Document Detail


Potassium channel openers attenuate atrioventricular block by bupivacaine in isolated hearts.
MedLine Citation:
PMID:  8498663     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Our purpose was to test if pinacidil and bimakalim (EMD 52692 or SR 44866), which are ATP-sensitive K+ (K+ATP) channel openers, can attenuate bupivacaine-induced atrioventricular (AV) block. Bupivacaine-induced AV block was studied in 24 isolated guinea pig hearts with or without either pinacidil or bimakalim. Hearts were perfused at 55 mm Hg with a modified Krebs' perfusate. Variables monitored were: heart rate, AV conduction time, left ventricular pressure, coronary flow, and myocardial oxygen extraction. Bupivacaine was infused at a constant concentration of 4 microM to induce first degree AV block and 15-25 microM to induce second degree heart block. During a stable AV block (e.g., first degree, 2:1, 3:2, or 4:3), K+ channel openers, pinacidil (up to 30 microM) or bimakalim (up to 2 microM) were added to perfusate containing bupivacaine. The effects of K+ channel openers were also examined in the presence of the selective K+ATP channel blocker, glibenclamide (2.2 microM). On the average, 4 microM bupivacaine prolonged AV conduction by 53%, and decreased heart rate by 13%, left ventricular pressure by 26%, coronary flow by 6%, and percent oxygen extraction by 7%. In the presence of bupivacaine, pinacidil and bimakalim additionally decreased left ventricular pressure and oxygen extraction, markedly increased coronary flow, and attenuated the prolongation of AV conduction by 20% with no further change in heart rate. The beneficial effect of bimakalim on AV block was reversed by glibenclamide. Second degree AV block produced by higher doses of bupivacaine was converted to first degree AV block by either pinacidil or bimakalim in 6 of 8 and 7 of 8 hearts, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
M Boban; D F Stowe; G J Gross; G M Pieper; J P Kampine; Z J Bosnjak
Related Documents :
2387933 - Incidence and prognostic significance of intraventricular conduction abnormalities afte...
50153 - The differences in atrioventricular conduction of premature beats in young and adult go...
18634983 - Prediction of cardiac events in patients with reduced left ventricular ejection fractio...
Publication Detail:
Type:  In Vitro; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  76     ISSN:  0003-2999     ISO Abbreviation:  Anesth. Analg.     Publication Date:  1993 Jun 
Date Detail:
Created Date:  1993-06-24     Completed Date:  1993-06-24     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1259-65     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, Medical College of Wisconsin, Milwaukee 53226.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Animals
Benzopyrans / antagonists & inhibitors,  therapeutic use*
Bupivacaine / adverse effects,  antagonists & inhibitors*
Dihydropyridines / antagonists & inhibitors,  therapeutic use*
Glyburide / pharmacology
Guanidines / antagonists & inhibitors,  therapeutic use*
Guinea Pigs
Heart Block / chemically induced*,  prevention & control
Pinacidil
Potassium Channels / drug effects*
Vasodilator Agents / therapeutic use*
Grant Support
ID/Acronym/Agency:
GM08377/GM/NIGMS NIH HHS; HL01901/HL/NHLBI NIH HHS; HL34708/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Benzopyrans; 0/Dihydropyridines; 0/Guanidines; 0/Potassium Channels; 0/Vasodilator Agents; 10238-21-8/Glyburide; 117545-11-6/bimakalim; 2180-92-9/Bupivacaine; 85371-64-8/Pinacidil

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


Previous Document:  Equivalence of postoperative analgesia with patient-controlled intravenous or epidural alfentanil.
Next Document:  Cardiac electrophysiologic effects of articaine compared with bupivacaine and lidocaine.