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Biomedical subjects

B Locker

Publications and source records attributed to B Locker.

23 records · Page 2Linked to original sources
PubMed1985

Monitoring serum bupivacaïne levels during arthroscopy.

Arthroscopy was carried out after subcutaneous injection of lignocaïne to produce local anaesthesia, using controlled pressure-irrigation with bupivacaïne, followed by final rinsing with an isotonic solution. This procedure, which was painless for the patient and had no systemic toxic effects, gave very good distension of the joint and clear visualization of its structure. A sharp peak in the serum bupivacaïne level (Cmax: 76.2 ng/ml) was observed only 5 min after the start of the irrigation, which was attributed to synovial resorption. This was followed by a slight increase in blood concentration 4 to 5 h after the end of the arthroscopy, probably as a result of absorption by the peripheral soft tissues. Bupivacaïne concentrations never exceeded 350 ng/ml (much lower than the toxic level). The drug persisted in blood for 36 to 48 h (terminal half-life 12.1 h).

Adult↗
PubMed1985

Prilocaine in arthroscopy: clinical pharmacokinetics and rational use.

Prilocaine pharmacokinetics were determined in 60 patients receiving the drug by two different routes of administration (intra-articular and subcutaneous) during arthroscopy under local anesthesia with controlled pressure irrigation. Resorption of prilocaine by subcutaneous tissues was slow and did not lead to high serum levels. On the contrary, prilocaine resorption by the synovium was fast and induced a sharp serum peak (265.8 +/- 163.5 ng/ml) in the hour after the end of the examination. The drug was completely eliminated from the blood after 24 hours, as the prilocaine t1/2 is about 5 hours. The first procedure was perfected to reduce the risk of methemoglobinemia, which occurred in four of 105 patients. Applied pressure was lowered to 100 mm Hg to prevent the escape of anesthetic solution into the soft tissue of the leg, the prilocaine concentration was reduced to 1 gm/L, and the arthroscope was only set up after a delay to allow the intra-articular anesthetic effect of prilocaine to become established. So far, 200 arthroscopies have been performed with this improved protocol without any problem.

Adolescent↗
PubMed1982

[Arthroscopy of the knee. Diagnostic value. 1005 cases].

The authors have performed 1 005 arthroscopies of the knee for diagnostic purposes. The exploratory method has made it possible to correct the initial diagnosis in 50% of the cases, to avoid arthrotomy in 10% and to suggest surgery in 9%. The most common cause of error was the radioclinical confusion between patellar and medial meniscus symptoms. The most frequent associated lesions were patellar chondropathy (73%), condylar chondropathy (33%) and middle patellar folds (34%).

Anesthesia, Local↗