Artículos de revistas
Hemodynamic Changes In Lipid Emulsion Therapy (smoflipid) For Bupivacaine Toxicity In Swines [alterações Hemodinâmicas Na Terapia Por Emulsão Lipídica (smoflipid) Na Intoxicação Por Bupivacaína Em Suínos]
Registro en:
Acta Cirurgica Brasileira. , v. 27, n. 4, p. 318 - 324, 2012.
1028650
10.1590/S0102-86502012000400007
2-s2.0-84860729055
Autor
de Simone Melo M.
Bonfm M.R.
Dreyer E.
Bassanezi B.S.B.
Udelsmann A.
Institución
Resumen
Purpose: To evaluate the hemodynamic changes following SMOFlipid emulsion therapy with after bupivacaine intoxication in swines. Methods: Large White pigs were anesthetized with thiopental, tracheal intubation was performed and mechanical ventilation was instituted. Hemodynamic variables were recorded with invasive pressure monitoring and pulmonary artery catheterization (Swan-Ganz catheter). After a 30-minute resting period, 5 mg.kg-1 of bupivacaine by intravenous injection was administered and new hemodynamic measures were performed 1 minute later; the animals were than randomly divided into two groups and received 4 ml.kg-1 of saline solution or 4 ml.kg-1 of SMOFlipid emulsion 20%. Hemodynamic changes were then re-evaluated at 5, 10, 15, 20 and 30 minutes. Results: Bupivacaine intoxication caused fall in arterial blood pressure, cardiac index, ventricular systolic work index mainly and no important changes in vascular resistances. SMOFlipid emulsion therapy was able to improve blood pressure mainly by increasing vascular resistance since the cardiac index had no signifcant improvement in our study. Hemodynamic results of the use of lipid emulsion in bupivacaine intoxication were better than the control group. Conclusion: The SMOFlipid emulsion is a option for reversing hypotension in cases of intoxication by bupivacaine. 27 4 318 324 Groban, L., Deal, D.D., Vernon, J.C., James, R.L., Butterworth, J., Cardiac resuscitation after incremental overdosage with lidocaine, bupivacaine, levobupivacaine and ropivacaine in anesthetized dogs (2001) Anesth Analg, 92 (1), pp. 37-43 Chang, D.H., Ladd, L.A., Copeland, S., Iglesias, M.A., Plummer, J.L., Mather, L.E., Direct cardiac effects of intracoronary bupivacaine, levobupivacaine and ropivacaine in the sheep (2001) Br J Pharmacol, 132 (3), pp. 649-658 Albright, G.A., Cardiac arrest following regional anesthesia with etidocaine or bupivacaine (1979) Anesthesiology, 51 (4), pp. 285-287 Melo, M.S.D., Silva, W.A., Moraes, A.C., Udelsmann, A., Comparison of hemodynamic changes in acute intoxication with intravenous bupivacaine and ropivacaine in swine (2009) Rev Bras Anestesiol, 59 (5), pp. 592-601 Leone, S., Cianni, S.D., Casati, A., Fanelli, G., Pharmacology, toxicology, and clinical use of new long acting long anesthetics, ropivacaine and levopubivacaine (2008) Acta Biomed, 79 (2), pp. 92-105 Mulroy, M.F., Systemic toxicity and cardiotoxicity from local anesthetics: Incidence and preventive measures (2002) Reg Anesth Pain Med, 27 (6), pp. 556-561 Brown, D.L., Ransom, D.M., Hall, J.A., Schroeder, D.R., Offord, K.P., Regional anesthesia and local anesthetic-induced systemic toxicity: Seizure frequency and accompanying cardiovascular changes (1995) Anesth Analg, 81 (2), pp. 321-328 Auroy, Y., Narchi, P., Messiah, A., Litt, L., Rouvier, B., Samii, K., Serious complications related to regional anesthesia: Results of a prospective survey in France (1997) Anesthesiology, 87 (3), pp. 479-486 Heavner, J.E., Local anesthetics (2007) Cur Opin Anaesthesiol, 20 (4), pp. 336-412 Groban, L., Butterworth, J., Lipid reversal of bupivacaine toxicity: Has the silver bullet been identifed? (2003) Reg Anesth Pain Med, 28 (3), pp. 167-169 Rosenblatt, M.A., Abel, M., Fischer, G.W., Itzkovich, C.J., Eisenkraft, J.B., Successful use of a 20% lipid emulsion to resuscitate after a presumed bupivacaine-related cardiac arrest (2006) Anesthesiology, 105 (1), pp. 217-218 Litz, R.J., Popp, M., Stehr, S.N., Koch, T., Successful resuscitation of a patient with ropivacaine-induced asystole after axilary plexus block using lipid emulsion (2006) Anaesthesia, 61 (8), pp. 800-801 Warren, J.A., Thoma, R.B., Georgescu, A., Shah, S.J., Intravenous lipid infusion in the successful resuscitation of local anesthetic-induced cardiovascular collapse after supraclavicular brachial plexus block (2008) Anesth Analg, 106 (5), pp. 1578-1580 Dix, S.K., Rosner, G.F., Nayar, M., Harris, J.J., Guglin, M.E., Winterfeld, J.R., Xiong, Z., Mudge Jr., G.H., Intractable cardiac arrest due to lidocaine toxicity successfully resuscitated with lipid emulsion (2011) Crit Care Med, 39 (4), pp. 872-874 Schlotzer, E., Kanning, U., Elimination and tolerance of a new parenteral lipid emulsion (SMOF)--a double-blind cross-over study in healthy male volunteers (2004) Ann Nutr Metab, 48 (4), pp. 263-268 Mertes, N., Grimm, H., Furst, P., Stehle, P., Safety and effcacy of a new parenteral lipid emulsion (SMOFlipid) in surgical patients: A randomized, double-blind, multicenter study (2006) Ann Nutr Metab, 50 (3), pp. 253-259 Holt, J.P., Rhode, E.A., Kines, H., Ventricular volumes and body weigh in mammals (1968) Am J Physiol, 215 (3), pp. 704-715 Aya, A.G., Ripart, J., Sebbane, M.A., de la Coussaye, J.E., Lipid emulsions for the treatment of systemic local anesthetic toxicity: Effcacy and limits (2010) Ann Fr Anesth Reanim, 29 (6), pp. 464-469 Turner-Laurence, D.E., Li Kerns, W., Intravenous fat emulsion: A potential novel antidote (2008) J Med Toxicol, 4 (2), pp. 109-114 Mazoit, J.X., le Guen, R., Beloeil, H., Benhamou, D., Binding of long-lasting local anesthethics to lipid emulsions (2009) Anestesiology, 110 (2), pp. 380-386 Mazoit, J.X., Cao, L.S., Samii, K., Binding of bupivacaine to human serum proteins, isolated albumin and isolated alpha-1-acid glycoprotein (1996) J Pharmacol Exp Ther, 276 (1), pp. 109-115. , Differences between the two enantiometers are partly due to cooperatively Cave, G., Harvey, M., Intravenous lipid emulsion as antidote beyond local anesthetic toxicity: A systematic review (2009) Acad Emerg Med, 16 (9), pp. 815-824 Ok, S.H., Sohn, J.T., Baik, J.S., Kim, J.G., Park, S.S., Sung, H.J., Shin, M.K., Chung, Y.K., Lipid emulsion reverses levobupivacaine-induced responses in isolated rat aortic vessels (2011) Anestesiology, 114 (2), pp. 293-301 Leskiw, U., Weinberg, G., Lipid resuscitation for local anesthetic toxicity: Is it realy life saving? (2009) Cur Opin Anaesthesiol, 22 (5), pp. 667-671 Weinberg, G.L., di Gregorio, G., Ripper, R., Kelly, K., Massad, M., Edelman, L., Schwartz, D., Feinstein, D.L., Resuscitation with lipid versus epinephrine in a rat model of bupivacaine overdose (2008) Anesthesiology, 108 (5), pp. 907-913 Chen, Y., Xia, Y., Liu, L., Shi, T., Shi, K., Wang, Q., Chen, L., Xu, X., Lipid emulsion reverses bupivacaine-induced asystole in isolated rat hearts (2010) Anesthesiology, 113 (6), pp. 1320-1325 Brull, S.J., Lipid emulsion for treatment of local anesthetic toxicity: Patient safety implications (2008) Anesth Analg, 106 (5), pp. 1337-1339