Chirocaine (levobupivacaine) / Purdue, AbbVie - LARVOL DELTA

Clinical Experience With Thoracic Segmental Spinal Anesthesia in High-Risk Surgical Patients. (PubMed, Case Rep Anesthesiol) - "Each patient received isobaric levobupivacaine combined with dexmedetomidine via thoracic or thoracolumbar spinal injection. It provides excellent intraoperative conditions, avoids the systemic effects of GA, and facilitates rapid recovery. With proper technique and patient selection, TSSA offers a valuable alternative to GA in complex surgical cases."

Journal • Anesthesia • Cardiovascular • Pain

Analgesic Efficacy of Combinational Continuous Suprainguinal Fascia Iliaca Block and Pericapsular Nerve Group Block: A Retrospective Observational Study. (PubMed, Anesthesiol Res Pract) - "In 40 patients who underwent elective total hip arthroplasty via anterior approach (April, 2023-April, 2024), suprainguinal fascia iliaca block and PENG block were performed with 25 mL of 0.2% levobupivacaine before induction of general anesthesia...In the remaining 17 patients, rebound pain was observed in 2 (12% [95% confidence interval: 0%-27%]). We conclude that in the patients who underwent total hip arthroplasty via anterior approach, combinational use of continuous suprainguinal fascia iliaca block and PENG block may frequently be insufficient to prevent postoperative acute pain but may be effective in reducing the incidence of rebound pain."

Journal • Observational data • Retrospective data • Anesthesia • Orthopedics • Pain

Co-crystals of highly and poorly soluble local anesthetics bidirectionally regulate their release for long-acting analgesia. (PubMed, J Control Release) - "Here we reported a co-crystal strategy for two local anesthetics, i.e., highly soluble QX314-OH and poorly soluble levobupivacaine, based on designer self-assembling peptide nanoparticles...This study provided an effective strategy to bidirectionally regulate the release of drugs with different solubility. It also introduced a promising long-acting anesthetic formulation for pain control in clinical practice."

Journal • Anesthesia • Pain

Levobupivacaine Administration Suppressed Cell Metabolism in Human Adenocarcinoma A549 Cells. (PubMed, Int J Mol Sci) - "The RT-PCR results indicated that the expressions of B-cell/CLL lymphoma 2 (BCL2) and wingless/integrated 1 (WNT1) were reduced after levobupivacaine treatment, but these effects were reversed with ACE2 siRNA induction. The administration of levobupivacaine suppressed A549 cell metabolism and downregulated HIF-1α, MMP-9, WNT1, EGFR, and BCL2 in an ACE2-dependent manner."

IO biomarker • Journal • Anesthesia • Chronic Lymphocytic Leukemia • Hematological Malignancies • Lung Adenocarcinoma • Lung Cancer • Lymphoma • Non Small Cell Lung Cancer • Oncology • Solid Tumor • BCL2 • CTNNB1 • EGFR • HIF1A • MMP9

Local anesthetic levobupivacaine promotes hip-fracture healing by targeting HIF/Ca2+signaling. (PubMed, Clinics (Sao Paulo)) - "Levobupivacaine facilitates bone healing by promoting migration and proliferation of BMSCs through activating HIF-1α/Ca2+ signaling. These findings identify the clinical potential of levobupivacaine in the treatment of bone fractures."

Journal • Anesthesia • Musculoskeletal Diseases • Orthopedics • HIF1A • THY1

Ultrasound-responsive phase-transitional nanomedicine enables intensity-tunable postoperative analgesia. (PubMed, Front Bioeng Biotechnol) - "Here we report a theranostic nanoplatform, Rg3-liposomes@DMSN-levobupivacaine-PFP (RDLP), which integrates ultrasound-triggered phase transition, contrast-enhanced ultrasound (CEUS) imaging, and intensity-tunable drug release to address these limitations...RDLP bridges imaging guidance and therapeutic intervention, leveraging ultrasound's deep tissue penetration and Rg3's natural biocompatibility to overcome limitations of conventional nerve blocks and ultrasound-responsive systems. This non-invasive, adjustable strategy offering potential to reduce opioid reliance and improve patient outcomes in perioperative care."

Journal • Anesthesia • Pain

Using Ropivacaine for Pain Control During Carotid Artery Surgery (ANZCTR) - P4 | N=60 | Not yet recruiting | Sponsor: UHC Sestre milosrdnice

New P4 trial • Anesthesia • Cardiovascular • Pain

Which Analgesic Should We Use to Relieve Pain After Knee or Hip Arthroplasty? A Systematic Review and Network Meta-analysis of RCTs. (PubMed, Clin Orthop Relat Res) - "For knee arthroplasty, local levobupivacaine appeared to be the most effective option. For hip arthroplasty, local ropivacaine combined with ketorolac and adrenaline appeared the best. In terms of functional improvement, nerve-block levobupivacaine combined with dexmedetomidine (used under monitored conditions) appeared the most effective after knee arthroplasty. Although most interventions had similar safety profiles, intravenous tramadol combined with metoclopramide decreased the risk of nausea. Clinicians should integrate these results with known safety profiles and patient-specific factors to guide individualized postoperative pain management after knee and hip arthroplasties."

Journal • Retrospective data • Musculoskeletal Pain • Orthopedics • Pain

Epidural labor analgesia in a pregnant woman with symptomatic recurrence of myelin oligodendrocyte glycoprotein antibody-associated disease: a case report. (PubMed, JA Clin Rep) - "Labor epidural analgesia provided effective pain control and was associated with symptom relief in a parturient with active MOGAD."

Journal • Anesthesia • CNS Disorders • Obstetrics • Pain • Solid Tumor

Local Anesthetic Systemic Toxicity Caused by Non-Anesthesiologists: A Narrative Review of Case Reports. (PubMed, J Korean Med Sci) - "These findings suggest that subcutaneous infiltration or topical administration of lidocaine overdoses by non-anesthesiologists, particularly in patients with or without risk factors for LAST, significantly contributes to LAST. Preventive strategies, including education on maximum recommended doses of local anesthetics, identification of patient risk factors for LAST, utilization of ultrasound-guided nerve blocks, and ensuring the availability of lipid emulsion treatment, should be emphasized. Lipid emulsions ought to be readily accessible for the management of LAST in all locations where local anesthetics are used."

Journal • Review • Anesthesia • Cardiovascular • CNS Disorders • Epilepsy • Pain

Efficacy of ultrasound-guided bilateral pecto-intercostal fascial plane block as a pre-emptive analgesic adjunct in patients undergoing cardiac surgery: A randomized, double-blinded study. (PubMed, J Anaesthesiol Clin Pharmacol) - "PIFB group (n = 45): received bilateral ultrasound-guided bilateral PIFB with 0.5% levobupivacaine and 2...The primary outcome of the study was to assess the effectiveness of PIFB on the requirement of intraoperative and postoperative fentanyl...No complications were noted in either group. Ultrasound-guided PIFB is very effective as a pre-emptive analgesic adjunct for sternotomy pain in patients undergoing cardiac surgery."

Clinical • Journal • Anesthesia • Cardiovascular • Pain

A single-center, randomized, double-blind, positive-controlled Phase II clinical study evaluating the preliminary efficacy, safety, and pharmacokinetic profile of levobupivacaine and 2-hydroxyethyl lidocaine aminium bromide injection (development code: LL10) for postoperative analgesia in patients undergoing elective surgery. (ChiCTR) - P2 | N=50 | Not yet recruiting | Sponsor: West China Hospital, Sichuan University; West China Hospital of Sichuan University

New P2 trial • Pain

A Comparative Study of Intrathecal Hyperbaric Levobupivacaine with Fentanyl versus Hyperbaric Ropivacaine with Fentanyl for Infra-Umbilical Surgeries in Adult Patients. (PubMed, J Pharm Bioallied Sci) - "Rescue analgesia timing and side effects were comparable. Both drugs are effective, but ropivacaine ensures quicker recovery, while levobupivacaine provides longer pain relief."

Journal • Anesthesia • Pain

A NEAR-FATAL CASE OF LOCAL ANESTHETIC SYSTEMIC TOXICITY: RAPID RECOGNITION AND SUCCESSFUL RESUSCITATION (CHEST 2025) - "Preoperative cardiac evaluation deemed her low risk, with a normal She received epidural injections of Liposomal Bupivacaine and Ropivacaine during the Surgery...She was extubated on postoperative day (POD) 1 and weaned off Epinephrine by POD 2...Severe toxicity remains a concern, particularly with bupivacaine, a racemic mixture known for its high cardiac and CNS toxicity compared to ropivacaine or levobupivacaine [2].LAST occurs when local anesthetics reach systemic circulation, leading to sodium channel blockade in the heart and CNS... This case underscores the importance of vigilance when using local anesthetics, particularly in high-risk populations, and highlights lipid emulsion therapy as a life-saving intervention."

Clinical • Anesthesia • Cardiovascular • CNS Disorders • Epilepsy • Hepatitis C • Hepatology • Hypertension • Hypotension • Infectious Disease • Inflammation • Liver Failure • Metabolic Disorders • Musculoskeletal Diseases • Orthopedics

Impact of pectoralis nerve block (pecs) on postoperative pain in patients submitted to mastectomy with lymphadenectomy (ESSO 2025) - "The objectives are to evaluate the effectiveness of PECS alone in pain control compared to the use of intravenous analgesics in the postoperative of mastectomy with lymphadenectomy, consumption of opioids in 24h and the efficacy of ropivacaine/levobupivacaine.Material and methods Randomized controlled study an oncology hospital. There was a low rate of complications such as PONV in both groups.Conclusions (For surgical proposals, write down NA) It was not possible to demonstrate the benefits of performing the pectoralis nerve block technique (PECS) in patients undergoing mastectomy with lymphadenectomy for breast cancer treatment. Registration: Registered with the Brazilian Clinical Trials Registry (http://ensaiosclinicos.gov.br)."

Clinical • Anesthesia • Breast Cancer • Pain • Solid Tumor

Intravenous lipid emulsions do not enhance recovery from ventricular repolarisation disturbances induced by levobupivacaine (ASA 2025) - "Levobupivacaine induced significant changes in ventricular repolarization parameters. In our experimental model, lipid emulsions did not facilitate recovery from the cardiotoxic alterations of levobupivacaine."

Anesthesia • Cardiovascular

Adductor Canal Block for Pain Management in Chronic Knee Osteoarthritis: A Systematic Review and Meta-Analysis (ASA 2025) - "Local anesthetics varied: four studies used bupivacaine, one levobupivacaine, and two lidocaine... The ACB may provide significant short-term pain relief in chronic knee osteoarthritis, particularly when used with adjuvants, making it a promising non-surgical option for pain management. However, its efficacy at 3 months remains uncertain due to heterogeneity in the data, although sensitivity analysis suggests potential benefits. Further high-quality RCTs are needed to confirm its long-term efficacy and optimize treatment protocols."

Retrospective data • Review • Anesthesia • Immunology • Osteoarthritis • Pain • Rheumatology

Functional Outcomes of Adductor Canal Block in Knee Osteoarthritis: A Meta-analysis (ASA 2025) - "All ACBs were performed under ultrasound guidance, with local anesthetics varying: four studies used bupivacaine, one levobupivacaine, and two lidocaine... ACB enhances short-term mobility in KOA, as shown by TUG improvement. Broader functional outcomes showed no significant short-term effects, but KOOS QoL improved at three months, suggesting mid-term benefits. ACB may serve as a non-surgical alternative for KOA, but further high-quality RCTs are needed to confirm long-term efficacy."

Retrospective data • Anesthesia • Immunology • Osteoarthritis • Pain • Rheumatology

Delayed-Onset Postsurgical Myofascial Pain Following Axillary Artery Cannulation: A Case Report. (PubMed, Cureus) - "Treatment included pregabalin, ultrasound-guided trigger point injections (TPIs) with levobupivacaine and triamcinolone, and type II pectoral nerve blocks. Five biweekly sessions led to significant pain relief, resolution of allodynia, and improved posture. This case highlights the importance of recognizing delayed-onset MPS as a musculoskeletal manifestation of CPSP following axillary artery cannulation, likely related to localized muscle trauma and pectoral nerve injury, and supports the value of multimodal management."

Journal • Fibromyalgia • Musculoskeletal Diseases • Musculoskeletal Pain • Pain

Effect of ultrasound-guided fascia iliaca compartment block on pain management in hip fracture patients: A double-blind placebo-controlled randomized clinical trial. (PubMed, Medicine (Baltimore)) - "Single-shot UG-FICB did not reduce 6 hours morphine consumption, but delayed first opioid use and allowed one quarter of patients to remain opioid-free. Larger adequately powered trials are required."

Clinical • Journal • CNS Disorders • Infectious Disease • Musculoskeletal Diseases • Novel Coronavirus Disease • Orthopedics • Pain

EFFECTIVENESS OF INTRAUTERINE ANESTHESIA ON PAIN MANAGEMENT DURING IUD INSERTION: SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS (FIGO 2025) - "Anesthetic agents used were lidocaine, levobupivacaine, and mepivacaine. Intrauterine anesthesia infusions slightly reduce pain during IUD insertion but do not provide substantial pain relief post-procedure. Therefore, intrauterine anesthesia infusions may be a preferred strategy to improve patient comfort during IUD placement."

Retrospective data • Review • Anesthesia • Long-acting Reversible Contraceptives • Pain

Regional Nerve Block for Hip Fracture Surgery in an Elderly Patient With Severe Aortic Stenosis: A Case Report. (PubMed, Cureus) - "A total of 35 mL of levobupivacaine at a concentration of 0.25% was applied for the PNB, after which complete anesthesia of the left hip and thigh region was achieved. Six hours after surgery, the pain score measured by a numeric rating scale was 3; analgesia was maintained with paracetamol and a reduced dose of metamizole intravenously. PNB achieves adequate conditions for trochanteric fracture surgery and postoperative analgesia, while preserving hemodynamic stability, which enables early rehabilitation and better recovery after surgery."

Journal • Anesthesia • Cardiovascular • Chronic Kidney Disease • Hypertension • Musculoskeletal Diseases • Nephrology • Orthopedics • Pain • Renal Disease

Postoperative erector spinae plane block does not reduce morphine consumption after lumbar spinal fusion: A randomized controlled trial. (PubMed, J Clin Anesth) - P4 | "Although postoperative bilateral ultrasound-guided ESPB provided statistically significant improvements in early pain scores and mobilization, these differences did not translate into reduced morphine consumption or meaningful clinical benefits in patients undergoing lumbar spinal fusion surgery. The optimal role of this technique in spine surgery remains to be determined."

Clinical • Journal • Anesthesia • Orthopedics • Pain

Early epidural analgesia for the preoperative management of suspected spontaneous pheochromocytoma rupture: a case report. (PubMed, JA Clin Rep) - "This case illustrates the potential utility of early epidural analgesia in the preoperative management of pheochromocytoma, particularly in patients with refractory abdominal pain and limited opioid tolerance."

Journal • Cardiovascular • Constipation • Gastroenterology • Gastrointestinal Disorder • Hypertension • Oncology • Pain • Solid Tumor

Intertransverse process block to improve quality of recovery and pain management in cardiac surgery: Protocol for a double-blinded randomized controlled trial. (PubMed, PLoS One) - P=N/A | "Current pain management strategies often rely heavily on opioids, which can have significant side effects and may not adequately address chronic postsurgical pain. This study investigates the efficacy of the intertransverse process block, a novel regional anesthesia technique, in reducing both acute and chronic postsurgical pain in cardiac surgery. Randomized controlled trials on intertransverse process block in cardiac surgery are limited. The results of this study will help define the role of intertransverse process block on the recovery process, and generate vital preliminary data on its potential long-term benefits in reducing chronic postsurgical pain in cardiac surgical population."

Clinical • Clinical protocol • Journal • Anesthesia • Cardiovascular • Pain