Articles: nerve-block.
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Rev Bras Anestesiol · May 2008
Comparative StudyComparison of histologic spinal cord and neurologic changes in guinea pigs after subarachnoid block with large volumes of racemic bupivacaine, 50% enantiomeric excess bupivacaine (S75-R25), and levobupivacaine.
Levobupivacaine has less central nervous system side effects than racemic bupivacaine, but its anesthetic effect is not as intense. The objective of this experimental study was to compare the adverse effects of large volumes of bupivacaine, S75-R25 bupivacaine, and levobupivacaine injected in the subarachnoid space of guinea pigs. ⋯ Large volumes of levobupivacaine caused little damage in the central nervous system when compared with bupivacaine. Statistically significant changes were not observed between levobupivacaine and S75-R25 bupivacaine.
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Sustained release of local anesthetics is frequently associated with myotoxicity. The authors investigated the role of particulate delivery systems and of the pattern of drug release in causing myotoxicity. ⋯ Whereas the release vehicles themselves were not myotoxic, both burst and extended release of bupivacaine were. A possible implication of the latter finding is that myotoxicity is an inevitable concomitant of sustained release of local anesthetics. Particles, and perhaps other vehicles, may enhance local toxicity through indirect mechanisms.
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Ophthal Surg Las Im · May 2008
The efficacy of retrobulbar block anesthesia only in pars plana vitrectomy and transconjunctival sutureless vitrectomy.
To evaluate the adequacy of retrobulbar block anesthesia only in vitreoretinal surgery. ⋯ Vitreoretinal surgery, particularly 25-gauge transconjunctival sutureless vitrectomy, can be safely and efficiently performed under retrobulbar block anesthesia only. Retrobulbar block anesthesia only could become a more acceptable anesthesia for vitreoretinal surgery for selected patients.