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Local anaesthetics with amide bases are generally thought to be safe to use. However, there is little research on its safety in diabetic individuals. The current study aimed to assess two widely used amide-based local anaesthetics, articaine and mepivacaine, in the context of healthy and diabetic rats to determine their impact and safety. A total of 30 male rats divided into two groups (healthy and diabetic groups) were used for this study. The rats were injected with local anaesthetic agents (articaine or mepivacaine). The rats' biochemical parameters were compared in order to assess the impact of various medications. The study's findings showed that, in comparison to the effects of articaine, mepivacaine considerably raised the levels of blood sugar (BS), aspartate aminotransferase (AST), alanine transaminase (ALT), and amylase in healthy rats. In diabetic rats, mepivacaine significantly increased BS, AST, ALT and amylase levels compared with articaine (p<0.001). In contrast, the increase in this group was higher than in healthy rats. However, the gammaglutamyl transpeptidase (GGT) level showed non-significant differences compared to the control group in both groups. Articaine induced the least change in biochemical parameter levels in healthy and diabetic rats compared to mepivacaine. [ABSTRACT FROM AUTHOR]

Abstract Background Anaesthetic methods and drugs with rapid onset, rapid recovery and better postoperative analgesia are more suitable for rapid recovery in obstetric anaesthesia. We formulated the following hypothesis: a combination of mepivacaine and ropivacaine could provide a longer analgesic effect and have more advantages in terms of rapid-recovery indicators. Methods A total of 180 pregnant women scheduled to undergo elective caesarean sections were randomly assigned to three surgical groups, which received 2% mepivacaine (Group M), 2% mepivacaine + 0.75% ropivacaine (Group MR) (Volume 1:1) or 0.75% ropivacaine (Group R) through an epidural catheter. The situation of postoperative analgesia and other indicators of rapid recovery were recorded. Results One hundred and fifty patients were included in the final analysis. Their demographic data were similar. The visual analogue scale (VAS) scores of Group MR and Group R were lower than Group M at 1 and 2 h after surgery both at rest and with movement (P

Background: Anaesthetic methods and drugs with rapid onset, rapid recovery and better postoperative analgesia are more suitable for rapid recovery in obstetric anaesthesia. We formulated the following hypothesis: a combination of mepivacaine and ropivacaine could provide a longer analgesic effect and have more advantages in terms of rapid-recovery indicators. Methods: A total of 180 pregnant women scheduled to undergo elective caesarean sections were randomly assigned to three surgical groups, which received 2% mepivacaine (Group M), 2% mepivacaine + 0.75% ropivacaine (Group MR) (Volume 1:1) or 0.75% ropivacaine (Group R) through an epidural catheter. The situation of postoperative analgesia and other indicators of rapid recovery were recorded. Results: One hundred and fifty patients were included in the final analysis. Their demographic data were similar. The visual analogue scale (VAS) scores of Group MR and Group R were lower than Group M at 1 and 2 h after surgery both at rest and with movement (P < 0.05), and the time to first ambulation in Group MR (17.38 ± 2.06 h) and Group M (17.20 ± 2.09 h) was shorter than that in Group R (22.18 ± 1.74 h) (P < 0.05). Conclusion: Application of 2% mepivacaine combined with 0.75% ropivacaine for epidural anaesthesia can provide longer postoperative analgesia and earlier ambulation, these effect may be more suitable than that of 2% mepivacaine or 0.75% ropivacaine alone for caesarean section. Trial registration: This study was registered at Chinese Clinical Trial Registry (Registration number: ChiCTR 2300078288; date of registration: 04/12/2023). [ABSTRACT FROM AUTHOR]

This systematic review with meta-analysis was conducted to evaluate the effectiveness of local anesthetic administration into temporomandibular joint cavities in relieving pain and increasing mandibular mobility. Randomized controlled trials were included with no limitation on report publication dates. Final searches were performed on 15 October 2023, using engines provided by the US National Library, Bielefeld University, and Elsevier Publishing House. The risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Articular pain and mandible abduction values and their mean differences were summarized in tables and graphs. Eight studies on a total of 252 patients evaluating intra-articular administration of articaine, bupivacaine, lidocaine, and mepivacaine were included in the systematic review. None of the eligible studies presented a high risk of bias in any of the assessed domains. An analgesic effect of intra-articular bupivacaine was observed for up to 24 h. In the long-term follow-up, there were no statistically significant changes in quantified pain compared to both the baseline value and the placebo group, regardless of the anesthetic used (articaine, bupivacaine, and lidocaine). There is no scientific evidence on the effect of intra-articular administration of local anesthesia on the range of motion of the mandible. Therefore, in the current state of knowledge, the administration of local anesthetics into the temporomandibular joint cavities can only be considered as a short-term pain relief measure. [ABSTRACT FROM AUTHOR]

Background: Peribulbar anesthesia had been developed as a safer, easier, and effective alternative to retrobulbar anesthesia that provides ocular akinesia and anesthesia. Objective: This study aimed to compare the efficacy of mepivacaine 3% - lidocaine 2% hyaluronidase mixture with that of bupivacaine 0.5% - lidocaine 2% - hyaluronidase to produce optimal operative and post-operative conditions in patients receiving single peribulbar injection for cataract surgery. Patients and Methods: In this randomized, double -blind study, 90 adult patients were assigned to one of two groups (M and B), each comprising 45 patients. Study participants received 6-8 ml combination of equal parts of either mepivacaine 3% (Group M) or bupivacaine 0.5% (Group B) both with lidocaine 2% and hyaluronidase 25 IU/ml. Akinesia was assessed with a 12-point scale at 2, 5, 10 and 15 min after injection. Onset of sensory block, time to start surgery, pain and requirement for supplemental injection were also assessed. Results: Group M showed better akinesia scores than Group B and the onset of globe akinesia and sensory block were significantly faster in Group M. The duration of globe and lid akinesia was longer in Group B (159.16 ± 5.71 min and 150.02 ± 4.42 min, respectively) than in Group M (142.89 ± 6.52 min and 135.69 ± 4.81 min, respectively) and this showed statistical significance (P < 0.001). The percentage of patients who required supplementary injection was significantly higher in Group B (7 patients) compared to that in Group M (2 patients). Conclusion: Using a mixture of mepivacaine and lidocaine gives perfect globe akinesia and quicker establishment of appropriate conditions to start cataract surgery and shortens the block onset time with faster recovery compared with the addition of bupivacaine to lidocaine in peribulbar anesthesia. [ABSTRACT FROM AUTHOR]

Background: Although most of the metabolism of local anesthetics (LAs) takes place in the liver, no study has investigated the effect of these anesthetics on the kidney function of single-kidney humans or animals. The present study was conducted to examine the effect of LAs on renal function in single-kidney rats. Materials and Methods: The present experimental animal study with two control groups was done in an animal laboratory. Forty-two rats were randomly assigned to seven groups of six rats, including two control groups and five experimental groups. The experimental groups underwent intraperitoneal anesthesia with 2% lidocaine, 2% lidocaine with 1:80,000 epinephrine, 4% articaine, 3% prilocaine with 0.03 IU Felypressin, and 3% mepivacaine, respectively. Unilateral nephrectomy was done. After 24 h, the rats' blood urea nitrogen (BUN), serum creatinine (Cr), and blood specific gravity (BSG) were measured. A standard dose of anesthetics was injected into the peritoneum for 4 days afterward. Then, these indices were measured again 24 h after the last injection. Data were analyzed using IBM SPSS (version 21.0). One-way analysis of variance, Tukey's honestly significant difference post hoc, and paired t-tests were used for statistical analysis. P < 0.05 was considered statistically significant. Results: The results indicated significant differences among groups in the rats' BUN and serum Cr 24 h after nephrectomy (P < 0.05). However, there were no significant differences in BUN, BSG, and Cr among groups after the interventions. Conclusion: LAs did not affect renal function in single-kidney rats. Therefore, dentists can use the anesthetics in single-kidney people. [ABSTRACT FROM AUTHOR]

The traditional axillary perineural (PN) approach for brachial plexus block is frequently used, but separate musculocutaneous nerve (MCN) block is required and increases procedure time and patient discomfort. We hypothesized that a block using the proximal perivascular (PPV) method at the MCN branching from the lateral cord would obviate the need for an MCN block while ensuring a quality similar to that of the PN method. For the PN group (n = 25), a needle was placed on each nerve, and 8 mL local anesthetic was infiltrated around the radial, ulnar, and median nerves (total: 24 mL). We then injected 6 mL local anesthetic around the MCN. In the PPV group (n = 25), we moved the probe proximally until the branching junction of the the MCN in the lateral cord. The needle tips were placed in the 12-o'clock and 6-o'clock positions of the axillary artery, and 15 mL local anesthetic was injected (total: 30 mL). The procedure time, number of needle passes, procedure-related complications, sensory/motor block level, and onset time were recorded. The PPV group had a significantly shorter procedure time than the PN group (3.9 ± 1.0 vs. 7.5 ± 3.3 min, p < 0.001). Furthermore, the PPV group required fewer needle passes. The PN group showed a significantly faster onset time than the PPV group (6.4 ± 2.7 vs. 10.4 ± 2.9 min, p < 0.001). The induction time did not show significant intergroup difference. Sensory blockade in the PN group occurred significantly faster than that in the PPV group at 5 and 10 min. There were no significant differences in motor nerve paralysis. PPV axillary block under ultrasound guidance was as effective as the PN axillary block. Therefore, the PPV axillary block is a simple, safe and effective regional technique for upper limb surgery. [ABSTRACT FROM AUTHOR]

In dentistry, local anesthesia is needed, especially for oral and maxillofacial surgery to reduce the sensation of pain. Besides its use as an analgesic, local anesthetics also have antibacterial activity which inhibits the growth of various bacteria. The purpose of this study was to determine the antibacterial activity of procaine and mepivacaine in inhibiting the growth of Porphyromonas gingivalis. In this study, the antibacterial activity test was carried out using the Kirby-Bauer diffusion method for ten repetitions and four treatment groups tested, 2% procaine, 3% mepivacaine, metronidazole as a positive control, and aquadest as a negative control dripped on paper discs and incubated for 24 hours. The results showed that procaine and mepivacaine had antibacterial activity with inhibition zone diameters of 9.36 mm and 8.47 mm, metronidazole 11.80 mm, and aquadest showed no inhibition diameter. The results of the research data were analyzed using the One-way ANOVA test. There was a significant difference in the diameter of the inhibition zone (p <0.05) between the four treatment. Two percent procaine and 3% mepivacaine have antibacterial activity against the growth of Porphyromonas gingivalis which is classified as a moderate inhibitory response according to David and Stout. [ABSTRACT FROM AUTHOR]

Purpose: The five-grade international scale for vesicoureteral reflux (VUR) has been the mainstay for describing VUR severity. The concept of the distal ureteral diameter to the L1--L3 vertebral body distance ratio has been validated. We validated the ureteral diameter ratio (UDR) for predicting VUR outcomes and determined the cutoff value for spontaneous resolution. Materials and Methods: This retrospective review included children with primary VUR and detailed serial voiding cystourethrograms (VCUGs) between March 2005 and December 2016. Patient characteristics, VUR grade, laterality, UDR, laboratory data, and follow-up results were collected. UDR was estimated as the largest distal ureteral diameter within the pelvis divided by the distance of the L1--L3 vertebral bodies. The primary outcome was the prediction of spontaneous VUR resolution. The secondary outcome was the determination of the cutoff value of UDR in the present cohort. Results: We recruited 101 children (59 boys and 42 girls) diagnosed as having primary VUR based on VCUGs at a mean age of 23.48 months. VUR resolved spontaneously in 31 (30.7%) children, 40 (39.6%) children had persistent disease, and 30 (29.7%) received surgical correction. In univariate analysis, laterality, VUR grade, and UDR were significantly associated with spontaneous resolution (P = 0.017, P = 0.026, and P = 0.001, respectively). Multivariate analysis revealed UDR as the prognostic factor for spontaneous VUR resolution (odds ratio, 4.167; P = 0.023). The area under the curve of UDR indicates that the prediction accuracy was 0.74. The optimal cutoff value for UDR in this study was 0.264 (sensitivity, 0.81 and specificity, 0.63). Conclusion: UDR is superior to the VUR grade for predicting spontaneous VUR resolution. Our findings add significant prognostic value for children with primary VUR. A cutoff value of 0.264 may assist with clinical assessment and future management. [ABSTRACT FROM AUTHOR]

Simple Summary: Surgical castration of piglets is generally recognized as a painful procedure. Thus, for animal welfare reasons, the German Animal Welfare Act stipulates the use of effective anesthesia during castration. However, whether local anesthesia provides adequate analgesia has been an ongoing debate in Germany. In the present study, we compared the behavior of 178 piglets allocated to various test groups in an observation arena before any of the applied procedures, after administration of the local anesthetic, and 0, 2 and 24 h after surgical castration. The local anesthetic and the injection techniques were evaluated and optimized in three sequential study parts. Overall, the results revealed that when local anesthesia was used, piglets less frequently showed pain-associated behaviors—such as changes in tail position—than piglets of the control group that had been castrated without local anesthesia. Non-castrated piglets showed the fewest pain-associated behaviors in the observation arena. In several test groups, the piglets showed changes in tail position, tail wagging, or hunched-back posture on the day following the procedure. These behaviors differed significantly from those shown before the procedure. The administration of local anesthetics in the present study considerably reduced castration-related pain. However, because local anesthesia has a limited duration of effect, adverse effects due to castration-related pain were still observable one day after castration. Surgical castration of piglets is generally recognized as a painful procedure, but there is currently no gold standard for the assessment of pain behavior in piglets. However, pain assessment is essential for evaluating the effectiveness of local anesthetics. In this study, we investigated the efficacy of four local anesthetics in terms of pain relief during and after surgical castration in three sequential study parts. To do so, we filmed 178 piglets before the applied procedures, after injection of the local anesthetic, and up to 24 h after castration (five observation times in total) in an observation arena and compared their behavior before and after castration and between treatments and control groups. The results showed significant differences in the behavior of the piglets before and after castration and between the sham-castrated control group and the control group castrated without anesthesia. The different local anesthesia treatment groups showed diverging differences to the control groups. The most frequently shown pain-associated behaviors of the piglets were changes in tail position and hunched back posture. We observed a reduction but no complete elimination of the expressed pain-associated behaviors after local anesthesia. Several behavioral changes—such as changes in tail position, hunched back posture or tail wagging—persisted until the day after castration. Owing to the limited duration of the effects of the local anesthetics, local anesthesia did not influence long-term pain. [ABSTRACT FROM AUTHOR]

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This systematic review with meta-analysis was conducted to evaluate the effectiveness of local anesthetic administration into temporomandibular joint cavities in relieving pain and increasing mandibular mobility. Randomized controlled trials were included with no limitation on report publication dates. Final searches were performed on 15 October 2023, using engines provided by the US National Library, Bielefeld University, and Elsevier Publishing House. The risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Articular pain and mandible abduction values and their mean differences were summarized in tables and graphs. Eight studies on a total of 252 patients evaluating intra-articular administration of articaine, bupivacaine, lidocaine, and mepivacaine were included in the systematic review. None of the eligible studies presented a high risk of bias in any of the assessed domains. An analgesic effect of intra-articular bupivacaine was observed for up to 24 h. In the long-term follow-up, there were no statistically significant changes in quantified pain compared to both the baseline value and the placebo group, regardless of the anesthetic used (articaine, bupivacaine, and lidocaine). There is no scientific evidence on the effect of intra-articular administration of local anesthesia on the range of motion of the mandible. Therefore, in the current state of knowledge, the administration of local anesthetics into the temporomandibular joint cavities can only be considered as a short-term pain relief measure.