NEWS HIGHLIGHTS
Published Studies Related to Bupivacaine and Epinephrine (Bupivacaine / Epinephrine Dental)
Effect of intraoperative injection of 0.25% bupivacaine with 1:200,000 epinephrine on intraoperative blood loss in FESS. [2009.07]
BACKGROUND: This study was designed to compare differences in intraoperative blood loss, mean arterial blood pressure (MABP), and duration of surgery when 0.25% bupivacaine with 1:200000 epinephrine is injected, preoperatively, versus normal saline (NS), during functional endoscopic sinus surgery (FESS)... CONCLUSION: There was no significant reduction in intraoperative blood loss during FESS when local anesthetic containing epinephrine was used compared with infiltration with NS. More importantly, Part II shows a significantly higher MABP associated with infiltration of epinephrine. Parts I and II did not show a significant difference in preoperative MABP or duration of surgery.
Posterior lumbar plexus block in postoperative analgesia for total hip arthroplasty: a comparative study between 0.5% Bupivacaine with Epinephrine and 0.5% Ropivacaine. [2009.05]
BACKGROUND AND OBJECTIVES: Posterior lumbar plexus block promotes effective postoperative analgesia in total knee arthroplasty. Ropivacaine and bupivacaine do not show differences in analgesic efficacy when used in different peripheral nerve blocks. The objective of this study was to compare the efficacy of postoperative analgesia resulting from the administration of a single dose of 0.5% bupivacaine or 0.5% ropivacaine in posterior lumbar plexus block for total hip arthroplasty... CONCLUSIONS: 0.5% Bupivacaine and 0.5% ropivacaine produced effective and prolonged postoperative pain relief after total hip arthroplasty, without clinical differences, when equivalent doses were administered for posterior lumbar plexus block.
Comparison of bupivacaine and lidocaine with epinephrine for digital nerve blocks. [2009.05]
OBJECTIVE: This study compared the efficacy in terms of pain of injection, time of onset and duration of action of digital blocks of bupivacaine 0.5% alone and lidocaine 1% with epinephrine (1:100,000)... CONCLUSION: Lidocaine (1%) with epinephrine (1:100 000) was significantly less painful and had a shorter duration of action than bupivacaine (0.5%), which had a similar onset of action for digital nerve block. Trial registration number: ISRCTN45121950.
A comparison of the pharmacodynamics and pharmacokinetics of bupivacaine, ropivacaine (with epinephrine) and their equal volume mixtures with lidocaine used for femoral and sciatic nerve blocks: a double-blind randomized study. [2009.02]
BACKGROUND: Mixtures of lidocaine with a long-acting local anesthetic are commonly used for peripheral nerve block. Few data are available regarding the safety, efficacy, or pharmacokinetics of mixtures of local anesthetics. In the current study, we compared the effects of bupivacaine 0.5% or ropivacaine 0.75% alone or in a mixed solution of equal volumes of bupivacaine 0.5% and lidocaine 2% or ropivacaine 0.75% and lidocaine 2% for surgery after femoral-sciatic peripheral nerve block. The primary end point was onset time... CONCLUSION: Mixtures of long-acting local anesthetics with lidocaine induced faster onset blocks of decreased duration. Whether there is a safety benefit is unclear, as the benefit of a decreased concentration of long-acting local anesthetic may be offset by the presence of a significant plasma concentration of lidocaine.
High-dose ropivacaine versus bupivacaine for posttonsillectomy pain relief in adults. [2008.12]
OBJECTIVE: To compare the efficacy and safety of preincisional high-dose ropivacaine with bupivacaine in relieving posttonsillectomy pain... CONCLUSION: Preincisional infiltration of the tonsils with high-dose ropivacaine markedly decreased the intensity of pain after tonsillectomy when compared with bupivacaine or placebo, especially until postoperative day 4 in adults.
Clinical Trials Related to Bupivacaine and Epinephrine (Bupivacaine / Epinephrine Dental)
2% Lidocaine Plus 0.5% Bupivacaine Versus 0.5% Bupivacaine in Brachial Block for Creation of Arteriovenous (AV) Fistula [Not yet recruiting]
Spinal Anesthesia for Cesarean Delivery: Bupivacaine With or Without Fentanyl [Recruiting]
The safest form of anesthesia for Cesarean section is a spinal anesthetic. All spinal
anesthetics contain a local anesthetic and/or a narcotic. A drug named bupivacaine is the
most commonly used local anesthetic in spinal anesthetics for Cesarean deliveries in North
America. Another drug named fentanyl is the most commonly used narcotic. This study will
look at whether a spinal anesthetic with 15mg of bupivacaine alone will be the same as a
spinal anesthetic with 12mg of bupivacaine and 15ug of fentanyl.
Epidural Fentanyl-Bupivacaine Versus Clonidine-Bupivacaine for Breakthrough Pain in Advanced Labor [Not yet recruiting]
Epidural analgesia is widely regarding as the most effective analgesic strategy for labor
pain. Modern practice is to utilize dilute local anesthetics as a continuous infusion along
with an opioid, e. g., our common "recipe" of 12 ml/hr of 0. 0625% bupivacaine with 2
micrograms/ml fentanyl, after the initial dose to maintain patient comfort until delivery.
This dose of the infusion often provides adequate comfort without interfering with the
mobility of the patient and her ability to effectively push during delivery. However, this
low dose epidural infusion strategy often results in recurrence of pain after an initial
pain free period.
This breakthrough pain is treated by administering small boluses of analgesics via the
epidural catheter. The pain occurring in labor is initially of visceral origin and is
mediated by pain fibers originating from the low thoracic and upper lumbar segments of the
spinal cord. As labor progresses to the late first phase (also known as transitional stage),
pain sensations originating from the distension of the pelvic floor, vagina and perineum
adds a somatic component to labor pain. This type of breakthrough pain is often difficult to
treat.
Although requests from patients to alleviate late stage breakthrough pain are common, no one
knows the most effective strategy for pain management in this stage of labor. This study is
designed to compare the efficacy of two treatments for controlling late first stage
breakthrough pain during labor with an epidural infusion in place: clonidine-bupivacaine
versus fentanyl-bupivacaine.
Women who have labor epidural analgesia in place will be enrolled to be randomized if and
when they present with breakthrough pain in the late first stage or second stage of labor
(≥ 8 cm dilated). They will receive 8 ml of a solution containing 10 mg bupivacaine and 75
micrograms of either fentanyl (an opioid or "narcotic") or clonidine (an "alpha-2 agonist
known to be effective as an epidural analgesic).
Pain relief, labor progress and outcome will be assessed to compare fentanyl versus
clonidine.
It is the hypothesis of this study that clonidine added to bupivacaine is a better analgesic
than fentanyl added to bupivacaine for breakthrough pain in advanced labor.
Does Bupivacaine in Laparoscopic Portals Reduce Post Surgery Pain in Tubal Ligation by Electrocoagulation? [Recruiting]
The use of bupivacaine , an anesthesic, in laparoscopic portals is recommended in some
surgeries. In the ase of tubal ligation by electrocoagulation, where pain is reduced, there
is no evidence of this benefit. The objective of this study is to verify the degree of pain
after laparoscopic tubal ligation surgery in patient who received bupivacaine 0. 5% in the
portal, or placebo
A Comparison of Bupivacaine and Ketorolac for Postoperative Analgesia After Iliac Crest Bone Harvesting [Recruiting]
The efficacy of three postoperative pain management regimens will be compared in patients
undergoing Lefort I osteotomy or alveolar cleft repair with Iliac crest bone grafts (ICBG)
to determine the best way of managing postoperative pain.
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