| The use of dye surrogates to illustrate local anesthetic drug sequestration by lipid emulsion: a visual demonstration of the lipid sink effect. | |
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MedLine Citation:
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PMID: 22354065 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND OBJECTIVES: We hypothesized that by substituting a dye surrogate in place of local anesthetic, we could visually demonstrate dye sequestration by lipid emulsion that would be dependent on both dye lipophilicity and the amount of lipid emulsion used. METHODS: We selected 2 lipophilic dyes, acid blue 25 and Victoria blue, with log P values comparable to lidocaine and bupivacaine, respectively. Each dye solution was mixed with combinations of lipid emulsion and water to emulate "lipid rescue" treatment at dye concentrations equivalent to fatal, cardiotoxic, and neurotoxic local anesthetic plasma concentrations. The lipid emulsion volumes added to each dye solution emulated equivalent intravenous doses of 100, 500, and 900 mL of 20% Intralipid in a 75-kg adult. After mixing, the samples were separated into a lipid-rich supernatant and a lipid-poor subnatant by heparin flocculation. The subnatants were isolated, and their colors compared against a graduated dye concentration scale. RESULTS: Lipid emulsion addition resulted in significant dye acquisition by the lipid compartment accompanied by a reduction in the color intensity of the aqueous phase that could be readily observed. The greatest amount of sequestration occurred with the dye possessing the higher log P value and the greatest amount of lipid emulsion. CONCLUSIONS: Our study provides a visual demonstration of the lipid sink effect. It supports the theory that lipid emulsion may reduce the amount of free drug present in plasma from concentrations associated with an invariably fatal outcome to those that are potentially survivable. |
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Authors:
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Aikaterini Papadopoulou; Johann W Willers; Theophilus L Samuels; David R Uncles |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Regional anesthesia and pain medicine Volume: 37 ISSN: 1532-8651 ISO Abbreviation: Reg Anesth Pain Med Publication Date: 2012 Mar-Apr |
Date Detail:
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Created Date: 2012-02-22 Completed Date: 2012-09-21 Revised Date: 2012-12-17 |
Medline Journal Info:
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Nlm Unique ID: 9804508 Medline TA: Reg Anesth Pain Med Country: United States |
Other Details:
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Languages: eng Pagination: 183-7 Citation Subset: IM |
Affiliation:
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Department of Anaesthesia and Intensive Care, Worthing Hospital, Western Sussex Hospitals NHS Trust, Worthing, West Sussex, United Kingdom. aipapadopoulou@yahoo.gr |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anesthetics, Local
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administration & dosage,
chemistry* Anthraquinones / administration & dosage, chemistry Chemistry, Pharmaceutical / instrumentation, methods* Color Coloring Agents / administration & dosage, chemistry* Dose-Response Relationship, Drug Emulsions Lipids / administration & dosage, chemistry* Rosaniline Dyes / administration & dosage, chemistry |
| Chemical | |
Reg. No./Substance:
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0/1-amino-9,10-dihydro-9,10-dioxo-4-(phenylamino)-2-anthracenesulfonic acid; 0/Anesthetics, Local; 0/Anthraquinones; 0/Coloring Agents; 0/Emulsions; 0/Lipids; 0/Rosaniline Dyes; Z1V8UTB56C/Victoria blue B |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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