Alexandra Lazăr, J Szederjesi, Ruxandra Copotoiu, Sanda-Maria Copotoiu and L Azamfirei
1. Cuvillon P, Nouvellon E, Ripart J, Boyer JC, Dehour L, Mahamat A, et al. 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. Anesth Analg. 2009;108:641-649.
2. Ye F, Feng YX, Lin JJ. A ropivacaine-lidocaine combination for caudal blockade in haemorrhoidectomy. J Int Med Res 2007;35:307-313.
3. Hansen TG. Ropivacaine: A
The purpose of the present study was to examine human articular chondrocyte viability and glycosaminoglycan (GAG) production after exposure to various concentrations of bupivacaine, levobupivacaine, and ropivacaine for various times in vitro. We also sought to determine whether the cytotoxicity observed involved the production of reactive oxygen species (ROS) or nitric oxide. We hypothesized that chondrotoxicity was directly dependent on the concentration of local anesthetics, exposure time, and type of local anesthetic.
Materials and methods
Anubhav Khajuria, Mujeeb ur Rehman Fazili, Riaz Ahmad Shah, Maajid Hassan Bhat, Firdous Ahmad Khan, Syed Hilal Yaqoob, Niyaz Ahmad Naykoo and Nazir Ahmad Ganai
. Fubini, S.L and Ducharme, N.G (eds.), first edition, Saunders, Missouri.
9. Ala-Kokko, T.I., Partanen, A., Kainen, J., Kiviluoma, K., Alahuhta, S. (2000). Pharmacokinetics of 0.2 % ropivacaine and 0.2 % bupivacaine following caudal blocks in children. Acta Anaesthesiol. Scand. 44, 1099-1102. http://dx.doi.org/10.1034/j.1399-6576.2000.440911.x PMid:11028730
10. Singh, K., Kinjavdekar., Amarpal., Aithal, H.P., Gopinathan, A., Singh, G.R., Singh, T., Pawde, A.M. Pratap, K. (2005). Clinicophysiological and hematobiochemical effects of
Andrijan Kartalov, Nikola Jankulovski, Biljana Kuzmanovska, Milka Zdravkovska, Mirjana Shosholcheva, Tatjana Spirovska, Aleksandra Panovska Petrusheva, Marija Tolevska, Marija Srceva, Vesna Durnev, Gjorgji Jota, Redzep Selmani and Atanas Sivevski
: a systematic review and meta-analysis of randomized trials. Br J Anaesth, Mar. 2014; 112(3): 427-39.
19. Marshall SC, Tardif G, Ashworth NL. Local corticosteroid injection for carpal tunnel syndrome. Cochrane Database Syst Rev. 2007; 18: CD001554.
20. M. Desmet, H. Braems, M. Reynvoet S. Plasschaert, J. Van Cauwelaert, H. Pottel, et al. I.V. and perineural dexamethasone are equivalent in increasing the analgesic duration of a single-shot interscalene block with ropivacaine for shoulder surgery: a prospective, randomized, placebo
Janos Szederjesi, Alexandra Lazar, Paul Rad and Emoke Almasy
Adding epinephrine to local anesthetics is recommended to extend the duration of peripheral nerve blocks. We describe in this article two cases of radial nerve injury possible due to coadministration of epinephrine during brachial plexus block.
Lazar Alexandra, Szederjesi Janos, Copotoiu Sanda Maria, Simon Noemi Szidonia, Badea Iudita and Azamfirei Leonard
1. Lazăr A, Szederjesi J, Azamfirei L, et al. Combination of Ropivacaine and Lidocaine for Long Lasting Locoregional Anesthesia. Acta Medica Marisiensis, 2014;60:41-43.
2. Ashish R.S, David M S. Axillary Brachial Plexus Block. Anesthesiol Res Pract, 2011; 2011: 173796.
3. Coventry DM, Barker KF, Thomson M. Comparison of two neurostimulation techniques for axillary brachial plexus blockade. Br J Anaesth, 2001; 86:80-83.
4. Kapral S, Greher M, Huber G, et al. Ultrasonographic guidance improves the success rate of interscalene
M. Gherghinescu, C. Molnar, D. Popa, C. Russu and C. Copotoiu
1. Poelman M, Apers J, Van den Brand H et al. The INCH-Trial: a multicentre randomized controlled trial comparing the efficacy of conventional open surgery and laparoscopic surgery for incisional hernia repair. BMC Surgery 2013;13:18.
2. Kingsnorth A, Banerjea A, Bhargava A. Incisional hernia repair - laparoscopic or open surgery? Ann R Coll Surg Engl 2009;91:631-636.
3. O’Neill P, Duarte F, Ribeiro I et al. Ropivacaine Continuous Wound Infusion Versus Epidural Morphine for Postoperative Analgesia
Mircea Gherghinescu, Călin Molnar, Daniel Popa, Cristian Russu, Alexandra Lazăr and Constantin Copotoiu
Background: Hepatitis C prevalence in Romania is 3.5%. Nowadays, the treatment of this condition comprise of interferon. One of the interferon’s side effects is the reduction of collagen synthesis, substance that is necessary in the process of abdominal wall healing.
Case report: We report the case of a 56 years old female patient, admitted in our Clinic for a giant, recurrent incisional hernia. The patient’s history was eventful: a hysterectomy for uterine fibroma in 2009, incisional hernia repair in 2010, the treatment with Interferon in 2011 and 2012 for viral hepatitis C. A well represented subcutaneous tissue is observed intraoperator, a wall defect of 15 cm in diameter with a 5 mm thick muscle aponeurosis lay. We performed abdominal wall plasty by components separation technique, reinforced with a polypropylene mesh disposed on lay. Postoperative analgesia was provided by inserting a wound catheter through which Ropivacaine 0,5% was continuously injected for 72 hours. The postoperative evolution was uneventful, the patient being discharged 7 days after the surgical intervention.
Conclusions: The treatment with Interferon of hepatitis C can favor the recurrence of an incisional hernia. The Oscar Ramirez procedure seemed to be the best choice for surgical treatment of this giant incisional hernia. Postoperative analgesia can be accomplished by a wound catheter through which Ropivacaine 5% is continuously infiltrated.
Background. The classic adductor canal block (ACB) is a regional technique that aims to introduce local anesthetic to the saphenous nerve as it traverses the adductor canal. It offers the benefit of preserved quadriceps strength, and is ideal for rehabilitation. Proximal ACB (PACB) allows the operator to place the block away from the surgical site, permitting preoperative placement. Our primary outcome was total opioid consumption; secondary outcomes included the highest numerical rating scale scores and total gait distance at the indicated time intervals.
Questions/purposes. We asked: 1) Does a Continuous Proximal ACB block with Periarticular knee injection (PACB) provide better analgesia than a Continuous Epidural (CSE)?; 2) Do PACB catheter patients do better with physical therapy compared to CSE patients?; 3) Are PACB patients discharged earlier than CSE patients?
Methods. With IRB approval we performed a retrospective chart review of patients who had underwent primary total knee arthroplasty between October 2015 and September 2016. The selected patients (n = 151) were divided into two groups: CSE group, 72 patients who received a continuous epidural catheter and the PACB group, 79 patients who received at PACB with Periarticular injection. The CSE group received a single-segment combined spinal epidural (CSE) in the operating room. The epidural catheter infusion was started with 0.1% ropivacaine at 8 mL/hour to 14 mL/hour during the post-operative period. The PACB group received a proximal adductor canal catheter with 20 ml of 0.5 % ropivacaine and maintained with ropivacaine 0.2% at 8 ml to 14 ml post operatively. Total opioid consumption, highest numeric rating scores and total gait distance travelled were recorded upon discharge from the PACU and completion of postoperative day (POD) 0, 1, and 2.
Results: We found that the median cumulative morphine consumption was significantly higher in the CSE group compared to the PACB group (194 (0-498) versus 126 (0-354) mg, p = 0.012), a difference that was most notable on POD 1 (84 (16-243) versus 60 (5-370) mg, p = 0.0001). Mean hospital length of stay was also shorter in the PACB group (2.6 ± 0.67 versus 3.0 ± 1.08 days, p = 0.01).
Conclusion: PACB group used significantly lower morphine consumption compared to the CSE group; they were better participants during physical therapy and achieved longer gait distances. The mean hospital length of stay was also shorter in the PACB group