Anesthesiology
-
Previous preclinical safety studies in ewes have found intravenous levobupivacaine and ropivacaine to be less potent toward causing central nervous system (CNS) and cardiac toxicity than bupivacaine. Analogous cardiotoxicity has been demonstrated directly in various cardiac preparations ex vivo. Moreover, drug-related arrhythmogenicity has been demonstrated from direct CNS injection of local anesthetic agents in vivo, suggesting CNS-related cardiotoxicity. This study investigated whether CNS site-directed blood-borne drug administration (with minimal systemic recirculation) would demonstrate drug-related cardiotoxicity. ⋯ Although CNS site-selective drug delivery produced quantitative differences between bupivacaine, levobupivacaine, and ropivacaine in some CNS effects and cardiac sequelae, no differences were found in their arrhythmogenic potential.
-
Elective cesarean section decreases the likelihood of vertical human immunodeficiency virus (HIV) transmission from mother to infant. This study aimed to determine whether cesarean section done with spinal anesthesia on HIV-1-infected pregnant women taking antiretroviral therapy is associated with intraoperative hemodynamic instability, postoperative complications, or changes in immune function or HIV-1 viral load. ⋯ Elective cesarean section under spinal anesthesia for women infected with HIV-1 taking antiretroviral therapy was not associated with intraoperative or postoperative complications.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Levobupivacaine 0.125% and lidocaine 0.5% for intravenous regional anesthesia in volunteers.
Levobupivacaine, a long acting, amino-amide, local anesthetic, may offer advantages over lidocaine for intravenous regional anesthesia (IVRA). The objective of this investigation was to compare levobupivacaine to lidocaine for IVRA. ⋯ Levobupivacaine 0.125% may be an alternative to lidocaine 0.5% for IVRA. Longer lasting analgesia after release of the tourniquet may be caused by a more profound and prolonged tissue binding effect of levobupivacaine.
-
Randomized Controlled Trial Clinical Trial
P6 acupoint injections are as effective as droperidol in controlling early postoperative nausea and vomiting in children.
P6 acupuncture in adults is reported to be an effective preventive treatment for postoperative nausea and vomiting (PONV). It is not clear, however, whether this technique is effective as a preventive treatment for PONV in children. ⋯ In children, P6 acupoint injections are as effective as droperidol in controlling early postoperative nausea and vomiting.