Safety and Pharmacokinetics of Levobupivacaine Following Fascia Iliaca Compartment Block in Elderly Patients.

BACKGROUND: Fascia iliaca compartment block (FICB) is an increasingly popular analgesic technique in elderly patients with hip fracture. Despite requiring large volumes of local anaesthetic, there are no plasma pharmacokinetic data on FICB in elderly patients. OBJECTIVES: The objective of this study was to determine the pharmacokinetic profile of a levobupivacaine 75 mg (30 mL 0.25%) FICB dose in patients aged ≥ 80 years with fractured femur. METHODS: This was a single-arm descriptive pilot study. Twelve adults aged ≥ 80 years with hip fracture received FICB performed under ultrasound guidance. Venous blood was sampled at 10, 20, 30, 45, 60, 75, 90, 105, 120 and 240 min after injection. Total plasma levobupivacaine concentration was measured by mass spectrometry. The main outcome measures were pharmacokinetic parameters, including maximum observed plasma concentration (Cmax), time to reach Cmax (tmax) and area under the plasma concentration-time curve. RESULTS: The median (interquartile range [IQR]) Cmax was 0.82 µg/mL (0.47-1.03). tmax was 45 min (41:20-60:00). No evidence of toxicity was identified. Plasma levobupivacaine concentrations were below the threshold associated with toxicity in younger, healthy patients (2.6 µg/mL). No association was found between individual patient Cmax and α1-acid glycoprotein, weight or body mass index, although the study was not powered for these outcomes. CONCLUSIONS: Absorption of levobupivacaine was slow and all patients had plasma concentrations below the toxic threshold. This pharmacokinetic analysis concludes that the technique appears to be well-tolerated and efficacious at reducing pain and is associated with systemic plasma concentrations unlikely to be associated with major adverse effects in elderly patients. CLINICAL TRIAL REGISTRATION: ISRCTN27364035 (UK Clinical Trials Gateway).

Current-Induced Torques with Dresselhaus Symmetry Due to Resistance Anisotropy in 2D Materials.

We report measurements of current-induced torques in heterostructures of Permalloy (Py) with TaTe2, a transition-metal dichalcogenide (TMD) material possessing low crystal symmetry, and observe a torque component with Dresselhaus symmetry. We suggest that the dominant mechanism for this Dresselhaus component is not a spin-orbit torque but rather the Oersted field arising from a component of current that flows perpendicular to the applied voltage due to resistance anisotropy within the TaTe2. This type of transverse current is not present in wires made from a single uniform layer of a material with resistance anisotropy but will result whenever a material with resistance anisotropy is integrated into a heterostructure with materials having different resistivities, thereby producing a spatially nonuniform pattern of current flow. This effect will therefore influence measurements in a wide variety of heterostructures incorporating 2D TMD materials and other materials with low crystal symmetries.

Spin-Orbit Torques in NbSe2/Permalloy Bilayers.

We present measurements of current-induced spin-orbit torques generated by NbSe2, a fully metallic transition-metal dichalcogenide material, made using the spin-torque ferromagnetic resonance (ST-FMR) technique with NbSe2/Permalloy bilayers. In addition to the out-of-plane Oersted torque expected from current flow in the metallic NbSe2 layer, we also observe an in-plane antidamping torque with torque conductivity σS ≈ 103 (ℏ/2e)(Ωm)-1 and indications of a weak field-like contribution to the out-of-plane torque oriented opposite to the Oersted torque. Furthermore, in some samples we also measure an in-plane field-like torque with the form m̂ × z, where m̂ is the Permalloy magnetization direction and z is perpendicular to the sample plane. The size of this component varies strongly between samples and is not correlated with the NbSe2 thickness. A torque of this form is not allowed by the bulk symmetries of NbSe2 but is consistent with symmetry breaking by a uniaxial strain that might result during device fabrication.