Artículos de revistas
Lipid Therapy With Two Agents In Ropivacaine-induced Toxicity: Experimental Study In Swine
Registro en:
Revista Brasileira De Anestesiologia. , v. 62, n. 5, p. 685 - 695, 2012.
347094
10.1016/S0034-7094(12)70167-8
2-s2.0-84866508838
Autor
Bonfim M.R.
De Simone Melo M.
Dreyer E.
Borsoi L.F.A.
de Oliveira T.G.
Udelsmann A.
Institución
Resumen
Background and objective: Compare hemodynamic changes after ropivacaine-induced toxicity followed by treatment with two lipid emulsions in swine. Methods: Large White pigs were anesthetized with thiopental, followed by intubation, and kept on mechanical ventilation. Hemodynamic variables at rest were recorded with invasive pressure monitoring and pulmonary artery catheterization. After 30 minutes, 7mg.kg-1 ropivacaine were injected intravenously and new hemodynamic measurements were performed within one minute. The animals were then randomly allocated into three groups and received: 4mL.kg-1 saline solution, or 4mL.kg-1 lipid emulsion with long-chain triglycerides, or 4mL.kg-1 lipid emulsion with longand medium-chain triglycerides. Hemodynamic changes were reevaluated at 5, 10, 15, 20 and 30 minutes. Results: Ropivacaine-induced toxicity mainly caused a drop in blood pressure and cardiac index without significant changes in vascular resistance. Therapy with lipid emulsions restored blood pressure primarily through increased vascular resistance, as cardiac index showed no significant improvement. Lipid emulsion with medium-chain triglycerides caused a greater increase in vascular resistance, particularly pulmonary. Conclusion: In groups receiving lipid emulsions, hemodynamic results were better than in control group. There were no differences in systemic arterial pressure and cardiac index between animals receiving lipid emulsion with long-chain triglycerides and mixed long- and medium-chain triglycerides. © 2012 Elsevier Editora Ltda. 62 5 685 695 Corcoran, W., Butterworth, J., Weller, R.S., Local anestheticinduced cardiac toxicity: a survey of contemporary practice strategies among academic anesthesiology departments (2006) Anesth Analg, 103, pp. 1322-1326 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, pp. 92-105 Neal, J.M., Weinberg, G.L., Bernards, C.M., ASRA practice advisory on local anesthetic systemic toxicity (2010) Reg Anesth Pain Med, 35, pp. 152-161 Albright, G.A., Cardiac arrest following regional anestesia with etidocaine or bupivacaine (1979) Anesthesiology, 51, pp. 285-287 Negri, P., Ivani, G., Tirri, T., del Pianno, A.C., New local anesthetics for pediatric anestesia (2005) Curr Opin Anaesthesiol, 18, pp. 289-292 Sakai, T., Manabe, W., Kamitani, T., Takeyama, E., Nakano, S., Ropivacaine induced late-onset systemic toxicity after transversus abdominis plane block under general anesthesia: successful reversal with 20% lipid emulsion (2010) Masui, 59, pp. 1502-1505 Weinberg, G.L., VadeBoncouer, T., Ramaraju, G.A., Garcia-Amaro, M.F., Cwik, M.J., Pretreatment or resuscitation with a lipid infusion shifts the dose-response to bupivacaine-induced asystole in rats (1998) Anesthesiology, 88, pp. 1071-1075 Weinberg, G.L., Ripper, R., Feinstein, D.L., Hoffman, W., Lipid emulsion rescues dogs from bupivacaine-induced cardiac toxicity (2003) Reg Anesth Pain Med, 28, pp. 198-202 Manavi, M.V., Lipid infusion as a treatment for local anesthetic toxicity: a literature review (2010) AANA J, 78, pp. 69-78 Weinberg, G.L., Limits to lipid in the literature and lab: what we know, what we don't know (2009) Anest Analg, 108, pp. 1062-1064 Weinberg, G.L., Di Gregorio, G., Ripper, R., Resuscitation with lipid versus epinephrine in a rat model of bupivacaine overdose (2008) Anesthesiology, 108, pp. 907-913 Mazoit, J.X., Le Guen, R., Beloeil, H., Benhamou, D., Binding of long-lasting local anesthetics to lipid emulsions (2009) Anesthesiology0, 110, pp. 380-386 Holt, J.P., Rhode, E.A., Kines, H., Ventricular volumes and body weight in mammals (1968) Am J Physiol, 212, pp. 704-715 Cave, G., Harvey, M., Intravenous lipid emulsion as antidote beyond local anesthetic toxicity: a systematic review (2009) Acad Emerg Med, 16, pp. 815-824 Shen, X., Wang, F., Xu, S., A cardiolipina é o alvo da cardiotoxicidade dos anestésicos locais? (2010) Rev Bras Anestesiol, 60, pp. 445-454 Aya, A.G.M., Ripart, J., Sebbane, M.A., de La Coussaye, J.E., Les émulsions lipidiques dans le traitement de la toxicité systémique des anesthésiques locaux: efficacité et limites (2010) Ann Fr Anesth Reanim, 29, pp. 464-469 Stojiljkovic, M.P., Zhang, D., Lopes, H.F., Hemodynamic effects of lipids in humans (2001) Am J Physiol Regul Integr Comp Physiol, 280, pp. 1674-1679 Kearney, M.T., Chowienczyk, P.J., Brett, S.E., Acute haemodynamic effects of lipolysis-induced increase of free fatty acids in healthy men (2002) Clin Sci, 102, pp. 495-500 Litonius, E.S., Niiya, T., Neuvonen, P.J., Intravenous lipid emulsion only minimally influences bupivacaine and mepivacaine distribution in plasma and does not enhance recovery from intoxication in pigs (2011) Anesth Analg, , [Epub ahead of print] Stehr, S.N., Ziegeler, J.C., Pexa, A., (2007) The effects of lipid infusion on myocardial function and bioenergetics in l-bupivacaine toxicity in the isolated rat heart, 104, pp. 186-192 Picard, J., Limit emulsion to treat drug overdose: past, present and future (editorial) (2009) Anaesthesia, 64, pp. 119-121 Bern, S., Weinberg, G., Local anesthetic toxicity and lipid resuscitation in pregnancy (2011) Curr Opin Anesthesiol, 24, pp. 262-267