| The toxicity of local anesthetics: the place of ropivacaine and levobupivacaine. | |
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MedLine Citation:
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PMID: 18784493 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE OF REVIEW: Ropivacaine and levobupivacaine were developed after evidence of bupivacaine-related severe toxicity. Despite a comparable analgesic profile, quantitative differences become evident with regard to their specific rate of systemic toxicity. The present article provides a concise review of the toxic potencies of levobupivacaine and ropivacaine. RECENT FINDINGS: As lipophilicity is known to be a major determinant in local anesthetic toxicity, the clinical safety profile of ropivacaine seems to be more favorable than that of levobupivacaine. Experimental studies and case reports confirm this hypothesis, showing that ropivacaine is characterized by fewer (cardio) toxic effects and, most probably, a greater margin of safety. Both agents also may dose dependently damage neurons and skeletal muscle tissue at the injection site. Although their specific rate of neurotoxicity appears to be rather low, levobupivacaine is characterized by an outstanding myotoxic potential. SUMMARY: Compared with bupivacaine, both agents may be considered as 'more well tolerated' but not as 'totally well tolerated', as they are still capable of inducing systemic and local toxicity. However, ropivacaine seems to have the greatest margin of safety of all long-acting local anesthetics at present. |
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Authors:
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Wolfgang Zink; Bernhard M Graf |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Current opinion in anaesthesiology Volume: 21 ISSN: 1473-6500 ISO Abbreviation: Curr Opin Anaesthesiol Publication Date: 2008 Oct |
Date Detail:
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Created Date: 2008-09-11 Completed Date: 2009-01-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8813436 Medline TA: Curr Opin Anaesthesiol Country: United States |
Other Details:
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Languages: eng Pagination: 645-50 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology, Emergency and Intensive Care Medicine, University of Goettingen, Goettingen, Germany. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Amides
/
adverse effects*,
pharmacology Anesthesia, Local / methods* Anesthetics, Local / adverse effects*, pharmacology Bupivacaine / adverse effects, analogs & derivatives, pharmacology Humans Therapeutic Equivalency |
| Chemical | |
Reg. No./Substance:
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0/Amides; 0/Anesthetics, Local; 0/levobupivacaine; 2180-92-9/Bupivacaine; 84057-95-4/ropivacaine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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