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Lipid Emulsion Improves Recovery from Bupivacaine-Induced Cardiac Arrest, but Not from Ropivacaine- or Mepivacaine-Induced Cardiac Arrest
- Source :
- Anesthesia & Analgesia. 109:1323-1326
- Publication Year :
- 2009
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2009.
-
Abstract
- Background Cardiac toxicity significantly correlates with the lipophilicity of local anesthetics (LAs). Recently, the infusion of lipid emulsions has been shown to be a promising approach to treat LA-induced cardiac arrest. As the postulated mechanism of action, the so-called "lipid sink" effect may depend on the lipophilicity of LAs. In this study, we investigated whether lipid effects differ with regard to the administered LAs. Methods In the isolated rat heart, cardiac arrest was induced by administration of equipotent doses of bupivacaine, ropivacaine, and mepivacaine, respectively, followed by cardiac perfusion with or without lipid emulsion (0.25 mL x kg(-1) x min(-1)). Subsequently, the times from the start of perfusion to return of first heart activity and to recovery of heart rate and rate-pressure product (to 90% of baseline values) were assessed. Results In all groups, lipid infusion had no effects on the time to the return of any cardiac activity. However, recovery times of heart rate and rate-pressure product (to 90% of baseline values) were significantly shorter with the administration of lipids in bupivacaine-induced cardiac toxicity, but not in ropivacaine- or mepivacaine-induced cardiac toxicity. Conclusions These data show that the effects of lipid infusion on LA-induced cardiac arrest are strongly dependent on the administered LAs itself. We conclude that lipophilicity of LAs has a marked impact on the efficacy of lipid infusions to treat cardiac arrest induced by these drugs.
- Subjects :
- Male
Fat Emulsions, Intravenous
Time Factors
medicine.drug_class
Antidotes
Mepivacaine
In Vitro Techniques
Pharmacology
Ventricular Function, Left
Heart Rate
Heart rate
Ventricular Pressure
medicine
Animals
Ropivacaine
Anesthetics, Local
Rats, Wistar
Bupivacaine
business.industry
Local anesthetic
Recovery of Function
Amides
Heart Arrest
Rats
Perfusion
Anesthesiology and Pain Medicine
Mechanism of action
Anesthesia
Lipophilicity
medicine.symptom
business
medicine.drug
Subjects
Details
- ISSN :
- 00032999
- Volume :
- 109
- Database :
- OpenAIRE
- Journal :
- Anesthesia & Analgesia
- Accession number :
- edsair.doi.dedup.....48f5414d66994e141d950ccfb6472350