The effects of levosimendan and dobutamine in experimental bupivacaine-induced cardiotoxicity

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• 作者：Ulku Kandemir (1)
  Fikret Maltepe (2)
  Baran Ugurlu (3)
  Necati Gokmen (2)
  Asli Celik (4)
  
• 关键词：Bupivacaine ; Cardiotoxicity ; Levosimendan ; Dobutamine ; Rat
• 刊名：BMC Anesthesiology
• 出版年：2013
• 出版时间：December 2013
• 年：2013
• 卷：13
• 期：1
• 全文大小：160 KB
• 参考文献：1. Mather LE, Chang DH: Cardiotoxicity with modern local anaesthetics: is there a safer choice? / Drugs 2001, 61:333-42. CrossRef
  2. Cooper GM, McClure JH: Anesthesia chapter from saving mothers lives reviewing maternal deaths to make pregnancy safer. / Br J Anaesth 2008,100(1):17-2. CrossRef
  3. Weinberg GL: Treatment of local anesthetic systemic toxicity (LAST). / Reg Anaest Pain Med 2010,35(2):188-93. CrossRef
  4. Heavner JE, Pitkanen MT, Shi B, Rosenberg PH: Resuscitation from Bu?ivacaine-induced asystole in rats: comparison of different cardioactive drugs. / Anesth Analg 1995, 80:1134-139.
  5. Neal JM, Bernards CM, Butterworth JF 4th, / et al.: ASRA practice advisory on local anesthetic systemic toxicity. / Reg Anesth Pain Med 2010, 35:152-61. CrossRef
  6. Figgitt DP, Gillies PS, Goa KL: Levosimendan. / Drugs 2001, 61:613-27. CrossRef
  7. Bergh CH, Andersson B, Dahlstr?m U, Forfang K, Kivikko M, Sarapohja T, Ullman B, Wikstr?m G: Intravenous levosimendan vs. dobutamine in acute decompensated heart failure patients on beta-blockers. / Eur J of Heart Fail 2010, 12:404-10. CrossRef
  8. Cavusoglu Y: The use of levosimendan in comparison and in combination with dobutamine in the treatment of decompensated heart failure. / Expert Opin Pharmacother 2007, 8:665-77. CrossRef
  9. Fuhrmann JT, Schmeisser A, Schulze MR, Wunderlich C, Schoen SP, Rauwolf T, Weinbrenner C, Strasser RH: Levosimendan is superior to enoximone in refractory cardiogenic shock complicating acute myocardial infarction. / Cric Care Med 2008, 36:42-9.
  10. Suominen PK: Single-center experience with levosimendan in children undergoing cardiac surgery and in children with decompensated heart failure. / BMC Anesthesiol 2011, 11:18. CrossRef
  11. Gulec S, Aydin Y, Uzuner K, Yelken B, Senturk Y: Effects of clonidine pre-treatment on bupivacaine and ropivacaine cardiotoxicity in rats. / Eur J Anaesthesiol 2004, 21:205-09.
  12. De La Coussaye JE, Bassoul BP, Gagnol JP, Sassine A, Eledjam JJ: Experimental treatment of bupivacaine cardiotoxicity: what is the best choice? / Reg Anesth 1991,16(2):120-22.
  13. Pham-Dang C, Beaumont S, Floch H, Bodin J, Winer A, Pinaud M: Acute toxic accident following lumbar plexus block with bupivacaine. / Ann Fr Anesth Reanim 2000,19(5):356-59.
  14. Huang L, Weil MH, Sun S, Cammarata G, Cao L, Tang W: Levosimendan improves postresuscitation outcomes in a rat model of CPR. / J Lab Clin Med 2005,146(5):256-61. CrossRef
  15. Feldman HS, Arthur GR, Pitkanen M, Hurley R, Doucette AM, Covino BG: Treatment of acute systemic toxicity after the rapid intravenous injection of ropivacaine and bupivacaine in the conscious dog. / Anesth Analg 1991, 73:373-84. CrossRef
  16. Chadwick HS: Toxicity and resuscitation in lidocaine- or bupivacaine-infused cats. / Anesthesiology 1985, 63:385-89. CrossRef
  17. Lindgren L, Randell T, Suzuki N, Kytt? J, Yli-Hankala A, Rosenberg PH: The effects of amrinone on recovery from severe bupivacaine intoxication in pigs. / Anesthesiology 1992, 77:309-15. CrossRef
  18. Lacombe P, Blaise G, Hollmann C, Tanguay M, Loulmet D: Isoproterenol corrects the effects of bupivacaine on the electrophysiologic properties of the isolated rabbit heart. / Anesth Analg 1991, 72:70-4.
  19. Kim JT, Jung CW, Lee KH: The effect if insulin on the resuscitation of bupivacaine-induced severe cardiovascular toxicity in dogs. / Anesth Analg 2004, 99:728-33. CrossRef
  20. Hicks SD, Salcido DD, Logue ES, Suffoletto BP, Empey PE, Poloyac SM, Miller DR, Callaway CW, Menegazzi JJ: Lipid emulsion combined with epinephrine and vasopressin does not improve survival in a swine model of bupivacaine-induced cardiac arrest. / Anesthesiology 2009, 111:138-46. CrossRef
  21. Weinberg GL, Di Gregorio G, Ripper R, Kelly K, Massad M, Edelman L, Schwartz D, Shah N, Zheng S, Feinstein DL: Resuscitation with lipid versus epinephrine in a rat model of bupivacaine overdose. / Anesthesiology 2008, 108:907-13. CrossRef
  22. Weinberg GL, Ripper R, Feinstein DL, Hoffman W: Lipid emulsion infusion rescues dogs from bupivacaine-induced cardiac toxicity. / Reg Anesth Pain Med 2003,28(3):198-02.
  23. La Coussaye JE, Bassoul B, Brugada J: Reversal of electrophysiologic and hemodynamic effects induced by high dose of bupivacaine by the combination of clonidine and dobutamine in anesthetized dogs. / Anesth Analg 1992, 74:703-11.
  24. Cave G, Harvey M, Prince G, Lahner D, Desmet J: Effect of hypertonic saline on electrocardiography QRS duration in rabbit model of toxicity resuscitated by intravenous lipid. / Anaesthesia 2010, 65:792-98. CrossRef
  25. Berger R, Moertl D, Huelsmann M, Bojic A, Ahmadi R, Heissenberger I, Pacher R: Levosimendan and prostaglandin E ₁ for uptitration of betablockade in patients with advanced chronic heart failure. / Eur J Heart Fail 2007, 9:202-08. CrossRef
  26. Nanas JN, Papazoglou P, Tsagalou EP, Ntalianis A, Tsolakis E, Terrovitis JV, Kanakakis J, Nanas SN, Alexopoulos GP, Anastasiou-Nana MI: Efficacy and safety of intermittent, long-term, concomitant dobutamine and levosimendan infusions in severe heart failure refractory to dobutamine alone. / Am J Cardiol 2005, 95:768-71. CrossRef
  27. De Hert SG, Lorsomradee S, Cromheecke S, Van der Linden PJ: The effects of levosimendan in cardiac surgery patients with poor left ventricular function. / Anaesth Analg 2007, 104:766-73. CrossRef
  28. Poelzl G, Zwick RH, Grander W, Metzler B, Jonetzko P, Frick M, Ulmer H, Pachinger O, Roithinger FX: Safety and effectiveness of levosimendan in patients with predominant right heart failure. / Herz 2008, 33:368-73. CrossRef
  29. Slawsky MT, Colucci WS, Gottlieb SS, Greenberg BH, Haeusslein E, Hare J, Hutchins S, Leier CV, LeJemtel TH, Loh E, Nicklas J, Ogilby D, Singh BN, Smith W: Acute hemodynamic and clinical effects of levosimendan in patients with severe heart failure. / Study Invest Circ 2000, 102:2222-227.
  30. Huang L, Weil MH, Tang W, Sun S, Wang J: Comparison between dobutamine and levosimendan for management of postresuscitation myocardial dysfunction. / Crit Care Med 2005,33(3):487-91. CrossRef
  31. Zausig YA, Geilfus D, Missler G, Sinner B, Graf BM, Zink W: Direct cardiac effects of dobutamine, dopamine, epinephrine, and levosimendan in isolated septic rat hearts. / Shock 2010,34(3):269-74. CrossRef
  32. Stehr SN, Christ T, Rasche B, Rasche S, Wettwer E, Deussen A, Ravens U, Koch T, Hübler M: The effects of levosimendan on myocardial function in ropivacaine toxicity in isolated guinea pig heart preparations. / Anesth Analg 2007,105(3):641-47. CrossRef
  33. Aittom?ki J, Liuhanen S, Sallisalmi M, Salmenper? MT, Heavner JE, Rosenberg PH: The effect of levosimendan on bupivacaine-induced severe myocardial depression in anesthetized pigs. / Reg Anesth Pain Med 2010, 35:34-0. CrossRef
  34. Dony P, Dewinde V, Vanderick B, Cuignet O, Gautier P, Legrand E, Lavand’homme P, De Kock M: The comparative toxicity of ropivacaine and bupivacaine at equipotent doses in rats. / Anesth Analg 2000, 91:1489-492. CrossRef
  35. Nanas JN, Papazoglou PP, Terrovitis JV, Kanakakis J, Dalianis A, Tsolakis E, Tsagalou EP, Agrios N, Christodoulou K, Anastasiou-Nana MI: Hemodynamic effects of levosimendan added to dobutamine in patients with decompensated advanced heart failure refractory to dobutamine alone. / Am J Cardiol 2004, 94:1329-332. CrossRef
  36. Xanthos T, Bassiakou E, Koudouna E, Rokas G, Goulas S, Dontas I, Kouskouni E, Perrea D, Papadimitriou L: Combination pharmacotherapy in the treatment of experimental cardiac arrest. / Am J Emerg Med 2009, 27:651-59. CrossRef
  37. Mebazaa A, Nieminen MS, Packer M, Cohen-Solal A, Kleber FX, Pocock SJ, Thakkar R, Padley RJ, Poder P, Kivikko M: SURVIVE investigators: levosimendan vs dobutamine for patients with acute decompensated heart failure: the SURVIVE randomized trial. / JAMA 2007,297(17):1883-891. CrossRef
  38. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2253/13/28/prepub
  
• 作者单位：Ulku Kandemir (1)
  Fikret Maltepe (2)
  Baran Ugurlu (3)
  Necati Gokmen (2)
  Asli Celik (4)
  
  1. Mus State Hospital, Clinic of Anaesthesia and Reanimation, (Formerly Dokuz Eylul University, Department of Anaesthesia and Reanimation, Izmir, Turkey), Mus, Turkey
  2. Department of Anaesthesia and Reanimation, Dokuz Eylul University, Medical Faculty, Izmir, Turkey
  3. Department of Cardiovasculary Surgery, Dokuz Eylul University, Medical Faculty, Izmir, Turkey
  4. Department of Experimental Laboratory Animal Science, Dokuz Eylul University, Medical Faculty, Izmir, Turkey
  
• ISSN：1471-2253

文摘

Background Accidental intravenous exposure to bupivacaine is highly cardiotoxic and may lead to death. Positive inotropic agents are usually utilized in resuscitative efforts. We have compared the efficacy of levosimendan, a novel inotropic agent, with dobutamine and their combination in a rat model of bupivacaine intoxication. Methods Twenty-eight male Wistar albino rats weighing between 250-300 g were divided into these four groups: control (C), levosimendan (L), dobutamine (D) and dobutamine+levosimendan (D+L). Bupivacaine was administered at a dose of 3 mg/kg/min until cardiac arrest occurred or for 120 min. ECG, heart rate, blood pressure, arterial blood gases, and end tidal CO2 levels were monitored. Levosimendan was administered as a bolus of 12 μg/kg for 10 min and continued as an infusion at 0.3 μg/kg/min. Dobutamine was infused at a dose of 3 μg/kg/min. The time required for a 50% and 75% decrease in heart rate and blood pressure with a total time to cardiac arrest and bupivacaine dose for obtaining cardiac arrest were analyzed. Results Time periods for heart rate reductions of 50% and 75% were significantly longer in groups L (903, 1198 s), D (984, 1542 s) and L+D (1705, 3152 s) compared with the control group (345, 538 s p-lt;-.001). Median times to mean blood pressure reductions of 50% and 75% were 399 - 504 s in the control group, 1005 -1204 s in group L, 685 - 1009 s in group D and 1544- 2982 s in group L+D, and the difference was significant compared with the control group. Median time duration to asystole was 703 s in the control group compared with 1385 s in group L, 1789 s in group D and 3557 s in group L+D. Time to cardiac arrest was significantly higher in all 3 study groups. It was also significantly higher in the L+D group compared with both groups L and D separately. Conclusion A combination of dobutamine with levosimendan significantly increased survival times in this bupivacaine-induced toxicity rat model compared with the control, levosimendan, and dobutamine groups.