Direct vascular effect of ropivacaine in femoral artery and vein of the dog

A study was conducted to examine the direct vascular effect of ropivacaine, in comparison with the effect of bupivacaine and lidocaine. Changes in tension induced by ropivacaine (10^-5-3 × mol 1^-1), bupivacaine (10^-5-3 times 10^-3 mol 1^-1) and lidocaine (10^-5-10^-2 mol 1^-1) were examined cumulatively in vascular rings of dog femoral artery and vein under basal tension, or in those which had been precontracted with phenylephrine submaximally in Krebs' bicarbonate solution at 37°C aerated with 95% O₂ and 5% CO₂ (pH 7.4). The change in tension induced by lo-² moll-¹ ropivacaine was tested under basal tension in vascular rings bathed in HEPES buffer (pH 6.8). Ropivacaine induced greater constriction than bupivacaine at concentrations over 10^-5 mol 1^-1 in vascular rings under basal tension (P<0.01). The maximal contraction was induced by ropivacaine at mol 1^-1, averaging 51.5± 2.8% (n = 11) and 27.0± 3.7% (n= 12) of the maximal contraction induced by epinephrine in the artery and vein, respectively, and the contractions induced by ropivacaine at 10^-3 mol 1^-1 were 16.3± 2.0% (n=11)and 5.5± 1.1% (n=9), respectively. Phenylephrine (10^-6mol 1^-1)-precontracted artery was contracted significantly by ropivacaine at 3 times 10^-4 mol 1^-1 and mol 1^-1, and by bupivacaine at 3 times 10-³ mol 1-¹, whereas the phenylephrine 10^-6mol 1^-1)-precontracted vein was relaxed by these anesthetics. Lidocaine did not exert constricting effects. It is concluded that ropivacaine is a potent vasoconstrictor, although its constrictive effect is slight at 10^-2 mol 1^-1, which may be relevant to the clinical local concentration.     

Primary hepatic lymphoma in a patient with chronic hepatitis B

Primary hepatic lymphoma is a rare disorder and the clinical behavior remains unknown. We report a patient with primary hepatic lymphoma who had chronic hepatitis B. She was asymptomatic; however, a solitary tumor in the left lobe was incidentally detected. After left hepatic lobectomy was performed, a diagnosis of non-Hodgkin's lymphoma was made. No tumor was found except in the liver. Immunohistochemical stains for hepatitis B surface and core antigens were positive in hepatocytes; however, both were negative in the tumor tissue. The patient received no chemotherapy and the tumor relapsed. After chemotherapy, the tumor disappeared. However, exacerbation of hepatitis occurred after the fourth chemotherapy. The patient was followed up without chemotherapy, and she remains in apparent remission. Chemotherapy is effective against primary hepatic lymphoma and, if possible, patients with this disorder should be treated with chemotherapy postoperatively.