| Lipid emulsion improves recovery from bupivacaine-induced cardiac arrest, but not from ropivacaine- or mepivacaine-induced cardiac arrest. | |
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MedLine Citation:
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PMID: 19762764 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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York A Zausig; Wolfgang Zink; Meike Keil; Barbara Sinner; Juergen Barwing; Christoph H R Wiese; Bernhard M Graf |
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Publication Detail:
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Type: Comparative Study; In Vitro; Journal Article |
Journal Detail:
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Title: Anesthesia and analgesia Volume: 109 ISSN: 1526-7598 ISO Abbreviation: Anesth. Analg. Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-09-18 Completed Date: 2009-10-01 Revised Date: 2010-05-27 |
Medline Journal Info:
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Nlm Unique ID: 1310650 Medline TA: Anesth Analg Country: United States |
Other Details:
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Languages: eng Pagination: 1323-6 Citation Subset: AIM; IM |
Affiliation:
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University of Regensburg, Department of Anaesthesiology, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany. york.zausig@klinik.uni-regensburg.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Amides
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toxicity* Anesthetics, Local / toxicity* Animals Antidotes / pharmacology* Bupivacaine / toxicity* Fat Emulsions, Intravenous / pharmacology* Heart Arrest / chemically induced, physiopathology, therapy* Heart Rate / drug effects Male Mepivacaine / toxicity* Perfusion Rats Rats, Wistar Recovery of Function Time Factors Ventricular Function, Left / drug effects Ventricular Pressure / drug effects |
| Chemical | |
Reg. No./Substance:
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0/Amides; 0/Anesthetics, Local; 0/Antidotes; 0/Fat Emulsions, Intravenous; 2180-92-9/Bupivacaine; 84057-95-4/ropivacaine; 96-88-8/Mepivacaine |
| Comments/Corrections | |
Comment In:
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Anesth Analg. 2010 Jun;110(6):1750-1; author reply 1751-2
[PMID:
20501817
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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