Medicine and Health Sciences Commons^™

A Systematic Record Review Of A Local Quality Improvement Impacts On Anesthesia Provider Knowledge And Attitudes Following A Presentation Of Current Evidence-Based Practices Involving Intrathecal Mepivacaine Use In Total Joint Arthroplasty Surgical Patients, Kevin Mcclellan

Doctor of Nursing Practice Scholarly Projects

Abstract Patients undergoing spinal anesthesia for total joint arthroplasty (TJA) must urinate and ambulate within 1-hour before discharge from the post-anesthesia care unit to indicate a healthy return of lower body neuro-function after spinal administration. The most common spinal medication used is bupivacaine which has complications including postoperative urinary retention (POUR), altered proprioception, delayed ambulation, and prolonged motor block, resulting in increased cost and length of stay. One alternative solution is mepivacaine, an intermediate local anesthetic lasting 1.5 to 2.5 hours with comparative surgical blockade but a quicker motor and sensory function return. Research suggests mepivacaine is just as safe …

Comparative Study Between Dexmedetomidine And Magnesium Sulphate As Adjuvants To Bupivacaine For Caudal Analgesia In Pediatrics, Mohammed Al-Saeed Abdo Abu Hatab, Salah Ramadan El-Sayed, Medhat Helaly Allam, Osama Helal Ahmed, Mohamed M. Abo Elenain

Al-Azhar International Medical Journal

Background: Assessing children's postoperative pain is complicated by the presence of a powerful emotional component.The purpose of the study: To match the safety and duration of postoperative pain relief using caudal Magnesium Sulfate and Dexmedetomidine as adjuvants with Bupivacaine 0.25percent in pediatric patients undergoing infra-umbilical surgeries.

Patients and methods: Sixty children cases with (ASA) Classes I & II, weighing up to 20 kg, were enrolled in this randomized controlled prospective trial at ALAzhar University Hospitals (Assiut). Each of the three groups consisted of twenty patients: Group A (Dexmedetomidine), Group B (Magnesium), and Group C (Control).Results: Our study showed that onset …

Comparative Study Of Dexmedetomidine Versus Fentanyl As Adjuvant To Bupivacaine Spinal Anesthesia In Cesarean Section, Ahmed Fathi Mohammed, Mohsen Badawi Sayed Mehrez, Essam Shafiq Muhammad Abd El-Wahab

Al-Azhar International Medical Journal

Background: Spinal anesthesia is considered the first choice for cesarean section owing to its deep sensory block as well as fewer side effects on mother and fetus. Despite many benefits of this method, it has a short duration and cannot provide sufficient postoperative analgesia.

Objective: to compare the efficacy of dexmedetomidine versus fentanyl as adjuvant to pubivacaine spinal anesthesia in cesarean section.

Patients and Methods: The current study was conducted on a total of 90 females who were undergone cesarean section . They were further subdivided into three groups (n=30). Group B comprised 30 patients where bupivacaine alone was injected; …

Transversus Abdominis Plane Block With Different Bupivacaine Concentrations In Children Undergoing Unilateral Inguinal Hernia Repair: A Single-Blind Randomized Clinical Trial, Meltem Savran Karadeniz, Ayşe Gülşah Atasever, Emine Aysu Salviz, Emre Sertaç Bingül, Hayriye Şentürk Çiftçi, Müşerref Beril Dinçer, Mukadder Orhan Sungur

2020-Current year OA Pubs

BACKGROUND: Current knowledge on the ideal local anesthetic concentration for the ultrasound-guided transversus abdominis plane block (TAPB) in pediatrics is scarce. The purpose of this study is to compare the efficacy of US-guided TAPB at two different concentrations of bupivacaine in pediatrics undergoing unilateral inguinal hernia repair.

METHODS: After random allocation, 74 children aged 1-8 were randomized to receive US-guided TAPB by using 1 mg.kg

RESULTS: Sixty-four children were recruited for the study. Postoperative pain scores were equal between the two groups. There was no need for a rescue analgesic in any group after the postoperative 6

CONCLUSION: TAPB using …

Efficacy Of Dexamethasone Addition To Bupivacaine For Transversus Abdominis Plane Block In Upper Abdominal Surgery, Eman M. A. Sultan, Ghada A. Hassan, Nagwa I. Mowafy, Sabry I. Abd-Allah

Menoufia Medical Journal

Background Ultrasound subcostal transversus abdominis plane block is an efficacious field block in abdominal surgeries. Various adjuvants have been used to prolong the local anesthetic effect. Objectives To evaluate the effect of adding dexamethasone to bupivacaine on pethidine consumption in the first 24 h postoperatively as a primary objective. Patients and methods Our randomized controlled double-blinded trial was conducted on 44 patients with American Society of Anesthesiologists physical status I and II, aged more than or equal to 18 and less than or equal to 60 years, scheduled for upper abdominal surgery under general anesthesia. The study was conducted at …

Mepivacaine Versus Bupivacaine Spinal Anesthesia For Early Postoperative Ambulation., Eric S. Schwenk, Vincent P. Kasper, Jordan D. Smoker, Andrew M. Mendelson, Mathew S. Austin, Scot A. Brown, William J. Hozack, Alexa J. Cohen, Jonathan J. Li, Christopher S. Wahal, Jaime L. Baratta, Marc Torjman, Alyson C. Nemeth, Eric E. Czerwinski

Department of Anesthesiology Faculty Papers

BACKGROUND: Early ambulation after total hip arthroplasty predicts early discharge. Spinal anesthesia is preferred by many practices but can delay ambulation, especially with bupivacaine. Mepivacaine, an intermediate-acting local anesthetic, could enable earlier ambulation than bupivacaine. This study was designed to test the hypothesis that patients who received mepivacaine would ambulate earlier than those who received hyperbaric or isobaric bupivacaine for primary total hip arthroplasty.

METHODS: This randomized controlled trial included American Society of Anesthesiologists Physical Status I to III patients undergoing primary total hip arthroplasty. The patients were randomized 1:1:1 to 52.5 mg of mepivacaine, 11.25 mg of hyperbaric bupivacaine, …

Comparison Between Intrathecal Bupivacaine, Intrathecal Bupivacaine Plus Dexmedetomidine, And Caudal Anesthesia With Bupivacaine In Pediatric Patients, Khaled Mousa Abo El-Enein, Marwa A. Mahmoud, Neveen M. Soliman, Zeinab A. Kasemy

Menoufia Medical Journal

Objective The aim of this study was to compare between anesthesia with intrathecal bupivacaine only, intrathecal bupivacaine plus dexmedetomidine, and caudal bupivacaine in children between 1 and 5 years of age. Background Regional anesthesia is mainly used to provide analgesia after surgery. Dexmedetomidine has been used to increase the duration of postoperative analgesia. Our study aimed to compare between intrathecal bupivacaine only, intrathecal bupivacaine plus dexmedetomidine, and caudal bupivacaine in children between 1 and 5 years of age. Patients and methods Sixty-three patients were included in a clinical trial from April 2015 to September 2016 and were divided into three …

Ultrasound-Guided Double-Injection Infraclavicular Brachial Plexus Block: Bupivacaine Alone Or With Added Dexmedetomidine Or Fentanyl, Ahmed A. Metwally, Ezzeldin S. Ibrahim, Marwa M. Al Lahouny, Wafiya R. Mahdy

Menoufia Medical Journal

Objective The aim of this study was to evaluate the effects of adding dexmedetomidine or fentanyl to bupivacaine in ultrasound-guided infraclavicular block (ICB) for upper limb surgeries. These effects include quality and duration of the analgesia and analgesic consumption. Background ICB provides anesthesia and analgesia to the upper limb. Many adjuvants have been used to improve the quality and duration of analgesia in various nerve blocks. Patients and methods A total of 120 adult patients undergoing elective forearm or hand surgeries received ICB with 27 ml of local anesthetic mixture, and were randomly allocated according to the local anesthetic mixture …

Ultrasound-Guided Transversus Abdominis Plane Block For Lower Abdominal Surgeries: Bupivacaine Alone Or Combined With Fentanyl Or Epinephrine, Ahmed A. R. Metwally, Khalid M. Abo-El-Enin, Nevin M. Soliman, Sabry I. Abd Allah, Walid A. Abo-Omar

Menoufia Medical Journal

Objective The objective of this study was to evaluate the effects of adding fentanyl or epinephrine to bupivacaine in ultrasound-guided transversus abdominis plane (TAP) block for lower abdominal surgeries. These effects include quality and duration of the analgesia and opioid consumption. Background TAP block provides analgesia to the anterior abdominal wall. Many adjuvants were used to improve the quality and duration of analgesia in various nerve blocks. Patients and methods Fifty-six adult patients undergoing elective lower abdominal surgeries under general anesthesia received TAP block with 20 ml of local anesthetic mixture bilaterally and were randomly allocated according to the local …

Bupivacaine Vs. Ropivacaine: Looking At The Chondrotoxic Effects Of Intraarticular Anesthetics In Osteoarthritic Joints, Sarah Burke, Lauren Price

Physician Assistant Capstones, 2016 to 2019

Objectives: Intraarticular injections of corticosteroids used in combination with local anesthetics are commonly used in orthopedic practice for osteoarthritic pain relief. Many orthopedists question whether these anesthetics have chondrotoxic effects on human articular cartilage. The purpose of this meta- analysis is to examine the chondrotoxic effects of local anesthetics on osteoarthritic human articular cartilage and to determine whether ropivacaine has fewer chondrotoxic effects than bupivacaine.

Methods: Studies were found using PubMed with the search terms, “Ropivacaine,” “Bupivacaine,” and “Chondrocytes.” Initially 20 studies were found. Several studies were eliminated using the following excluding factors: human studies, published in last 10 years, …

Pain Management Efficacy Study Between Continuous And Single-Administration Bupivacaine Following Lumbar Spinal Fusion, Jay Tumulak, Steve Johnston, Patty Adams

College of Nursing Faculty Research and Publications

Poorly managed postoperative pain decreases patient satisfaction, impedes early patient mobilization, lengthens inpatient hospital stay, and increases healthcare costs. Multimodal analgesia with local anesthetics is considered most effective for postoperative pain management. This study compared patients undergoing lumbar fusion who received plain bupivacaine from May 2011 until August 2012 with those who received liposomal bupivacaine from September 2012 until May 2013. The aim was to determine which preparation reduced postoperative opioid use the most. All lumbar spinal fusion surgeries in the periods indicated were included in the study. Ninety-three patient charts were reviewed: 47 for the plain bupivacaine group and …

Bupivacaine With Fentanyl To Treat Labor Pain: A Quality Improvement Initiative, Irvin Lee

Walden Dissertations and Doctoral Studies

Epidurals used for labor are common regional anesthesia techniques that are easily placed and controlled, while providing the most reliable method of pain relief in obstetrics for parturient women. Local anesthetics, narcotics, and/or combinations of the two are administered through epidurals to treat labor pain. Hence, the choice of medication is important, as it can highly influence outcomes of pain relief. The purpose of this DNP project was to evaluate the effectiveness of a new service line medication, bupivacaine 0.1% with fentanyl 2mcg/ml, to treat labor pain in parturient women at a rural community hospital in southern California guided by …

Effect Of Continuous Local Anesthetic Use For Pain Control And Narcotic Use After Cesarean Section: A Randomized Trial, Jerome L. Yaklic, Rose Maxwell, Keira Urschel, S. Robinson, M. K. Dearmond, Steven R. Lindheim

Obstetrics and Gynecology Faculty Publications

Background: Post-operative pain control after Cesarean delivery is a major concern for both patients and physicians. The current literature provides mixed results on the effectiveness of the local continuous infiltration of anesthesia for pain control and reduction of morphine use. Methods: This was a randomized, double-blind, placebo controlled trial with a 1:1 group allocation. Fifty women who had a Cesarean delivery were randomly assigned to receive bupivacaine (Bupivacaine group) or saline (Saline group) delivered via locally placed catheters at the sub-fascial plane and at the uterine incision. Forty women (20 per group) completed the study. Total post-operative narcotic use and …

Intrathecal Versus Intravenous Dexmedetomidine In Characteristics Of Bupivacaine Spinal Block In Lower Abdominal Surgery, Ashraf M. Mohammed, Khaled E. Ellisy, Mohammed H. Afifi, Sabry I. Abdullah

Menoufia Medical Journal

Background Dexmedetomidine was shown to improve bupivacaine spinal anesthesia. Objective The aim of this study was to compare between intrathecal and intravenous (i.v.) dexmedetomidine as an adjuvant to bupivacaine spinal anesthesia. Patients and methods Sixty ASA physical status I-II aged 20-60 years scheduled for lower abdominal surgery under spinal anesthesia were assigned randomly to two groups. The intrathecal group received intrathecal 15 mg hyperbaric bupivacaine with 5.0 μg dexmedetomidine, followed by an i.v. infusion of normal saline solution during surgery. The i.v. group received intrathecal hyperbaric bupivacaine 15 mg with 0.5 ml normal saline solution, followed by a loading dose …

The Effects Of Bupivacaine Combined With Different Adjuvants On Block Onset And Duration And On Ion Channel Expressions (Scn9a, Trpm) In Sciatic Nerve Block In Rats, Nurgül Dolu, Levent Şahi̇n, Davut Si̇nan Kaplan, Tuncer Demi̇r, Hasan Şi̇mşek, Mehri̇can Şahi̇n, Beyhan Cengi̇z

Turkish Journal of Medical Sciences

Background/aim: The objective of this experimental study was to examine the effects of epinephrine, dexmedetomidine, and clonidine added as adjuvants to bupivacaine on block onset and effect times, as well as the effects on the Na+ and Ca+2 channel gene expressions, which may indicate cell damage in the sciatic nerve cell membrane. Materials and methods: Rats were divided into five groups: Group S (sham), saline solution; Group B, bupivacaine; Group BD, bupivacaine + dexmedetomidine; Group BC, bupivacaine + clonidine; and Group BE, bupivacaine + epinephrine. For each group, 0.2 mL of local anesthetic was injected into the sciatic nerve bifurcation …

A Comparison Of The Effects Of Hyperbaric And Isobaric Bupivacaine Spinal Anesthesia On Hemodynamics And Heart Rate Variability, Mehmet Toptaş, Si̇nan Uzman, İlke İşi̇temi̇z, Tümay Uludağ Yanaral, İbrahi̇m Akkoç, Gülşen Bi̇can

Turkish Journal of Medical Sciences

To compare the effects of hyperbaric and isobaric bupivacaine spinal anesthesia on hemodynamics and heart rate variability (HRV) in nonobstetric surgery. Materials and methods: Sixty patients were randomly allocated to 2 groups. Group I (n = 30) received 15 mg (3 mL) of hyperbaric bupivacaine and Group II (n = 30) received 15 mg (3 mL) of isobaric bupivacaine for spinal anesthesia. Hemodynamic parameters were recorded before and after spinal anesthesia over 30 min. Analyses of HRV were performed on the day of surgery, after volume loading, and 20 min after spinal injection. Low frequency (LF) values, high frequency (HF) …

Comparison Of Intraarticular Bupivacaine And Levobupivacaine Injection In Rat Synovial Inflammation, Beki̇r Suat Kürkçüoğlu, Melahat Dönmez, Seher Altinel, Seda Banu Akinci, Fatma Saricaoğlu, Ülkü Aypar

Turkish Journal of Medical Sciences

Both bupivacaine and levobupivacaine are local anesthetics with strong analgesic efficacy that can be used intraarticularly. The aim of this study was to compare the effects of intraarticular bupivacaine and levobupivacaine injection on inflammation in articular cartilage and the synovium of the rat knee joint. Materials and methods: Twenty Sprague-Dawley rats were injected in the right knee joint with 0.2 mL of bupivacaine, while 0.2 mL of levobupivacaine was injected into the left knee joint. Groups of 5 were sacrificed on days 1, 7, 14, and 21 after bupivacaine and levobupivacaine administration and knee joints were examined for subintimal fibrosis, …

The Effect Of Addition Of Lidocaine To Bupivacaine On Anesthesia Beginning Time, Block Time, And Block Quality In Lateral Sagittal Infraclavicular Block, Özgür Özmen, Haci Ahmet Alici, Mi̇ne Çeli̇k, Ayşenur Dostbi̇l, Mehmet Cesur

Turkish Journal of Medical Sciences

To investigate whether a 2% lidocaine addition to 0.5% bupivacaine that is used in a lateral sagittal infraclavicular block, when administered in an upper extremity surgery, decreases the block onset time, drug effect time, and drug activity when compared with bupivacaine alone. Materials and methods: This study was performed on 120 American Society of Anesthesiology classification I-II patients who were 18–65 years old and scheduled to undergo an upper extremity surgery. The group testing in the study was as follows: 20 mL (5 mg/mL) bupivacaine, 10 mL (5 mg/mL) bupivacaine + 10 mL (20 mg/mL) lidocaine, and 20 mL (20 …

Comparison Of The Effects Of Epidural 0.5% Bupivacaine And 0.5% Levobupivacaine Administration On Anesthesia Quality, Side Effect Incidence, And Analgesia Requirement Times In Hip And Lower Extremity Surgery, Fesi̇h Kara, Hüsnü Kürşad, Mi̇ne Çeli̇k, Ayşenur Dostbi̇l, İlker İnce, Ahmet Faruk Gi̇ren, Haci Ahmet Alici

Turkish Journal of Medical Sciences

To compare the anesthetic effectiveness of epidural levobupivacaine and bupivacaine without adjuvant medication in patients who were to have elective operations on the lower extremities and hips. Materials and methods: This study was conducted on a total of 70 ASA I-II patients aged between 30 and 70 years, who underwent elective hip and lower extremity operations. The patients that received bupivacaine were assigned to Group B (n = 35) and those that received levobupivacaine to Group L (n = 35). Results: No statistically significant difference was found between the groups in terms of the onset and regression times of the …

Final Baricity Of Ropivacaine Or Bupivacaine Combined With Fentanyl For Intrathecal Administration, Berri̇n Günaydin, İrfan Güngör, Seval İzdeş

Turkish Journal of Medical Sciences

We determined the baricity of fentanyl-added bupivacaine or ropivacaine with or without dextrose by analyzing the specific gravity for a better understanding of the final baricity of the intrathecal drug combinations that are supposed to be used for surgery.

Effects On Hypotension Incidence: Hyperbaric, Isobaric, And Combinations Of Bupivacaine For Spinal Anesthesia In Cesarean Section, Bülent Serhan Yurtlu, Volkan Hanci, Rahşan Di̇lek Okyay, Seli̇me Evri̇m Bostankolu, Gülay Erdoğan Kayhan, Sedat Haki̇moğlu, Hi̇lal Ayoğlu, İnan İlker Arikan, Ülkü Bayar, Işil Özkoçak Turan

Turkish Journal of Medical Sciences

To determine if hypotension frequency changes when hyperbaric or isobaric formulations of bupivacaine, or their sequential administrations, are used for cesarean section. Hypotension after spinal anesthesia for cesarean section is common. Materials and methods: A total of 144 patients who were to undergo cesarean section with spinal anesthesia were allocated into 4 groups. Spinal anesthesia was achieved with 10 mg of hyperbaric bupivacaine in Group H10, sequential 5-mg administrations of hyperbaric and isobaric bupivacaine in Group H5P5, sequential 5-mg administrations of isobaric and hyperbaric bupivacaine in Group P5H5, and 10 mg of isobaric bupivacaine in Group P10. Hemodynamic parameters were …

A Comparison Of The Effects Of Intrathecal Ropivacaine And Bupivacaine During Cesarean Section*, Nuray Camgöz Eryilmaz, Berri̇n Günaydin

Turkish Journal of Medical Sciences

To compare the effects of intrathecal plain bupivacaine or ropivacaine with those of opioids on sensory and motor block characteristics during cesarean section (C/S). Materials and methods: Fifty-two ASA I or II women were randomly allocated into 2 groups to administer either 10 mg of 0.5% plain bupivacaine (Group B), or 15 mg of 0.75% plain ropivacaine (Group R) with 25 \mug fentanyl and 100 µg morphine for spinal anesthesia. Characteristics of the sensory and motor block were recorded. Results: The time to achieve sensory block at T_6 was significantly faster in Group B than in Group R (2.7 ± …

The Effects Of Local Anaesthesia With Bupivacaine And Botulinum Toxin-A After Thoracotomy On Stress Hormone Levels, Makbule Ergi̇n, Ali̇ Yegi̇nsu, İsmai̇l Kürşat Gürlek

Turkish Journal of Medical Sciences

To investigate the effects of local and systemic analgesics on stress hormone levels, which increase after thoracotomy. Materials and methods: Sixty-three male rats were divided into 9 groups (n = 7). In the control animals, only a blood sample was taken. In the thoracotomy group, a retractor was inserted for 1 h. In the local anaesthesia group, intercostal nerve block was performed with bupivacaine or botulinum toxin-A. In the systemic analgesia group, blockade was performed with bupivacaine and diclofenac sodium was given intraperitoneally. Blood samples were taken twice 4 h and 24 h after thoracotomy. Results: At 4 h, stress …

Wound Infiltration With Bupivacaine Versus Ketorolac For Postoperative Pain Relief In Minor To Moderate Surgeries, Mohammad Irfan Akhtar, Mohammad Saleem, Jawad Zaheer

Department of Anaesthesia

OBJECTIVE: To compare the analgesic efficacy of Bupivacaine 0.25% wound infiltration with Ketorolac incisional infiltration in relieving postoperative pain for first twenty-four hours.

METHODOLOGY: Analytical, interventional and comparative study was performed on seventy patients, of both sexes, with varied age groups. Patients underwent minor and moderate surgeries, confined to American Society of Anaesthesiologist ASA category 1-II. Patients were selected by convenience sampling and were divided into two groups i.e. Group I and Group II. Group-I comprised of thirty five patients and were infiltrated with Bupivacaine 0.25% at wound margins postoperatively. Group-II also comprised of thirty-five patients and were infiltrated with …

Adjuncts (Tramadol And Magnesium) Potentiate Impulse Inhibition By A Local Anaesthetic In Isolated Frog Siatic Nerves?, Belgi̇n Büyükakilli, Nurcan Doruk, Ülkü Çömelekoğlu, Handan Çamdevi̇ren, Sevgi̇ Güneş

Turkish Journal of Medical Sciences

Aim: In clinical use, the addition of adjuncts (magnesium or tramadol) to local anesthetic agents is used for different reasons. However, reports about the effect of magnesium plus bupivacaine and of tramadol plus bupivacaine on in vitro preparations are scarce. The aim of this study was to examine the ability of local anesthetics to reduce the amplitude of compound nerve action potentials of the isolated frog sciatic nerve in the absence and presence of adjuncts (magnesium and tramadol). Materials and Methods: The experiments were done on frog sciatic nerves, using an extracellular recording technique. Isolated frog sciatic nerves were bathed …

Reversible Conduction Block In Frog Sciatic Nerve For Three Different Concentrations Of Bupivacaine, Belgi̇n Büyükakilli, Ülkü Çömelekoğlu, Oya Öğenler

Turkish Journal of Medical Sciences

We examined the effects of various concentrations of the bupivacaine commonly used for spinal anaesthesia on the reversibility of conduction block in isolated frog sciatic nerves measured by the extracellular recording technique. Seventy-two isolated nerves were divided into 3 groups (n = 24), each of which was bathed in a different bupivacaine solution in a range of concentrations (10, 20 or 30 mM for 20 min). In each group, the extracellular action potentials were recorded before exposure to the bupivacaine solution to provide the control data. The extracellular action potentials were recorded after 20 min exposure to the drug by …