department of Anesthesiology, the First Affiliated Hospital, Wenzhou Medical University, Zhejiang, China.

Background And Objectives: Although intravenous lipid emulsion has been proved a powerful antidote for local anesthetic toxicity, there are few pharmacokinetic data on using lipid infusion as a pretreatment for other clinical applications. We assessed the influence of lipid pretreatment on the pharmacodynamics and pharmacokinetics of levobupivacaine.

Methods: Altogether, 12 patients undergoing below-knee surgery for a fracture were randomly assigned to 2 groups (6 patients per group): pretreatment with 1. Read More

Int J Med Sci 2018 14;15(7):713-722. Epub 2018 May 14.

Department of Anesthesiology and Pain Medicine, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, 15 Jinju-daero 816 Beon-gil, Jinju-si, Gyeongsangnam-do, 52727, Republic of Korea.

Lipid emulsion has been shown to be an effective treatment for systemic toxicity induced by local anesthetics, which is reflected in case reports. A systemic review and meta-analysis confirm the efficacy of this treatment. Investigators have suggested mechanisms associated with the lipid emulsion-mediated recovery of cardiovascular collapse caused by local anesthetic systemic toxicity; these mechanisms include lipid sink, a widely accepted theory in which highly soluble local anesthetics (particularly bupivacaine) are absorbed into the lipid phase of plasma from tissues (e. Read More

J Clin Pharm Ther 2018 Oct 9;43(5):733-736. Epub 2018 Jun 9.

East Carolina Heart Institute at ECU, Greenville, NC, USA.

What Is Known And Objective: Lidocaine infused at 1-4 mg/min is an appropriate treatment modality for hemodynamically stable ventricular tachycardia (VT) with normal hepatic function. A case of acute lidocaine toxicity in the setting of left ventricular assist device (LVAD) is reported.

Case Summary: A 71-year-old with a HeartMate II LVAD on chronic mexiletine and normal liver function presented with ventricular tachycardia requiring systemic lidocaine and subsequently developed altered mental status with tremors. Read More

Sci Total Environ 2018 Nov 5;640-641:862-873. Epub 2018 Jun 5.

Department of Biology, University of Naples Federico II, Via Cinthia, Edificio 7, 80126 Naples, Italy. Electronic address:

The presence of illicit drugs in the aquatic environment represents a new potential risk for aquatic organisms, due to their constant exposure to substances with strong pharmacological activity. Currently, little is known about the ecological effects of illicit drugs. The aim of this study was to evaluate the influence of environmental concentrations of cocaine, an illicit drug widespread in surface waters, on the skeletal muscle of the European eel (Anguilla anguilla). Read More

Anesth Analg 2018 Oct;127(4):1035-1043

From the Department of Anesthesiology, Intensive Care Medicine and Pain Medicine.

Background: Ultrasound, nerve stimulation, and their combination are all considered acceptable ways to guide peripheral nerve blocks. Which approach is most effective and associated with the fewest complications is unknown. We therefore used a large registry to analyze whether there are differences in vascular punctures, multiple skin punctures, and unintended paresthesia. Read More

Yakugaku Zasshi 2018 ;138(6):809-813

Graduate School of Pharmaceutical Sciences, The University of Tokyo.

　During the preclinical research period of drug development, animal testing is widely used to help screen out a drug's dangerous side effects. However, it remains difficult to predict side effects within the central nervous system. Here, we introduce a machine learning-based in vitro system designed to detect seizure-inducing side effects before clinical trial. Read More