bupivacaine and Paralysis studies

Bupivacaine: A widely used local anesthetic agent.
1-butyl-N-(2,6-dimethylphenyl)piperidine-2-carboxamide : A piperidinecarboxamide obtained by formal condensation of the carboxy group of N-butylpipecolic acid with the amino group of 2,6-dimethylaniline.
bupivacaine : A racemate composed of equimolar amounts of dextrobupivacaine and levobupivacaine. Used (in the form of its hydrochloride hydrate) as a local anaesthetic.

Paralysis: A general term most often used to describe severe or complete loss of muscle strength due to motor system disease from the level of the cerebral cortex to the muscle fiber. This term may also occasionally refer to a loss of sensory function. (From Adams et al., Principles of Neurology, 6th ed, p45)

Research Excerpts

Excerpt	Relevance	Reference
" We report a case of prolonged femoral nerve palsy secondary to liposomal bupivacaine use during wound infiltration after inguinal herniorrhaphy."	7.83	Inadvertent Prolonged Femoral Nerve Palsy After Field Block with Liposomal Bupivacaine for Inguinal Herniorrhaphy. ( Amundson, A; Kopp, S; Olsen, D, 2016)
" In this report, we present the case of a 39-year-old man who experienced severe, transient hypokalemic paralysis in the context of TPI therapy with methylprednisolone, bupivacaine, and epinephrine."	3.85	A Case of Trigger-Point Injection-Induced Hypokalemic Paralysis. ( Bhattarai, M; Hudali, TH; Soriano, PK; Vogler, CN, 2017)
" We report a case of prolonged femoral nerve palsy secondary to liposomal bupivacaine use during wound infiltration after inguinal herniorrhaphy."	3.83	Inadvertent Prolonged Femoral Nerve Palsy After Field Block with Liposomal Bupivacaine for Inguinal Herniorrhaphy. ( Amundson, A; Kopp, S; Olsen, D, 2016)
" She developed post-dural puncture headache (PDPH) on the third postpartum day which was managed by palliative measures: bed rest (patient's position of choice), increased hydration (water: 3 litres po per day), lysine acetyl salicylate (5."	3.70	Unilateral trigeminal and facial nerve palsies associated with epidural analgesia in labour. ( Agustí, M; Carrero, EJ; Fábregas, N; Fernández, C; Valldeoriola, F, 1998)
" One minute after performing a second stellate ganglion block the patient showed signs of apnea and paralysis of the upper extremities and face, with no involvement of oculomotor muscles or the lower extremities, and no loss of consciousness."	3.70	[A possibility of central diffusion during stellate ganglion blockade: "the sheath of the spinal rachidian nerve"]. ( Escudero, A; Fas, MJ; Ortiz, M; Roca, G; Soriano, C; Vidal, F, 1999)
"We describe a case of transitory monoplegia following obstetric epidural anaesthesia which we believe to be either due to direct trauma to the nerve roots or radicular artery spasm resulting in spinal cord ischaemia both secondary to the epidural catheter."	2.40	Monoplegia following obstetric epidural anaesthesia. ( Cheong, KF; Loo, CC, 1997)

Research

Studies (35)

Authors

Clinical Trials (2)

Trial Overview

Trial Outcomes

Forced Expiratory Volume in 1 Sec (FEV1)

Timeframe	Studies, this research(%)	All Research%
pre-1990	12 (34.29)	18.7374
1990's	14 (40.00)	18.2507
2000's	5 (14.29)	29.6817
2010's	4 (11.43)	24.3611
2020's	0 (0.00)	2.80

Authors	Studies
Soriano, PK	1
Bhattarai, M	1
Vogler, CN	1
Hudali, TH	1
Olsen, D	1
Amundson, A	1
Kopp, S	1
Chaudhri, BB	1
Macfie, A	1
Kirk, AJ	1
Joannides, AJ	1
Santarius, T	1
Fernandes, HM	1
Laing, RJ	1
Trivedi, RA	1
Meyer, MJ	1
Krane, EJ	1
Goldschneider, KR	1
Klein, NJ	1
Shivashanmugam, T	1
Kundra, P	1
Sudhakar, S	1
Varela, C	1
Palacio, F	1
Reina, MA	1
López, A	1
Benito-León, J	1
Katsumata, K	1
Seki, H	1
Kaneda, T	1
Evans, PJ	1
Lloyd, JW	1
Wood, GJ	1
Maione, M	1
Mazzi, C	1
Nannicini, P	1
Soni, N	1
Holland, R	1
Holmboe, J	1
Kongsrud, F	1
Purnell, RJ	1
Ravindran, RS	1
Turner, MS	1
Muller, J	1
Nicholson, A	1
O'Hanlon, J	1
Allen, RW	1
Parris, WC	1
Kirshner, HS	1
Lauder, GR	1
Derrick, JL	1
Aun, CS	1
Sharrock, NE	1
Hotchkiss, R	1
Ennis, WJ	1
Weiland, A	1
Bisby, MA	1
Tetzlaff, W	1
Brown, MC	1
Loo, CC	1
Cheong, KF	1
Carrero, EJ	1
Agustí, M	1
Fábregas, N	1
Valldeoriola, F	1
Fernández, C	1
Uefuji, T	1
Yamauchi, Y	1
Abe, S	1
Sudo, S	1
Kimura, S	1
Nagaro, T	1
Arai, T	1
Soriano, C	1
Ortiz, M	1
Fas, MJ	1
Escudero, A	1
Roca, G	1
Vidal, F	1
Möllmann, M	1
Cord, S	1
Holst, D	1
Auf der Landwehr, U	1
Forrester, DJ	1
Mukherji, SK	1
Mayer, DC	1
Spielman, FJ	1
Benumof, JL	1
Winnie, AP	1
La Vallee, DA	1
Pe Sosa, B	1
Masud, KZ	1
Otto, CW	1
Wall, CL	1
Blunt, RJ	1
Vrbová, G	1
Li, DF	1
Bahar, M	1
Cole, G	1
Rosen, M	1
Bashein, G	1
Robertson, HT	1
Kennedy, WF	1
Roy-Shapira, A	1
Amoury, RA	1
Ashcraft, KW	1
Holder, TM	1
Sharp, RJ	1

Trial	Phase	Enrollment	Study Type	Start Date	Status
A Comparison of Ultrasound-assisted Paravertebral Block and General Anesthesia for Outpatient Breast Cancer Surgery, a Prospective Randomized Trial[NCT00645138]	Phase 3	40 participants (Anticipated)	Interventional	2008-04-30	Completed
Comparison Of Ultrasound-Assisted Paravertebral Block And Traditional Paravertebral Block For Pain Control After Thoracic Surgery, A Prospective Randomized Trial[NCT01949480]		45 participants (Actual)	Interventional	2013-07-01	Completed
[information is prepared from clinicaltrials.gov, extracted Sep-2024]

Forced expiratory volume in 1 sec (FEV1) preoperatively and at 24 - hour interval. Then the values were analyzed as percentage in change from per-surgery measurement (post-surgery/pre-surgery). (NCT01949480)
Timeframe: Preoperatively and postoperatively

Forced Vital Capacity (FVC)

Intervention	percentage in change from per-surgery (Mean)
Traditional Approach Paravertebral Nerve Block	0.561
Ultrasound Assisted Paravertebral Nerve Block	0.571

Forced vital capacity (FVC) measured preoperatively and at 24 - hour interval. Then values were analyzed as percentage in change from per-surgery measurement (post-surgery/pre-surgery). (NCT01949480)
Timeframe: Preoperatively and postoperatively

Incentive Spirometry

Intervention	percentage in change from per-surgery (Mean)
Traditional Approach Paravertebral Nerve Block	0.551
Ultrasound Assisted Paravertebral Nerve Block	0.504

Inspiratory Volume as measured by incentive spirometer preoperatively and at 24 hours post PCA initiation. The data is reported as a percentage in change from per-surgery measurements (post-surgery/pre-surgery). (NCT01949480)
Timeframe: Preoperatively and Postoperatively

Inspired Oxygen Concentration and Blood Oxygen Saturation (SpO2)

Intervention	percentage in change from per-surgery (Mean)
Traditional Approach Paravertebral Nerve Block	0.658
Ultrasound Assisted Paravertebral Nerve Block	0.716

Inspired oxygen concentration and SpO2 preoperatively and at 24 - hour interval. Value reported is an average of the preoperative and the 24-hour postoperative SpO2 measurements. (NCT01949480)
Timeframe: Pre-operatively and at 24 hour post-operative

Number of Local Anesthetic Boluses Requested by PCA

Intervention	Percentage of SpO2 (Mean)
Traditional Approach Paravertebral Nerve Block	95
Ultrasound Assisted Paravertebral Nerve Block	94

The number of local anesthetic boluses over 24- hour period post PCA initiation will also be recorded. (NCT01949480)
Timeframe: 24 hours postoperatively

Opioid Consumption at 24 Hours Postoperatively

Intervention	Number of boluses requested (Mean)
Traditional Approach Paravertebral Nerve Block	27.5
Ultrasound Assisted Paravertebral Nerve Block	48

Hydromorphone (Dilaudid) consumption or opiate equivalent at 24-hour interval post PCA initiation at the post-anesthesia care unit (PACU). (NCT01949480)
Timeframe: 24 hours after patient-controlled analgesia (PCA) was initiated

Peak Expiratory Flow Rate(PEF)

Intervention	mg (Mean)
Traditional Approach Paravertebral Nerve Block	5.75
Ultrasound Assisted Paravertebral Nerve Block	6.38

Peak expiratory flow rate preoperatively (PEF) and at 24 - hour interval. Then values were analyzed as percentage in change from per-surgery measurement (post-surgery/pre-surgery). (NCT01949480)
Timeframe: Preoperatively and postoperatively

Respiratory Rate

Intervention	percentage in change from per-surgery (Mean)
Traditional Approach Paravertebral Nerve Block	0.568
Ultrasound Assisted Paravertebral Nerve Block	0.542

Respiratory rate (RR) per minute after surgery. (NCT01949480)
Timeframe: 24 hours postoperatively

Sensory Level

Intervention	breaths per one minute (Mean)
Traditional Approach Paravertebral Nerve Block	17
Ultrasound Assisted Paravertebral Nerve Block	17.7

Sensory level as assessed by temperature and pin prick test assessed every 5 min for 30 min after nerve block as defined as the patient returning to their bed. Data below are in number of patients who didn't have any change during the ice and pin prik test. (NCT01949480)
Timeframe: 6 assessments starting 5 minutes after nerve block and ending 30 minutes after nerve block.

Total Local Anesthetic Infusions Over 24- Hour Period

Intervention	Participants (Count of Participants)
Traditional Approach Paravertebral Nerve Block	3
Ultrasound Assisted Paravertebral Nerve Block	1

The total local anesthetic infusions over 24- hour period. (NCT01949480)
Timeframe: 24 hours postoperatively

Total Number of Local Anesthetic Boluses in 24 Hours

Intervention	mL (Mean)
Traditional Approach Paravertebral Nerve Block	173
Ultrasound Assisted Paravertebral Nerve Block	186

Total Number of Local Anesthetic bolus doses given within the 24-hours post-operatively. (NCT01949480)
Timeframe: postoperatively, up to 24 hours

Pain 11-point Numerical Rating Scale (NRS)at Rest and With Deep Breathing

Intervention	number of boluses (Mean)
Traditional Approach Paravertebral Nerve Block	1
Ultrasound Assisted Paravertebral Nerve Block	2

The pain level assessed using an 11-point numerical rating scale (NRS) with 0 indicating no pain and 10 indicating the worst pain possible with deep breathing and rest at 24 hours post PCA initiation. (NCT01949480)
Timeframe: 24 hours post PCA initiation

Intervention	units on a scale (Mean)
	NRS at rest after 24 hrs	NRS during deep inspiration at 24 hrs
Traditional Approach Paravertebral Nerve Block	1.73	4
Ultrasound Assisted Paravertebral Nerve Block	2.92	4.77

Article	Year
A Case of Trigger-Point Injection-Induced Hypokalemic Paralysis. The American journal of case reports, 2017, Apr-26, Volume: 18 Topics: Adult; Anesthetics, Local; Bupivacaine; Glucocorticoids; Humans; Hypokalemia; Injections, Intramuscu	2017
Inadvertent Prolonged Femoral Nerve Palsy After Field Block with Liposomal Bupivacaine for Inguinal Herniorrhaphy. A & A case reports, 2016, Jun-01, Volume: 6, Issue:11 Topics: Anesthetics, Local; Bupivacaine; Femoral Neuropathy; Hernia, Inguinal; Herniorrhaphy; Humans; Liposo	2016
Inadvertent total spinal anesthesia after intercostal nerve block placement during lung resection. The Annals of thoracic surgery, 2009, Volume: 88, Issue:1 Topics: Aged; Anesthesia, Spinal; Bupivacaine; Carcinoma, Non-Small-Cell Lung; Follow-Up Studies; Humans; In	2009
Transient perioperative brainstem paralysis secondary to a local anesthetic. Journal of neurosurgery. Pediatrics, 2012, Volume: 10, Issue:1 Topics: Adolescent; Anesthetics, Local; Arnold-Chiari Malformation; Brain Stem; Bupivacaine; Decompression,	2012
Case report: neurological complications associated with epidural analgesia in children: a report of 4 cases of ambiguous etiologies. Anesthesia and analgesia, 2012, Volume: 115, Issue:6 Topics: Analgesia, Epidural; Anesthesia, General; Anesthetics, Local; Bupivacaine; Child; Colitis, Ulcerativ	2012
Iliac compartment block following ilioinguinal iliohypogastric nerve block. Paediatric anaesthesia, 2006, Volume: 16, Issue:10 Topics: Anesthetics, Local; Bupivacaine; Child; Femoral Neuropathy; Hernia, Inguinal; Humans; Male; Nerve Bl	2006
[Horner's syndrome secondary to epidural anesthesia]. Neurologia (Barcelona, Spain), 2007, Volume: 22, Issue:3 Topics: Adult; Anesthesia, Epidural; Anesthesia, Obstetrical; Anesthetics, Local; Arm; Bupivacaine; Cesarean	2007
[Case of postoperative increased anesthesia level with spinal anesthesia]. Masui. The Japanese journal of anesthesiology, 2007, Volume: 56, Issue:6 Topics: Adult; Anesthesia Recovery Period; Anesthesia, Obstetrical; Anesthesia, Spinal; Bupivacaine; Cesarea	2007
Accidental intrathecal injection of bupivacaine and dextran. Anaesthesia, 1981, Volume: 36, Issue:7 Topics: Adult; Anesthesia, Epidural; Bupivacaine; Dextrans; Hernia, Inguinal; Humans; Hypotension; Injection	1981
Accidental intrathecal injection of bupivacaine and dextran. Anaesthesia, 1981, Volume: 36, Issue:7 Topics: Adult; Anesthesia, Epidural; Bupivacaine; Dextrans; Hernia, Inguinal; Humans; Hypotension; Injection	1981
Accidental intrathecal injection of bupivacaine and dextran. Anaesthesia, 1981, Volume: 36, Issue:7 Topics: Adult; Anesthesia, Epidural; Bupivacaine; Dextrans; Hernia, Inguinal; Humans; Hypotension; Injection	1981
Accidental intrathecal injection of bupivacaine and dextran. Anaesthesia, 1981, Volume: 36, Issue:7 Topics: Adult; Anesthesia, Epidural; Bupivacaine; Dextrans; Hernia, Inguinal; Humans; Hypotension; Injection	1981
[Accidental dural puncture the execution of a peridural block with a 0.50% bupivacaine-fentanyl combination]. Minerva anestesiologica, 1983, Volume: 49, Issue:5 Topics: Anesthesia, Spinal; Bupivacaine; Dura Mater; Female; Fentanyl; Humans; Iatrogenic Disease; Middle Ag	1983
An extensive lumbar epidural block. Anaesthesia and intensive care, 1981, Volume: 9, Issue:2 Topics: Adolescent; Anesthesia, Epidural; Anesthesia, Obstetrical; Bupivacaine; Female; Humans; Injections,	1981
Delayed respiratory arrest after bupivacaine. Anaesthesia, 1982, Volume: 37, Issue:1 Topics: Anesthesia, Epidural; Bupivacaine; Hernia, Inguinal; Humans; Male; Middle Aged; Muscular Diseases; P	1982
Scoliosis correction and epidural analgesia. Prolonged block following Harrington rod insertion. Anaesthesia, 1982, Volume: 37, Issue:11 Topics: Anesthesia, Epidural; Bupivacaine; Child; Female; Humans; Methods; Orthopedic Fixation Devices; Para	1982
Neurologic effects of subarachnoid administration of 2-chloroprocaine-CE, bupivacaine, and low pH normal saline in dogs. Anesthesia and analgesia, 1982, Volume: 61, Issue:3 Topics: Anesthesia, Epidural; Animals; Bupivacaine; Dogs; Hydrogen-Ion Concentration; Injections; Paralysis;	1982
Painless epidural haematoma. Anaesthesia and intensive care, 1994, Volume: 22, Issue:5 Topics: Aged; Aged, 80 and over; Anesthesia, Epidural; Bupivacaine; Fatal Outcome; Female; Hematoma, Epidura	1994
Inadvertent spinal block during epidural analgesia in an anaesthetized patient. European journal of anaesthesiology, 1994, Volume: 11, Issue:2 Topics: Accidents; Adult; Analgesia, Epidural; Anesthesia, General; Bupivacaine; Female; Humans; Nerve Block	1994
Motor paralysis of the lower extremities following lumbar sympathetic block. Anesthesiology, 1993, Volume: 78, Issue:5 Topics: Adult; Autonomic Nerve Block; Back Pain; Bupivacaine; Humans; Leg; Lumbosacral Region; Male; Paralys	1993
Interpleural analgesia and phrenic nerve paralysis. Anaesthesia, 1993, Volume: 48, Issue:4 Topics: Analgesia; Bupivacaine; Cholecystectomy; Female; Humans; Middle Aged; Pain, Postoperative; Paralysis	1993
Transient femoral nerve palsy after ilioinguinal block. Anaesthesia and intensive care, 1996, Volume: 24, Issue:1 Topics: Bupivacaine; Child; Femoral Nerve; Humans; Male; Nerve Block; Paralysis; Peripheral Nervous System D	1996
Brachial plexus surgery through the infraclavicular approach using an interscalene block. The Journal of hand surgery, 1996, Volume: 21, Issue:2 Topics: Adult; Arm; Brachial Plexus; Bupivacaine; Clavicle; Electric Stimulation; Female; Humans; Mepivacain	1996
GAP-43 mRNA in mouse motoneurons undergoing axonal sprouting in response to muscle paralysis of partial denervation. The European journal of neuroscience, 1996, Volume: 8, Issue:6 Topics: Animals; Axons; Base Sequence; Bupivacaine; GAP-43 Protein; Growth Substances; Membrane Glycoprotein	1996
Unilateral trigeminal and facial nerve palsies associated with epidural analgesia in labour. Canadian journal of anaesthesia = Journal canadien d'anesthesie, 1998, Volume: 45, Issue:9 Topics: Adult; Analgesia, Epidural; Analgesia, Obstetrical; Anesthetics, Local; Anti-Inflammatory Agents, No	1998
[Persistent neurological deficit and adhesive arachnoiditis following spinal anesthesia with bupivacaine containing preservatives]. Masui. The Japanese journal of anesthesiology, 1999, Volume: 48, Issue:2 Topics: Aged; Anesthesia, Spinal; Anesthetics, Local; Arachnoiditis; Bupivacaine; Female; Humans; Muscle Hyp	1999
[A case of Guillain-Barrè syndrome with severe sciatica preceding motor paralysis in the lower extremities]. Masui. The Japanese journal of anesthesiology, 1999, Volume: 48, Issue:2 Topics: Analgesia, Epidural; Analgesia, Patient-Controlled; Anesthetics, Local; Bupivacaine; Humans; Leg; Ma	1999
[A possibility of central diffusion during stellate ganglion blockade: "the sheath of the spinal rachidian nerve"]. Revista espanola de anestesiologia y reanimacion, 1999, Volume: 46, Issue:3 Topics: Adult; Anesthetics, Local; Apnea; Autonomic Nerve Block; Bupivacaine; Diffusion; Facial Paralysis; F	1999
Dilute infusion for labor, obscure subdural catheter, and life-threatening block at cesarean delivery. Anesthesia and analgesia, 1999, Volume: 89, Issue:5 Topics: Adult; Analgesia, Epidural; Analgesia, Obstetrical; Anesthetics, Local; Bupivacaine; Catheterization	1999
Permanent loss of cervical spinal cord function associated with interscalene block performed under general anesthesia. Anesthesiology, 2000, Volume: 93, Issue:6 Topics: Adult; Anesthesia, General; Arm; Blood Pressure; Bupivacaine; Cervical Vertebrae; Epinephrine; Exper	2000
Clinical pharmacokinetics of local anaesthetics. Canadian Anaesthetists' Society journal, 1977, Volume: 24, Issue:2 Topics: Adult; Analgesia; Anesthesia, Local; Anesthetics, Local; Bupivacaine; Humans; Kinetics; Lidocaine; M	1977
Total spinal anesthesia: a rare complication of intrathoracic intercostal nerve block. The Annals of thoracic surgery, 1976, Volume: 22, Issue:3 Topics: Bupivacaine; Female; Humans; Injections; Intercostal Nerves; Middle Aged; Nerve Block; Pain Manageme	1976
The use of local anaesthetics to produce prolonged motor nerve block in the study of denervation hypersensitivity. Pflugers Archiv : European journal of physiology, 1975, Jun-26, Volume: 357, Issue:3-4 Topics: Acetylcholine; Animals; Bupivacaine; Hindlimb; Lidocaine; Muscle Contraction; Muscles; Myelin Sheath	1975
Neurological toxicity of the subarachnoid infusion of bupivacaine, lignocaine or 2-chloroprocaine in the rat. British journal of anaesthesia, 1985, Volume: 57, Issue:4 Topics: Anesthetics, Local; Animals; Anterior Horn Cells; Bupivacaine; Lidocaine; Paralysis; Procaine; Rats;	1985
Persistent phrenic nerve paresis following interscalene brachial plexus block. Anesthesiology, 1985, Volume: 63, Issue:1 Topics: Brachial Plexus; Bupivacaine; Diaphragm; Humans; Male; Middle Aged; Movement; Nerve Block; Paralysis	1985
Transient quadriceps paresis following local inguinal block for postoperative pain control. Journal of pediatric surgery, 1985, Volume: 20, Issue:5 Topics: Bupivacaine; Child; Child, Preschool; Femoral Nerve; Hernia, Inguinal; Humans; Male; Muscular Diseas	1985

bupivacaine and Paralysis