Artículos de revistas
Comparison Of The Hemodynamic Effects In Acute Intoxication With Racemic Bupivacaine And With 50% Enantiomeric Excess Mixture (s75-r25). An Experimental Study In Dogs [comparação Entre Os Efeitos Hemodinâmicos Da Intoxicação Aguda Com Bupivacaína Racêmica E A Mistura Com Excesso Enatiomérico De 50% (s75-r25). Estudo Experimental Em Cães]
Registro en:
Revista Brasileira De Anestesiologia. , v. 56, n. 4, p. 391 - 401, 2006.
347094
2-s2.0-33748578366
Autor
Udelsmann A.
Munhoz D.C.
Silva W.A.
De Moraes A.C.
Marcondes G.
Institución
Resumen
BACKGROUND AND OBJECTIVES: Racemic bupivacaine has been widely used in locoregional anesthesia due to the quality and duration of its anesthetic action. However, its cardiovascular toxicity has worried anesthesiologists for a long time, and new options have been sought. One of them is the use of its levorotatory isomer that, due to a lesser affinity for the sodium channel receptors in the cardiac cell, would be less toxic. The presentation containing 75% of the levorotatory isomer and 25% of the dextrorotatory isomer, named 50% enantiomeric excess mixture (S75-R25), is available in our country. The objective of this study was to compare the hemodynamic effects of the acute intoxication with racemic bupivacaine and with the S75-R25 mixture in animals. METHODS: Forty-four dogs were anesthetized with pentobarbital, intubated and placed on mechanical ventilation. Hemodynamic monitorization was accomplished with a Swan-Ganz catheter and intra-arterial blood pressure measurements. After a period of rest, they were randomly and blindly divided in two groups, according to the intoxication with either agent at a dose of 5 mg.Kg -1. Hemodynamic data were collected during 30 minutes and analyzed statically to allow for the comparison of both agents. RESULTS: The mixture S75-R25 had more hemodynamic repercussions causing, especially, a significant reduction of the mean arterial pressure, cardiac index, and the left ventricle work index. CONCLUSIONS: These results contradict those found in human beings regarding the pure levorotatory isomer, but confirm recent animal studies. One must be very careful when extrapolating data to human beings. 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