Document Detail


Lipid emulsion reverses bupivacaine-induced asystole in isolated rat hearts: concentration-response and time-response relationships.
MedLine Citation:
PMID:  21068661     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The concentration-response and time-response relationships of lipid emulsions used to reverse bupivacaine-induced asystole are poorly defined.
METHODS: Concentration response across a range of lipid concentrations (0-16%) to reverse bupivacaine-induced asystole were observed using isolated rat heart Langendorff preparation. Cardiac function parameters were recorded during infusion. Concentrations of bupivacaine in myocardial tissue were measured by liquid chromatography and tandem mass spectrometry at the end of the experiment.
RESULTS: Although all lipid-treated hearts recovered (cardiac recovery was defined as a rate-pressure product more than 10% baseline), no nonlipid-treated hearts (control group) did so. The ratio of the maximum rate pressure product during recovery to baseline value demonstrated a concentration-dependent relationship among lipid groups, with 0.25, 0.5, 1, 2, 4, 8, and 16%. Mean ± SD values for each corresponding group were 22 ± 4, 24 ± 5, 29 ± 6, 52 ± 11, 73 ± 18, 119 ± 22, and 112 ± 10%, respectively (n = 6, P < 0.01). Rate-pressure product in lipid groups with 4-16% concentrations was lower at 15-40 min than at 1 min, showing a decreasing tendency during recovery phase (P < 0.01). The concentration of myocardial bupivacaine in all lipid-treated groups was significantly lower than in the control group (P < 0.01). It was also lower in lipid groups with 2-16% concentrations than in those with concentrations at 0.25-1% (P < 0.05), with the 16% group lower than groups with 2-8% concentrations (P < 0.001).
CONCLUSION: Lipid application in bupivacaine-induced asystole displays a concentration-dependent and time-response relationship in isolated rat hearts.
Authors:
Ying Chen; Yun Xia; Le Liu; Tong Shi; Kejian Shi; Quanguang Wang; Limei Chen; Thomas J Papadimos; Xuzhong Xu
Publication Detail:
Type:  In Vitro; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesiology     Volume:  113     ISSN:  1528-1175     ISO Abbreviation:  Anesthesiology     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-24     Completed Date:  2010-12-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1320-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, First Affiliated Hospital, Wenzhou Medical College, Zhejiang, China.
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MeSH Terms
Descriptor/Qualifier:
Algorithms
Anesthetics, Local / antagonists & inhibitors*,  pharmacokinetics,  toxicity
Animals
Blood Pressure / drug effects
Bupivacaine / antagonists & inhibitors*,  pharmacokinetics,  toxicity
Dose-Response Relationship, Drug
Fat Emulsions, Intravenous / pharmacology*
Heart / drug effects*
Heart Arrest / chemically induced*,  drug therapy*
Heart Rate / drug effects
Male
Myocardium / metabolism
Rats
Rats, Sprague-Dawley
Ventricular Function, Left / drug effects
Chemical
Reg. No./Substance:
0/Anesthetics, Local; 0/Fat Emulsions, Intravenous; 2180-92-9/Bupivacaine

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


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