Ropivacaine Research Articles

Multifunctional Analgesic Sutures from Microfluidic Spinning Technology.

Sutures are the most commonly used wound repair method after surgery. However, addressing delayed recovery and pain management remains a significant challenge. Here, microfibers are developed from microfluidic spinning with long-lasting analgesia capabilities for sutures. By using a solvent extraction manner, the polycaprolactone (PCL) microfibers encapsulated with ropivacaine (ROP), a well-known analgesic, can be continuously obtained from microfluidics. The intrinsic property of PCL and the advantage of microfluidic spinning technique impart the microfiber with highly controlled morphologies, mechanical strengths, as well as drug release. After exploring their biocompatibility both at in vitro and in vivo levels, the microfibers are directly applied to wound suture. The results demonstrate the lasting analgesic effect of the microfiber on mice with incision pain, highlighting its potential as promising suture for post-surgery treatments. It is anticipated that the multifunctional analgesic sutures produced through microfluidic spinning will pave the way for utilizing fibers as effective sutures in clinical incision wound treatment.

Assessment of intercostal nerve block analgesia and local anesthetic infiltration for thoracoscopic pulmonary bullae resection: a comparative study

ObjectiveThe purpose of this study was to compare the analgesic effects of intercostal nerve block (ICNB) and local anesthetic infiltration (LAI) on postoperative pain and recovery following thoracoscopic resection of pulmonary bullae.MethodsA total of 160 patients undergoing thoracoscopic pulmonary bullae resection were randomly assigned to receive either ICNB (n = 80) or LAI (n = 80). An experienced anesthesiologist administered ultrasound guided ICNB at the T4 and T7 levels with 5 mL of 0.375% ropivacaine hydrochloride for the ICNB group. Instead, the LAI group received 10 mL of the same concentration of ropivacaine hydrochloride at the same concentration used for ICNB for infiltration anesthesia at the incision sites. Out of the initial cohort, 146 patients completed the study (ICNB group, n = 71; LAI group, n = 75). The collected data included preoperative clinical characteristics, visual analog scale (VAS) scores for pain at various time points post-surgery (6, 12, 24, 48, and 72 h). Additionally, the Quality of Recovery-15 (QoR-15) questionnaire was administered 24 h after surgery, and sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI).ResultsNo significant differences were found in drainage volume, use of additional analgesics, duration of chest tube placement, or hospital stay between the two groups. However, the ICNB group had significantly lower VAS scores and QoR-15 scores 24 h postoperatively (p < 0.05), indicating better pain management and recovery. The ICNB group also reported better sleep quality, as reflected by lower PSQI scores.ConclusionICNB provides superior analgesia compared to LAI after thoracoscopic resection of pulmonary bullae, significantly improving postoperative recovery.

Effects of spinal-epidural anesthesia combined with intravenous etomidate on adrenocortical and immune stress in elderly patients undergoing anorectal surgery: A retrospective analysis.

The management of anesthesia in elderly patients undergoing surgery presents unique challenges, particularly in mitigating stress responses and ensuring stability. Etomidate may alleviate adrenocortical and immune stress. This study aims to investigate the anesthetic effects of combined spinal-epidural anesthesia (CSEA) supplemented with etomidate during anorectal surgery in elderly patients. The medical records of 49 cases treated with CSEA and etomidate (ETO group) and 48 cases treated with CSEA alone (control group) were reviewed and analyzed. All patients received ropivacaine hydrochloride for anesthesia, with the ETO group additionally receiving an infusion of etomidate for sedation. Parameters such as arterial blood gas, visual analog scale (VAS), Ramsay sedation scale (RSS), serum cortisol and norepinephrine levels, pro-inflammatory cytokines, and lymphocyte ratios were assessed at different time points. Compared to the control group, the ETO group showed increased mean arterial pressure, decreased heart rate, and elevated arterial SpO2 30 minutes after anesthesia. The ETO group also had higher RSS scores, lower VAS scores, and reduced serum cortisol and norepinephrine levels. Additionally, decreased levels of pro-inflammatory cytokines, such as interleukin (IL)-6, tumor necrosis factor (TNF)-α, and IL-8, were observed, along with an increase in the regulatory cytokine IL-10. An increased proportion of CD4+ T cells and a higher CD4/CD8 ratio were also noted. This study demonstrates the benefits of using etomidate to mitigate adrenocortical and immune stress in elderly patients undergoing anorectal surgery.

A Randomized, Controlled Trial to Assess the Efficacy and Safety of PF-72 Mixed with 0.75% Ropivacaine Hydrochloride in the Management of Postoperative Pain in Patients Undergoing Elective Arthroscopic Shoulder Surgery

A Randomized, Controlled Trial to Assess the Efficacy and Safety of PF-72 Mixed with 0.75% Ropivacaine Hydrochloride in the Management of Postoperative Pain in Patients Undergoing Elective Arthroscopic Shoulder Surgery

Development of ropivacaine hydrochloride-loaded dissolving microneedles as a local anesthetic agent: A proof-of-concept

Ropivacaine hydrochloride (RPL) is a local anesthetic agent that has been widely used for the treatment of pain during or after surgery. However, this drug is only available in parenteral dosage form and may contribute to the infiltration of RPL into the plasma, causing some undesirable side effects. Intradermal delivery of RPL using dissolving microneedles may become a promising strategy to deliver such drugs into the skin. This research aimed to develop RPL-loaded dissolving microneedles (DMN-RPLs) as a proof of the concept of intradermal delivery of a local anesthetic. The DMN-RPLs were fabricated using either centrifugation or air-pressurized chamber methods. Several polymers, such as poly(vinyl pyrrolidone) (PVP), poly(vinyl alcohol) (PVA), and sodium hyaluronate (SH), were utilized for manufacturing the DMN-RPLs. The prepared DMN-RPLs were assessed for their thermal properties, chemical bonds, mechanical strength, insertion ability, skin-dissolution study, and drug content. Furthermore, in-skin deposition and dermatokinetic studies were also performed. The results showed that F9 (30 % w/w PVP-4 % w/w SH) and F10 (30 % w/w PVP-5 % w/w PVA) containing 5 % w/w of RPL were the most promising formulations, as shown by their needle height reduction (<10 %) and insertion depth (∼400 μm). Both formulations were also able to deliver more than 60 % of the RPL contained in the DMNs into the epidermis, dermis, and receiver compartment. This study, for the first time, has provided a proof concept to deliver RPL as a local anesthetic using DMNs and the intradermal route, aiming to minimize pain and discomfort during administration and improve the patient's experience.

A Prospective, Single-Center, Single-Blind, Randomized, Confirmatory, Controlled Trial to Assess the Efficacy and Safety of PF-72 Combined with 0.75% Ropivacaine Hydrochloride in Patients Undergoing Single-Level Lumbar Discectomy

A Prospective, Single-Center, Single-Blind, Randomized, Confirmatory, Controlled Trial to Assess the Efficacy and Safety of PF-72 Combined with 0.75% Ropivacaine Hydrochloride in Patients Undergoing Single-Level Lumbar Discectomy

A COMPARISON OF INTRAPERITONEAL INSTILLATION OF ROPIVACAINE AND ROPIVACAINE WITH DEXMEDETOMIDINE FOR POSTOPERATIVE ANALGESIA FOLLOWING LAPAROSCOPIC CHOLECYSTECTOMY: A PROSPECTIVE STUDY

Objective: laparoscopic cholecystectomy surgeries are having advantages over open cholecystectomy with less pain and quick recovery. Intraperitoneal route of administration of a local anaesthetic is a cheap, easy and non-invasive method of reducing the intensity of post laparoscopic pain. This study compared the postoperative analgesic effect of intraperitoneal instillation of ropivacaine 0.5% and ropivacaine 0.5% with dexmedetomidine (1µg/kg) in patients undergoing laparoscopic cholecystectomy under general anaesthesia.&#x0D; Methods: Total 86 patients were divided equally in 2 groups. Patients in group R received 20 ml 0.5% isobaric ropivacaine hydrochloride+5 ml NS where in Group RD, patients received 20 ml 0.5% isobaric ropivacaine hydrochloride with 1µg/kg dexmedetomidine hydrochloride. Solution was diluted with normal saline to make a total volume 25 ml. Hemodynamic parameters were noted during surgery Postoperatively, patient was assessed for pain using the visual analogue scale (VAS) at 30 min, then 2,4,8,12 and 24 h. Total analgesic consumption in the first 24 h also compared.&#x0D; Results: Baseline demographic profile of study participants were similar. Mean duration of analgesia was significantly higher in group RD (10.05±6.916 h) as compared to group R (5.59±6.8) (p=0.003). Mean dose of rescue analgesia was significantly higher in group R (130.81±61.44) as compared to group RD (75±36.6) (p&lt;0.001). VAS score was significantly higher in group R as compared to group RD at different time intervals.&#x0D; Conclusion: We concluded that intraperitoneal Ropivacaine with Dexmedetomidine produced postoperative analgesia better than ropivacaine alone.

Local anesthetic effect and safety of ropivacaine oily solution

Purpose: To investigate the effectiveness and safety of ropivacaine oily solution (ROPOS).&#x0D; Methods: After effecting nerve block in postoperative rats by injection of ROPOS near the sciatic nerve, the expression levels of sodium-potassium-chloride co-transporter 1 (NKCC1) and potassium-chloride co-transporter 2 (KCC 2) in the spinal dorsal horn, were assayed. The safety of ROPOS in beagle dogs was evaluated through subcutaneous injection.&#x0D; Results: The duration of anesthetic effect of ROPOS was 5 times longer than that of ropivacaine hydrochloride injection. The analgesic effect occurred via downregulation of the expression of NKCC1. Dogs administered ROPOS had acute inflammatory reactions at the injection sites within 3 days, but they recovered after 14 days. No other toxic reactions were observed. The Tmax values for dogs subcutaneously injected with ROPOS at doses of 15, 30 and 60 mg/kg were 2.15 ± 3.09, 6.25 ± 9.62 and 14.85 ± 11.82 h; with the Cmax values of 0.78 ± 0.51, 1.35 ± 0.38 and 2.09 ± 0.53 µg/mL, while the AUC(0-48h) values were 15.88 ± 5.41, 31.46 ± 11.45 and 66.10 ± 17.81 h·µg/mL, respectively. The values of Tmax, Cmax and AUC(0-48h) were positively correlated with ROPOS dose.&#x0D; Conclusion: Ropivacaine oily solution has a longer duration of local anesthetic effect than ropivacaine hydrochloride injection and it also possesses a good safety profile. The acute inflammatory reactions are noteworthy and will be further investigated in subsequent studies.

Effect of esketamine on postpartum depression after labor analgesia and potential mechanisms: a randomized, double-blinded controlled trial

BackgroundTo evaluate the effect of esketamine combined with ropivacaine hydrochloride on the occurrence of postpartum depression (PPD) after labor analgesia under epidural analgesia pump and explore the possible mechanisms.MethodsA total of 120 women aged 24 to 36 years old who underwent labor analgesia by epidural analgesia pump, with American Society of Anesthesiologists (ASA) physical status II were enrolled. According to the formula of epidural analgesia pump, all participants were randomly divided into two groups: esketamine group (Group E) and control group (Group C). Epidural anaesthesia were operated in all women between L2 and L3 after cervical dilation up to 2 ~ 3 cm. After successful puncture, the epidural catheter was placed 3.5 cm toward the head and 1% lidocaine was injected for 3 ml. The epidural analgesia pump was connected. Esketamine (0.2 mg/kg) combined with 0.75% ropivacaine hydrochloride (20 ml) were diluted by normal saline up to 100 ml in Group E, when only the equal dose of ropivacaine hydrochloride was used in Group C. The visual analogue scale (VAS) before analgesia (T1), 5 (T2), 10 (T3) and 20 (T4) minutes after analgesia were measured. The duration of the first and second stage of labor, the Apgar score of fetus at delivery, postpartum hemorrhage, consumption of esketamine and ropivacaine were recorded. The incidence of PPD was recorded at 1 week and 6 weeks after delivering. The occurrence of side effects such as nausea and vomiting, dizziness, and nightmares were also recorded for 48 h after delivering. The levels of leptin, norepinephrine(NE), and epinephrine(E) in the peripheral venous blood were measured before labor analgesia and at 24 h, 1 week, and 6 weeks after delivering.ResultsCompared with Group C, the VAS score at T2, T3 and T4 were significantly lower in Group E (P < 0.01). Compared with Group C, the incidence of PPD was significantly lower at 1 week and 6 weeks after delivering in Group E (P < 0.01). Compared with Group C, the levels of leptin were significantly higher at 24 h and 1 week after delivering in Group E (P < 0.01), while NE and E (P < 0.01) were lower at the same time (P < 0.01). There were no significant difference of the duration of the first and second stage of labor, the Apgar score of fetus at delivery, postpartum hemorrhage, consumption of ropivacaine and the side effects for 48 h after delivering between the two groups.ConclusionEsketamine combined with ropivacaine hydrochloride used in labor analgesia can significantly reduce the incidence of postpartum depression after delivering without increasing related side effects, which may be related to the regulation of leptin, norepinephrine, and epinephrine in the serum.Trial registrationThe trial was registered at the Chinese Clinical Trial Registry on 30/05/2022 (CTRI registration number—ChiCTR2200060387). URL of registry: https://www.chictr.org.cn/bin/home.

Effect of ultrasound-guided stellate ganglion block on lung protection for patients undergoing one-lung ventilation.

To explore the potential effect of ultrasound-guided stellate ganglion block (SGB) on lung protection for patients undergoing one-lung ventilation (OLV). A total of 123 patients undergoing elective one-lung ventilation surgery were selected as research subjects in this prospective study. These patients were randomly divided into the SGB group, control group and blank group on average. Stellate ganglion block was carried out in the SGB and control groups. Patients in the SGB group were injected with 6 ml mixture of 0.25% ropivacaine hydrochloride and 1% lidocaine hydrochloride, while those in the control group were injected with 6 mL of 0.9% saline. Punctures weren't performed for patients in the blank group. The same induction and maintenance of general anesthesia was adopted for all three groups. Hemodynamics, respiratory parameters and arterial blood gas analysis were recorded after entering the operation room (T0), pre-OLV (T1), 30 min after OLV (T2), 60 min after OLV (T3), at the end of surgery (T4), and 30 min after extubation (T5). Oxygenation index (OI), pulmonary shunt fraction (Qs/Qt) and pH value were compared at different time points. Intravenous serum was collected at T0, T3 and T5 for the detection of surfactant proteins A (SP-A), superoxide dismutase (SOD), malondialdehyde (MDA), interleukin-6 (IL-6) and interleukin-10 (IL-10) levels, respectively. The complications related to SGB after surgery and the postoperative pulmonary complications within 72 h were recorded. At T1, T2, and T3, MAP level in SGB group was lower than that in blank and control groups (P<0.05). At T2, and T3, SGB group had lower hear rate (HR), peak airway pressure (Ppeak) and tidal volume (TV) than blank and control groups (all P<0.05). From T2 to T5, SGB group had higher OI but lower Qs/Qt than blank and control groups (both P<0.05). At T3 and T5, SGB group had lower SP-A, IL-6, and MDA levels but higher IL-10 and SOD levels than blank and control groups (all P<0.05). There was one case of hypoxemia in the blank group within 72 h after surgery. Ultrasound-guided SGB has lung-protective effects on patients undergoing OLV, which significantly improves patients' OI, reduces intrapulmonary shunts, declines ventilator-induced lung damage, and inhibits inflammatory response as well as oxidative stress (China Clinical Trial Registry, registration number ChiCTR2000033385, https://www.chictr.org.cn).

A Study to Assess the Efficacy of Ultrasound-guided Bilateral Erector Spinae Plane Block for Total Abdominal Hysterectomy under Spinal Anesthesia: A Prospective Randomized Control Study

Abstract Background: Postoperative discomfort after a total abdominal hysterectomy (TAH) is severe. The Erector spinae plane block (ESPB) is the latest addition to the multimodal pain management regimen, providing both visceral and somatic analgesia. Aim: The aim of this study was assessed the postoperative analgesic efficacy of ultrasound-guided bilateral ESPB for TAH. Materials and Methods: 70 female patients aged 40 to 60 years, American society of anaesthesiology (ASA) physical status class I and II posted for TAH were enrolled. Group ESPB+SA(n=35) received bilateral ESPB using 0.25% ropivacaine hydrochloride 15ml with 0.5µ/kg dexmedetomidine on each side before spinal anaesthesia, while group SA (n=35) received only spinal anaesthesia. Postoperative follow-up for 24 hours.Statistical analysis used: Independent-samples student t-test. Results: The total dose of tramadol injection consumed in the first 24 hours postoperatively in group ESPB+SA was significantly low (110.34mg) as compared to group SA (334.29mg) (P &lt; 0.001). Time for first rescue analgesia was prolonged significantly in group ESPB+SA while it was very short in Group SA(P &lt; 0.001). Postoperatively the mean modified defense and veterans pain rating scale (DVPRS) for pain was lower in group ESPB+SA than in group SA, and the difference was statistically significant (P &lt; 0.001). Similarly, scores for other modified DVPRS components, such as sleep, activity, mood and stress were lower in the ESPB+SA group. Conclusions: Bilateral ultrasound-guided ESPB prior to spinal anaesthesia offers effective and prolonged postoperative analgesia, with significantly lower postoperative tramadol use and a higher satisfaction score in patients undergoing TAH under spinal anaesthesia.

Bilateral ultrasound guided erector spinae plane block vs. preoperative pregabalin for postoperative pain management in lumbar spine surgery

Background &amp; Objective: Injecting local anesthetics into the erector spinae plane and obstructing the dorsal and ventral rami could reduce the pain. Pregabalin and gabapentin are used to reduce neuropathic pain; however, pregabalin has demonstrated greater analgesic potency than gabapentin. This work aimed to compare the analgesic effects and complications between preoperative pregabalin and erector spinae plane block (ESPB) for lumbar spine surgery under general anesthesia.&#x0D; Methodology: Sixty patients were allocated to the 2 groups using a computer-generated random number that was hidden in sealed, opaque envelopes. In Group 1, the patients received pregabalin 150 mg twice daily for 3 days before surgery. After preoxygenation and before induction of anesthesia, dexmedetomidine 1 µg/kg was given in both of the groups. In Group 2, after the patient was placed in the prone position for the operation and after the induction of general anesthesia, ESPB was carried out bilaterally under ultrasound guidance. Ropivacaine hydrochloride was administered at a quantity of 20 mL upon confirmation of the needle's proper insertion. Numerical Rating Scale (NRS) was used to assess the pain intensity.&#x0D; Results: There was a longer-lasting analgesia in the ESPB group with significantly lower NRS only at 12 h and 18 h (P = 0.001) compared to the pregabalin group, but they were comparable at 24 h (P = 0.407). The time to request first rescue analgesic and the total morphine consumption were significantly different; a significantly longer time for the first rescue analgesic (17.10 vs. 11.73 h) and a significantly reduced amount of morphine consumption (6.30 vs. 10.33 mg) in ESPB group.&#x0D; Conclusion: Both bilateral erector spinae plane block and preoperative pregabalin seem to be helpful for providing adequate pain management postoperatively for lumbar spine surgery; however, bilateral erector spinae plane block was superior in pain management during the first 24 h postoperatively with fewer side effects.&#x0D; Abbreviations: ESPB - Erector Spinae Plane Block; α2-AR - Alpha 2 Adrenoreceptors; NRS - Numerical Rating Scale; ACE - Angiotensin Converting Enzyme; NaCl - Normal Saline; MAP - Mean Arterial Blood Pressure; IV - Intravenous; PACU - Post-Anesthesia Care Unit; X2 - Chi-square; IQR - Interquartile Range; MAC - Minimum Alveolar Concentration;&#x0D; Preregistration: The study had approval from the Ethical Committee and Institutional Review Board of the Faculty of Medicine, Tanta University with approval code (35692/9/22).&#x0D; Key words: US-ESPB; Ultrasound Guided; Erector Spinae Plane Block; Pregabalin; Lumbar Spine Surgery&#x0D; Citation: Mohamed RM, Morsy I, Hamed JMD. Bilateral ultrasound guided erector spinae plane block vs. pregabalin for postoperative pain management in lumbar spine surgery. Anaesth. pain intensive care 2023;27(5):513−520; DOI: 10.35975/apic.v27i5.2306&#x0D; Received: April 07, 2023; Reviewed &amp; Accepted: July 01, 2023

Establishment of A Mouse Model of Stellate Ganglion Block and Subsequent Biphasic Effects on Bilateral Cerebral Cortical Blood Flow

Background and objectives: Stellate ganglion block (SGB) has significant therapeutic efficacy in various clinical practices and further exploration of SGB is needed. The mouse model of SGB had not been reported and the effect on cerebral cortical blood flow (CCBF) was controversial. We aimed to establish an stellate ganglion block (SGB) mouse model and explore how SGB influences CCBF.&#x0D; Methods: Male C57BL/6 mice were randomly divided into five groups (n = 6): groups L (left SGB) and R (right SGB) received an injection of 0.25% ropivacaine hydrochloride (0.08 mL) on the respective stellate ganglion; similarly, groups SL (left saline control) and SR (right saline control) received an injection of normal saline (0.08 mL) instead. Group C received no intervention. CCBF was assessed before SGB (T0) and 10 (T1), 30 (T2), 60 (T3), 90 (T4), and 120 min (T5) after SGB using laser speckle contrast imaging system.&#x0D; Results: The SGB mouse model was successfully established in groups L and R. Compared with baseline, CCBF on the blocked side decreased at T1, increased at T2–T5, and peaked at T3 in groups L and R (all, P &lt; 0.01). Compared with groups C and SL, the CCBF on the left side decreased at T1 and increased at T2–T5 in group L (all, P &lt; 0.05). A similar trend was noted in groups C and SR relative to group R. The CCBF on the unblocked side decreased at T1, increased at T2–T5, and peaked at T3 in groups L and R (all, P &lt; 0.01).&#x0D; Conclusions: The SGB mouse model was established successfully. Unilateral SGB can affect bilateral cerebral cortical blood flow, which shows a transitory decrease followed by a significant increase for at least 2 h.

Chinese mini percutaneous nephrolithotomy for upper urinary calculi under local infiltration anesthesia.

Percutaneous nephrolithotomy is generally performed under general or regional anesthesia; however, it is rarely performed under local infiltration anesthesia (LIA). This study aimed to assess the safety and effectiveness of Chinese mini percutaneous nephrolithotomy (MPCNL) for upper urinary calculi under LIA. A retrospective analysis of 52 patients with upper urinary stones who underwent MPCNL under LIA from April 2019 to May 2022 was performed. Pethidine and Phenergan were intramuscularly injected 30 minutes preoperatively. Oxybuprocaine hydrochloride gel was applied to the urethra for lubricating and mucosal anesthesia. Ropivacaine hydrochloride and lidocaine were injected into the whole percutaneous channel for local anesthesia. An 8/9.8F ureteroscope and an 18F vacuum-assisted access sheath were applied in MPCNL. All 52 patients tolerated procedures and underwent operations successfully; none of them converted the anesthesia method or required additional analgesia. The mean visual analogue scale scores intraoperatively and at 6 hours, 24 hours, and 48 hours after surgery were 3.25 ± 0.52, 3.13 ± 0.69, 2.25 ± 0.56, and 1.58 ± 0.50, respectively. The stone free rate was 84.6%. Complications were seen in 6 (11.5%) patients, including fever in 2 patients (Clavien I), renal colic in 1 patient (Clavien I), clinically insignificant bleeding in 2 patients (Clavien I), and urinary tract infection in 1 patient (Clavien II). No severe complications were observed in any patients. Chinese MPCNL under LIA was a feasible option and achieved good outcomes in appropriately selected patients, and it may become the routine procedure for general patients.

Effect of Ultrasound-Guided Transversus Abdominis Plane Block Combined with Lornoxicam on Pain and Recovery Quality After Abdominal Surgery in Patients with Drug Addiction

Objective: This paper aims to analyze the analgesic effect of ultrasound-guided transversus abdominis plane block (TAPB) combined with non-steroidal anti-inflammatory analgesic drug lornoxicam on abdominal surgery in patients with a history of drug addiction. Methods: 32 patients aged 18–60 who underwent lower abdominal surgery in the First People’s Hospital of Liangshan Yi Autonomous Prefecture and Butuo County People’s Hospital of Liangshan Yi Autonomous Prefecture from January 2022 to March 2023 were selected, the patients must have drug abuse history for more than 1 year, with a history of drug withdrawal and relapse. The patients were divided into observation group and control group by the envelope method, with 16 cases in the observation group and 16 cases in the control group. Two groups of patients underwent ultrasound-guided bilateral transversus abdominis plane block after the operation. The observation group was treated with dexmedetomidine hydrochloride 1μg/kg + 0.25% ropivacaine hydrochloride 40ml, and the control group was treated with 40ml 0.9% sodium chloride injection, the two groups of patients returned to the ward after operation and given intravenous infusion of lornoxicam for relieving the pain. The visual analogue scale(VAS) score of postoperative pain, the times of rescue analgesia, the time of postoperative anal exhaust, the time of ambulation, nausea and vomiting, withdrawal symptoms, related adverse reactions, and hospitalization days were compared between the two groups. Results: The VAS score of postoperative pain in the observation group was significantly lower than that in the control group, P &lt; 0.05. Patients in the observation group used less postoperative rescue analgesics than those in the control group, P &lt; 0.05. For postoperative anal exhaust time, the difference between the two groups of patients was relatively small, and the time in the observation group was shorter, P &gt; 0.05. The time to get out of bed and the length of hospital stay were not significantly different between the control group and the observation group, P &gt; 0.05. The withdrawal symptoms of the patients in the observation group were better, P &lt; 0.05, nausea and vomiting, and other adverse reactions were lower in the control group, P &lt; 0.05. Conclusion: Ultrasound-guided transversus abdominis plane block combined with lornoxicam can be used to relieve pain in abdominal surgery for patients with drug addiction, which can effectively improve the therapeutic effect of patients and reduce the number of postoperative rescue analgesia. Thus, it has high clinical application value.

Topical ropivacaine hydrochloride 0.5% and lidocaine hydrochloride 2% significantly reduce corneal sensitivity without short-term negative side effects in horses.

To evaluate corneal sensitivity and acute side effects following application of ropivacaine hydrochloride 0.5% and lidocaine hydrochloride 2% on the healthy equine cornea. Eight healthy adult horses. A randomized, masked, crossover study design was utilized. Baseline Semiquantitative Preclinical Ocular Toxicology (SPOT) scores and corneal touch thresholds (CTT) using a Cochet-Bonnet esthesiometer were recorded and measured, respectively, for eight healthy adult horses before medication application. Commercially available eyewash was used as a negative control. Ropivacaine hydrochloride 0.5% or lidocaine hydrochloride 2% solution was sprayed on a randomly selected eye, and the contralateral eye received eyewash. CTT was measured in both eyes at 1, 5, 15, 25, 35, 45, 55, 65, and 75 min post-application. Post-application SPOT scores were recorded immediately following the trial. Linear mixed model statistical analyses (mean ± standard error) were performed (p < .05). Mean eyewash CTT (3.41 cm ± 0.464) was significantly different from ropivacaine-treated (1.44 cm ± 0.562) (p = .008) and lidocaine-treated eyes (1.75 cm ± 0.562) (p = .024); CTT was not significantly different between drug groups (p = .88). Time to maximum anesthesia was not significantly different between ropivacaine (13.25 min ± 3.353) and lidocaine (16.25 min ± 3.353) (p = .40). No side effects were appreciated as confirmed by SPOT. Ropivacaine and lidocaine similarly decreased corneal sensitivity when applied topically without clinically evident short-term ocular side effects. Lidocaine may be preferable in clinical settings due to its large, multi-use vials and similar effects to ropivacaine.

Effect of Ropivacaine Hydrochloride Nanoliposomes on Delayed Cerebral Vasospasm After Subarachnoid Hemorrhage in Rabbits

This research was aimed to investigate the effect of ropivacaine hydrochloride (RP-HCl) nanoliposome (NLP) on delayed cerebral vasospasm (DCVS) after subarachnoid hemorrhage (SAH) in rabbits. RP-HCl liposomes were prepared with RP-HCl, chloroform-ether, soybean phospholipid, dipalmitoyl phosphatidyl glycerol, and L-lysine 5% glucose solution by secondary emulsification, and blank NLP (without RP-HCl) was constructed at the same time. Additionally, an SAH model was also established by secondary blood injection into the large occipital pool. Forty New Zealand rabbits were randomly assigned into sham operation group (the injected liquid was 0.9% sodium chloride injection), control (Ctrl) group (the injected liquid was autologous blood and sodium chloride injection in sequence), no-load group (the injected liquid was autologous blood and blank liposomes in sequence), drug-loaded group (the injected liquid was autologous blood and RP-HCl NLP in sequence), and conventional group (the injected liquid was sodium chloride injection and ropivacaine in sequence), with eight rabbits in each group. The effects of RP-HCl NLP were analyzed through the changes in mean blood flow velocity (Vm), peak systolic blood flow velocity (Vp), neuron-specific enolase (NSE), S100B, diameter and apoptosis of the basilar artery (BA), vascular endothelial cell (EC) (VEC) endothelin-1 (ET-1), and endothelial nitric oxide synthase (eNOS). Results: the average particle size of RP-HCl NLP was 17.73±3.22 μm, and the average encapsulation efficiency was 86.40%. Relative to those before modeling, the Vm, Vp, NSE, and S100B levels in the BA of the five groups were increased on the 1st, 5th, and 10th days after modeling (P &lt;0.05). In contrast to sham group, Vm, Vp, NSE, S100B, ET-1, and the apoptosis index were increased on the 1st, 5th, and 10th days after modeling in the other four groups, while the caliber and eNOS were decreased (P &lt;0.05). The Vm, Vp, NSE, S100B, ET-1, and apoptosis index on the 1st, 5th, and 10th days after modeling in Ctrl and no-load groups were increased versus drug-loaded group, while the pipe diameter and eNOS were decreased (P &lt;0.05). In conclusions, RP-HCl NLP can regulate the balance between ET-1 and eNOS, enhance neurological function, alleviate EC apoptosis, and reduce cerebral blood flow velocity to relieve DCVS after SAH.

Effect of nalbuphine plus ropivacaine on vaginal labor in epidural analgesia

BackgroundVarious approaches using epidural analgesia have been employed for relieving labor pain and promoting spontaneous delivery. We aimed to evaluate the effect of nalbuphine and ropivacaine versus fentanyl and ropivacaine on the duration of delivery in parturients.MethodsClinical data of 160 full-term primiparous women who received either nalbuphine or fentanyl in combination with ropivacaine infusion for epidural labor analgesia in our hospital from December 2020 to May 2022 were retrospectively analyzed. The participants were divided into two groups based on anesthesia methods: nalbuphine group (NR group, n = 78) received 0.2 mg/mL nalbuphine combined with 0.1% ropivacaine hydrochloride for patient-controlled epidural analgesia (PCEA) and fentanyl group (FR group, n = 82) received 2 ug/mL fentanyl citrate and 0.1% ropivacaine hydrochloride for PCEA. Both groups received an epidural blockade for labor analgesia at lumbar 2–3 interspace. The duration of the first, second, and third stages of labor, the onset of analgesia, and time before delivery (T0), 15 min of analgesia (T1), 30 min of analgesia (T2), full opening of the uterine opening (T3),exerts force during childbirth(T4), heart rate (HR), blood pressure (BP), blood saturation (SpO2), visual analogue pain scale (VAS) score, Ramsay sedation score, and modified Bromage score, and 5 min were recorded at 2 h postpartum (T5). The neonatal Apgar score, neonatal behavioral neurological assessment (NBNA) score, maternal nausea, vomiting, and itchy skin were recorded.ResultsCompared with the FR group, the first stage of labor duration (p < 0.05) and total duration of labor (p < 0.05) were shortened and the onset of analgesia (p < 0.05) was increased in the NR group. NR group had lower incidence of urinary retention than FR group (p < 0.05). The maternal and neonatal investigational parameters and scores had no significant difference between the two groups.ConclusionsNalbuphine combined with ropivacaine in epidural block labor has a faster onset of analgesia and has a lower incidence of urinary retention than fentanyl combined with ropivacaine, and nalbuphine shortens the duration of the first and total stages of labor. Both nalbuphine and fentanyl can reduce pain during labor, have little effect on maternal hemodynamics, and have no significant effect on neonatal Apgar or NBNA scores.

In situ enrichment and determination of 6 kinds of caine-type anesthetics in cosmetics and rat serum by thin layer chromatography-Raman spectroscopy

A simple, economical and selective method has been established for simultaneous detection of 6 kinds of caine-type anesthetics in cosmetics and rat serum by in situ enrichment thin layer chromatography (TLC) and Raman spectroscopy. The target caine-type anesthetics, procaine hydrochloride (Pro), tetracaine hydrochloride (Tet), dibucaine (Dib), mepivacaine hydrochloride (Mep), lidocaine hydrochloride (Lid) and ropivacaine hydrochloride (Rop), were separated by TLC. The original spots (or position of Rf equal to that of the standard) of anesthetics on TLC plates were in situ enriched into much smaller ones driven by solvent from different directions, and followed by Raman measurement for quanlitative and quantitative analysis, resulting in the improvement of sensitivity and selectivity. Optimization and standardization of the experimental conditions, the composition and proportion of developing solvent, were conducted. Thus a robust and reliable approach which enabled effective separation, accurate identification and quantification has been developed with the lowest detectable amounts of 0.4, 0.2, 1.2, 1, 1 and 1 μg for Pro, Tet, Dib, Mep, Lid and Rop, respectively. The established method was successfully applied in anesthetics analysis in cosmetics (essence, cream and gel) and rat serum without complex sample pretreatment processes, and the results were verified by HPLC. It turned out that the in situ enrichment TLC-Raman technique was feasible and effective for separation and determination of 6 caine-type anesthetics in biological samples and cosmetics, and would have good prospects for on-site qualitative screening of prohibited goods and adulterants.

LC-MS/MS quantification of ropivacaine and local analgesic and adverse effects of Long-acting Ropivacaine Injection based on pharmacokinetic-pharmacodynamic modelling in Bama minipigs

The local analgesic efficacy and adverse effects of a new Long-acting Ropivacaine formulation were examined based on pharmacokinetic-pharmacodynamic (PK-PD) modelling in Bama minipigs. 24 Bama minipigs, 12 males and 12 females, were randomly and equally divided into the following treatment groups: normal saline injection, drug vehicle injection, Long-acting Ropivacaine Injection and Ropivacaine Hydrochloride Injection. After routine disinfection, a skin incision about 3 cm long and 3 cm deep was produced in the leg of each pig, and mechanical withdrawal threshold (MWT) measured at various times pre- and post-injection as an index of analgesia against incision pain. Plasma ropivacaine concentrations were also measured at the same times using a novel liquid chromatography-tandem mass spectroscopy (LC-MS/MS) method. Minipigs were sacrificed 24 h post-injection and hearts collected for drug concentration measurements by LC-MS/MS. The LC-MS/MS method demonstrated high sensitivity, linearity and precision. The Long-acting Ropivacaine formulation produced a longer analgesic effect (∼12 h) at a lower plasma concentration than Ropivacaine Hydrochloride (∼4h), suggesting a better side-effects profile. A PK-PD model revealed a direct relationship between plasma ropivacaine concentration and MWT, with peak analgesia at about 1000 ng/mL and behaved good prediction ability. Long-acting Ropivacaine Injection is a superior local anaesthetic-analgesic treatment due to longer-lasting efficacy at lower concentrations compared to Ropivacaine Hydrochloride, which will reduce the risk of side effects such as cardiotoxicity.