Document Detail


Bupivacaine for intercostal nerve blockade in patients on long-term beta-receptor blocking therapy.
MedLine Citation:
PMID:  6152885     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Possible cardiovascular side effects of a local anaesthetic in patients on long-term beta-receptor blocking therapy were studied in 26 patients given postoperative intercostal nerve blockades (ICB) with 18-28 ml of plain bupivacaine 0.5% (1.30-1.82 mg kg-1). The patients had a history of hypertension and/or ischaemic heart disease and were scheduled for gall bladder surgery. Thirteen patients were randomized to a gradual preoperative withdrawal of the beta-receptor blockers and the other 13 continued the beta-receptor blockade until surgery. Cardiovascular changes were measured noninvasively and 11 patients were also monitored with pulmonary artery catheters. Blood pressure and heart rate (HR) were stable in all patients although those in whom the beta-receptor blockade was withdrawn had the highest HR and most frequent arrhythmias both before and after ICB. The ICB was associated with a decrease in the overall postoperative arrhythmia incidence, but seemed most efficient (P less than 0.02) concerning the ventricular arrhythmias in the beta-receptor-blocked patients (even including idionodal rhythm). The bupivacaine blood levels did not modify other cardiovascular changes except in one beta-receptor-blocked patient with cardiac failure in whom signs of a slight transient cardiodepression were observed. It is concluded that bupivacaine does not negatively affect cardiovascular stability in long-term beta-receptor-blocked patients. In the presence of cardiac failure, however, an additive cardiodepression may be elicited.
Authors:
J Pontén; B Biber; B A Henriksson; C Jonsteg
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica. Supplementum     Volume:  76     ISSN:  0515-2720     ISO Abbreviation:  Acta Anaesthesiol Scand Suppl     Publication Date:  1982  
Date Detail:
Created Date:  1989-04-06     Completed Date:  1989-04-06     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370271     Medline TA:  Acta Anaesthesiol Scand Suppl     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  70-7     Citation Subset:  IM    
Affiliation:
Department of Anaesthesia, University of Göteborg, Sweden.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / adverse effects,  therapeutic use*
Aged
Bupivacaine*
Cholecystectomy
Clinical Trials as Topic
Hemodynamics
Humans
Middle Aged
Nerve Block*
Random Allocation
Substance Withdrawal Syndrome
Time Factors
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 2180-92-9/Bupivacaine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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