Chirocaine (levobupivacaine) / Purdue, AbbVie - LARVOL DELTA

A Prospective, Randomized Comparative Study of Intravenous and Perineural Dexamethasone as an Adjuvant to Levobupivacaine in Ultrasound-Guided Supraclavicular Brachial Plexus Block for Adult Patients Undergoing Elective Upper Limb Surgery. (PubMed, Cureus) - "Group A received 19 mL of 0.5% levobupivacaine with 1 mL of normal saline perineurally and 4 mg (1 mL) of intravenous dexamethasone. It also provides superior postoperative analgesia without increasing adverse effects. It is recommended as the preferred route for dexamethasone administration in upper limb surgeries."

Clinical • Journal • Anesthesia • Pain

Peripheral Nerve Blockade for Trimalleolar Ankle Fracture Surgery in a Third-Trimester Pregnancy: A Case Report. (PubMed, Cureus) - "For the popliteal sciatic block, 15 mL of 0.5% levobupivacaine and 10 mL of 1.3% lidocaine were administered...Also, the risk of pulmonary aspiration, hypotension, and hypoxia is avoided. Well-planned anesthesia and postoperative analgesia are essential to protect the mother and fetus."

Journal • Anesthesia • Gynecology • Hypotension • Musculoskeletal Diseases • Obstetrics • Orthopedics • Pain

Retraction notice to "Local infiltration of the surgical wounds with levobupivacaine, dexibuprofen, and norepinephrine to reduce postoperative pain: A randomized, vehicle-controlled, and preclinical study" [Biomed. Pharmacother. 92 (2017) 459-467]. (PubMed, Biomed Pharmacother) - No abstract available

Journal • Preclinical • Pain

Duration of analgesia and factors associated with block failure in ultrasound-guided ankle and popliteal/saphenous nerve blocks in elective foot and ankle surgery: A prospective observational study. (PubMed, Foot (Edinb)) - "Ultrasound-guided ankle and popliteal/saphenous blocks using levobupivacaine provided prolonged, safe, and effective analgesia. Variable soak-time appears to be a key modifiable factor influencing block reliability and warrants further investigation."

Journal • Observational data • Anesthesia • Infectious Disease • Orthopedics • Pain

EPPIL: Peritumoral and Periganglionic Infiltration of Levobupivacaine Prior to Conservative Surgery for Triple-negative Breast Cancer (clinicaltrials.gov) - P2 | N=760 | Not yet recruiting | Sponsor: Institut Jean-Godinot

New P2 trial • Breast Cancer • Oncology • Solid Tumor • Triple Negative Breast Cancer

Case Report: Local anesthetic systemic toxicity during regional anesthesia in a patient with rheumatoid arthritis. (PubMed, Front Med (Lausanne)) - "Older patients with rheumatoid arthritis may be at increased risk for LAST due to disease-related vascular permeability changes, showing the need for increased vigilance during the administration of regional anesthesia. Early diagnosis and timely administration of intravenous lipid emulsion (ILE) remain critical for the successful management of this potentially life-threatening complication."

Journal • Anesthesia • Cardiovascular • Developmental Disorders • Immunology • Inflammatory Arthritis • Musculoskeletal Diseases • Orthopedics • Rheumatoid Arthritis • Rheumatology

Clinical effectiveness of transversus abdominis plane block versus local anaesthesia wound infiltration for postoperative pain relief after laparoscopic appendicectomy in children: A multicentre, double-blind, randomised, controlled phase III trial. (PubMed, Eur J Anaesthesiol) - P=N/A | "TAP block does not appear to provide a greater opioid-sparing effect than LAWI of trocar insertion sites after laparoscopic appendicectomy in children, when combined with systemic multimodal analgesia including nonsteroidal anti-inflammatory drugs."

Journal • P3 data • Anesthesia • Pain • Pediatrics

EpiLow: Eficacy of epidural analgesia initiated with dural puncture epidural technic for labour with ultra-low concentration of levobupivacaine. (clinicaltrialsregister.eu) - P4 | N=534 | Not yet recruiting | Sponsor: Hospital Universitario La Paz

New P4 trial • Anesthesia • Obstetrics

A Study on the Analgesic Effects of Two Different Doses of Morphine Added to Intrathecal Levobupivacaine in Cesarean Section: A Randomized Double-Blind Study. (PubMed, Cureus) - "In this study, both 50 µg and 100 µg doses of intrathecal morphine provided effective and safe postoperative analgesia following elective cesarean section. However, the 100 µg dose demonstrated superior analgesia in terms of a reduced requirement for supplemental NSAIDs, rather than a difference in the time to first analgesic request. As this benefit was achieved without an increase in opioid-related side effects, 100 µg of intrathecal morphine may be the preferred dosage for post-cesarean analgesia."

Journal • Anesthesia • CNS Disorders • Depression • Dermatology • Pain • Pruritus • Psychiatry

Correlation Between Injected Volume and Cranial Spread in Broad-Aged Pediatric Caudal Anesthesia: A Retrospective Ultrasound-Guided Study. (PubMed, Local Reg Anesth) - "Volumes of 0.25% levobupivacaine required to achieve cranial spread to vertebral levels S1, L2 and L1 were recorded...Real-time ultrasound guidance enhances procedural accuracy and safety by confirming epidural spread and detecting anatomical variation. These data support development of an individualized dosing nomogram for pediatric caudal anesthesia."

Journal • Retrospective data • Anesthesia • Obesity • Pediatrics

Distal nerve blocks at the elbow for traumatic fingertip semi-amputation repair - A case report. (PubMed, Saudi J Anaesth) - "Ultrasound-guided blocks of the median, radial, and ulnar nerves at the elbow were performed with 2% Lidocaine and 0.5% Levobupivacaine...One needs to keep in mind the dermatomal distribution of innervation as other digits may not require covering all three nerves as the 4th digit does. Caution must be taken to account for any possibility of increased risk of regurgitation, as well as the use of an upper arm pneumatic tourniquet."

Journal • Anesthesia • Musculoskeletal Diseases • Obstructive Sleep Apnea • Orthopedics • Pain • Pediatrics • Respiratory Diseases • Sleep Disorder

Thoracic Spinal Anesthesia With Erector Spinae Plane Block Versus Conscious Sedation for Medical Thoracoscopy: A Comparative Pilot Study. (PubMed, Cureus) - "Conscious sedation was administered with fentanyl and midazolam in graded doses with local instillation of lignocaine 2%. TSA was administered at the T6-T7 level with 25 mcg of fentanyl and 0.5% levobupivacaine (1.5 ml), followed by ESPB with 0.25% levobupivacaine (10 ml). No block/anesthesia-related complications were reported in either group. Conclusion The combination of TSA with ESPB can be a novel, effective, and safe anesthetic technique for MT, offering better quality of recovery, improved postoperative analgesia, shorter procedure duration, and reduced perioperative morbidity."

Journal • Anesthesia • Pain

Effectiveness of repeated ultrasound-guided suprascapular nerve blocks in hemiplegic shoulder pain: A randomized controlled trial. (PubMed, Medicine (Baltimore)) - "Repeated SSNB effectively reduces pain and improves ROM in patients with HSP when combined with physiotherapy. However, it does not significantly impact spasticity or motor function. Further research with longer follow-ups and active comparators is needed to determine its long-term benefits."

Clinical • Journal • Cardiovascular • Movement Disorders • Musculoskeletal Pain • Pain

Local Anaesthetic Infiltration at Trocar Sites for Early Postoperative Pain Control in Laparoscopic Surgery. (PubMed, Cureus) - "Longer-acting agents such as bupivacaine, levobupivacaine, and ropivacaine generally yield more sustained relief than lidocaine. Although infiltration does not replace multimodal analgesia, it reliably enhances early comfort, may reduce opioid requirements, and aligns well with enhanced recovery principles. The technique is simple, low-risk, and easily integrated into routine laparoscopic practice, making it a practical adjunct for optimizing immediate postoperative recovery."

Journal • Review • Anesthesia • Pain

Ketamine Versus Magnesium Sulphate as Adjuvants for ESPB in Breast Cancer Surgery (clinicaltrials.gov) - P2 | N=60 | Completed | Sponsor: Assiut University | Active, not recruiting ➔ Completed

Trial completion • Breast Cancer • Oncology • Solid Tumor

Comparison of Dexmedetomidine In Ultrasound-Guided Supraclavicular Brachial Plexus Block Versus Intramuscular Administration In Upper Limb Surgeries. (PubMed, AANA J) - "All patients received 2% lidocaine (10 mL) + 0.5% levobupivacaine (10 mL) + normal saline (5 mL). The onset and duration of blockade were comparable between the two groups. Onset and duration of brachial plexus block are comparable whether dexmedetomidine is given perineurally or intramuscularly as an adjunct to local anesthetic."

Clinical • Journal • Anesthesia

Thoracic Intervertebral Foramen Blocks Compared to Midpoint-to-Pleura Transverse Process Blocks for the Management of Acute Rib Fracture Pain. (PubMed, Pain Physician) - "For patients with rib fractures, the CTIFB offered superior pain management, fewer requests for opioids, and better respiratory function than did the CMTPB."

Clinical • Journal • Aesthetic Medicine • Anesthesia • Critical care • Infectious Disease • Musculoskeletal Diseases • Neuralgia • Orthopedics • Pain • Pneumonia • Respiratory Diseases

Clinical study on the application of levobupivacaine liposome injection for upper trunk brachial plexus block in postoperative analgesia after shoulder arthroscopy: A single-center randomized controlled prospective study (ChiCTR) - P=N/A | N=150 | Not yet recruiting | Sponsor: Zhongnan Hospital of Wuhan University; Zhongnan Hospital of Wuhan University

New trial • Orthopedics

Comparison of Ultrasound-guided Continuous Erector Spine Plane Block and Epidural Block for Postoperative Analgesia in Laparoscopic Nephrectomy: A Prospective Interventional Study. (PubMed, Ann Afr Med) - "ESPB is a suitable and better alternative to epidural block for postoperative analgesia in laparoscopic nephrectomy, in the context of ease administration and unilateral block."

Journal • Anesthesia • Cardiovascular • Infectious Disease • Pain • Respiratory Diseases

A comparative study of clonidine and dexmedetomidine as an adjuvant to levobupivacaine for caudal analgesia in children undergoing below umbilical surgeries: A randomized double-blind controlled trial. (PubMed, Agri) - "Dexmedetomidine (1 µg/kg) added to 0.2% levobupivacaine (1 ml/kg) for caudal block provides prolonged analgesia with better sedation scores when compared to clonidine (1 µg/kg) with 0.2% levobupivacaine (1 ml/kg) for below umbilical surgeries in pediatric patients, without increasing the incidence of adverse effects. Hence, we would recommend the use of 1 µg/kg dexmedetomi-dine as an adjuvant to 0.2% levobupivacaine."

Clinical • Journal • Anesthesia • Pain • Pediatrics

Is there a benefit to adding dexamethasone to levobupivacaine in ultrasound-guided adductor canal block following anterior cruciate ligament reconstruction? (PubMed, Front Med (Lausanne)) - "Three patients in the non-dexamethasone group reported rebound pain (χ 2 = 0.2564; p = 0.61), while blood glucose levels were significantly higher in the dexamethasone group (χ 2 = 4.329; p = 0.037). The addition of dexamethasone to the local anesthetic during ACB after ACL reconstruction is not supported due to the lack of benefits related to postoperative pain levels and the associated increase in glucose levels."

Journal • Anesthesia • Pain

Ultralow concentration levobupivacaine 0.0625% for continuous wound infusion after open abdominal surgery: a prospective observational study. (PubMed, Anaesth Rep) - "Six patients (12%) required intravenous morphine rescue in the first 48 h, with a median dose of 3 mg. Continuous wound infusion with levobupivacaine 0.0625% after open abdominal surgery was feasible and associated with minimal opioid use. These findings provide preliminary evidence supporting the feasibility of an ultralow concentration regimen."

Journal • Observational data • Anesthesia • Pain

Comparison of Analgesic Efficacy of Hyperbaric Levobupivacaine With or Without Clonidine in Patients Undergoing Intramedullary Nailing for Fracture Femur Under Subarachnoid Block: A Randomised Controlled Trial. (PubMed, Cureus) - "No major side effects were observed in either of the groups except one patient (6.7%) in group LC and one patient (6.7%) in group LN developed nausea, and five patients (33.3%) in group LC and three patients (20.0%) in group LN had shivering, which was managed promptly. Conclusion Addition of 15 mcg of clonidine to 3 mL (15 mg) of 0.5% hyperbaric levobupivacaine provides a longer duration of effective analgesia with minimal side effects."

Journal • Anesthesia • Musculoskeletal Diseases • Orthopedics • Pain

Comparison of levobupivacaine versus ketamine and levobupivacaine for ultrasound-guided adductor canal block in patients undergoing unilateral total knee replacement: A randomized, double-blinded study. (PubMed, J Anaesthesiol Clin Pharmacol) - "Patients in Group L had significantly higher numerical rating scale compared to Group LK at rest at 4, 6, and 12 h and on movement at 2, 4, 6, and 12 h postoperatively. The addition of ketamine to levobupivacaine in ACB resulted in prolongation of the pain-free interval, decreased requirement for rescue analgesia, and better pain control during rest and movement."

Clinical • Journal • Musculoskeletal Diseases • Orthopedics • Pain

Effect of different doses of intrathecal morphine on postoperative fentanyl consumption in open live donor hepatectomy - A double-blind, randomized controlled trial. (PubMed, J Anaesthesiol Clin Pharmacol) - "Group C exhibited a higher incidence of side effects when compared to groups B and A, respectively (35 vs. 13 vs. 5, P < 0.001). A dose of 200 μg of ITM provides effective postoperative pain control in patients undergoing open live donor hepatectomy and results in fewer opioid-related side effects, compared to 300 and 400 μg doses."

Journal • Anesthesia • Pain • Transplantation