Measurement of the efficacy of 2% lipid in reversing bupivacaine- induced asystole in isolated rat hearts

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• 作者：Hongfei Chen ; Yun Xia ; Binbin Zhu ; Xiawei Hu ; Shihao Xu ; Limei Chen…
• 关键词：Anaesthetics local ; bupivacaine ; Complications ; cardiac arrest ; Lipid emulsion
• 刊名：BMC Anesthesiology
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：14
• 期：1
• 全文大小：430 KB
• 参考文献：1. Weinberg, GL, VadeBoncouer, T, Ramaraju, GA, Garcia-Amaro, MF, Cwik, MJ (1998) Pretreatment or resuscitation with a lipid infusion shifts the dose–response to bupivacaine-induced asystole in rats. Anesthesiology 88: pp. 1071-1075 CrossRef
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  12. Chen, Y, Xia, Y, Liu, L, Shi, T, Shi, K, Wang, Q, Chen, L, Papadimos, TJ, Xu, X (2010) Lipid emulsion reverses bupivacaine-induced asystole in isolated rat hearts: concentration-response and time-response relationships. Anesthesiology 113: pp. 1320-1325 CrossRef
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• 刊物主题：Anesthesiology; Internal Medicine; Emergency Medicine; Intensive / Critical Care Medicine;
• 出版者：BioMed Central
• ISSN：1471-2253

文摘

Background The reversal efficacy of 2% lipid emulsion in cardiac asystole induced by different concentrations of bupivacaine is poorly defined and needs to be determined. Methods Forty-two male Sprague–Dawley rats were randomly divided into seven groups: B40, B60, B80, B100, B120, B140 and B160, n--. The Langendorff isolated heart perfusion model was used, which consisted of a balanced perfusion with Krebs-Henseleit solution for 25?minutes and a continuous infusion of 100?μmol/L bupivacaine until asystole had been induced for 3?minutes. The hearts in the seven groups were perfused with Krebs-Henseleit solution containing a 2% lipid emulsion, and 40, 60, 80, 100, 120, 140 or 160?μmol/L bupivacaine, respectively. Cardiac recovery was defined as a spontaneous and regular rhythm with a rate-pressure product--0% of the baseline value for more than 1?minute. Our primary outcome was the rate-pressure product 25?minutes after cardiac recovery. Other cardiac function parameters were also recorded. Results All groups demonstrated cardiac recovery. During the recovery phase, heart rate, rate-pressure product, the maximum left ventricular pressure rise and decline in heart rate in the B120-B160 groups was significantly lower than those in the B40-B80 groups (P--.05). The concentration of bupivacaine and the reversal effects of a 2% lipid emulsion showed a typical transoid S-shaped curve, R2--.9983, IC50 value was 102.5?μmol/L (95% CI: 92.44 - 113.6). Conclusions There is a concentration-response relationship between the concentrations of bupivacaine and the reversal effects of 2% lipid emulsion.