Document Detail


Potentiation by mild hypothermia of ventricular conduction disturbances and reentrant arrhythmias induced by bupivacaine in dogs.
MedLine Citation:
PMID:  2719314     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
High concentrations of bupivacaine and profound hypothermia individually cause intraventricular conduction disturbances and reentrant arrhythmias. The effects of the combination of relatively low concentrations of bupivacaine and mild hypothermia are unknown and are the subject of this study. Three groups (n = 10-12) of dogs anesthetized with thiopental-chloralose were treated as follows: group 1, bupivacaine + hypothermia; group 2, bupivacaine alone; group 3, hypothermia alone. Bupivacaine was administered as a 4 mg/kg iv bolus followed by an iv infusion of 0.1 mg.kg-1.min-1. Hypothermia, i.e., a 4 degrees C reduction in core temperature, was produced by cooling the blood with an extracorporeal circuit. The peripheral ECG was recorded to determine the duration of QRS complexes and the QT interval. Conduction time and effective refractory period (ERP) of ventricular contractile tissue were measured with right ventricular endocavitary electrodes. Measurements were made with the heart paced at 180 beats/min and without pacing. In group 1 dogs, bupivacaine (plasma level, 2.8 +/- 0.3 microgram/ml) initially caused a prolongation of conduction time and QRS duration, which were further lengthened (approximately doubled) by a temperature decrease of 4 degrees C from baseline. The QT interval and ERP also were increased but to a lesser degree. In dogs in which the effects were most pronounced, rhythm disorders, such as wave burst arrhythmias (most common), premature systoles, ventricular tachycardia, and even ventricular fibrillation, occurred either spontaneously or during pacing. Bupivacaine alone (group 2) increased QRS duration and conduction time significantly, whereas hypothermia alone (Group 3) did not cause changes in any conduction variables. In neither group were dysrhythmias observed.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
M Freysz; Q Timour; R I Mazze; L Bertrix; S Cohen; K Samii; G Faucon
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anesthesiology     Volume:  70     ISSN:  0003-3022     ISO Abbreviation:  Anesthesiology     Publication Date:  1989 May 
Date Detail:
Created Date:  1989-06-12     Completed Date:  1989-06-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  799-804     Citation Subset:  AIM; IM    
Affiliation:
Claude Bernard University, Lyon, France.
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MeSH Terms
Descriptor/Qualifier:
Animals
Arrhythmias, Cardiac / chemically induced*
Bupivacaine / administration & dosage,  toxicity*
Dogs
Electrocardiography
Female
Heart Conduction System / drug effects*
Hypothermia, Induced / adverse effects*
Male
Chemical
Reg. No./Substance:
2180-92-9/Bupivacaine

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


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