Abstract:
BACKGROUND:The use of lipid emulsions to reduce cardiac toxicity of local anaesthetics (LAs) has shown success in experimental studies and some clinical cases, and thus has been implemented in clinical practice. However, lipid treatment is usually given after the occurrence of neurological or cardiovascular symptoms of systemic intoxication. The aim of this study was to determine if pretreatment with lipid emulsion reduces cardiac toxicity produced by bupivacaine or mepivacaine. METHODS:Isolated rat hearts were perfused with or without lipid emulsion (0.25 ml kg(-1) min(-1)) before administration of equipotent doses of bupivacaine (250 µM) or mepivacaine (1000 µM). Haemodynamic parameters and times from start of perfusion LA to a 1 min period of asystole and recovery were determined. RESULTS:Pretreatment with lipid emulsion extended the time until occurrence of asystole and decreased times to recovery in bupivacaine-induced cardiac toxicity but not in mepivacaine-induced cardiac toxicity compared with control. Lipid pretreatment impaired rate-pressure product recovery in mepivacaine-intoxicated hearts. CONCLUSIONS:This study confirms that pretreatment with a lipid emulsion reduces cardiac toxicity of LAs. The efficacy of pretreatment with lipid emulsion was LA-dependent, so pharmacokinetic properties, such as lipophilicity, might influence the effects of lipid emulsion pretreatment.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Aumeier C,Kasdorf B,Gruber M,Busse H,Wiese CH,Zink W,Graf BM,Zausig YAdoi
10.1093/bja/aet353subject
Has Abstractpub_date
2014-04-01 00:00:00pages
735-41issue
4eissn
0007-0912issn
1471-6771pii
S0007-0912(17)30892-9journal_volume
112pub_type
杂志文章abstract::We have examined the extradural space using a flexible extraduroscope in 74 patients undergoing extradural anaesthesia at the L2-3 interspace. Extraduroscopy showed that the extradural space becomes widely patent and the fatty tissue in the extradural space diminishes with increasing age. We postulate that these age-r...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/78.2.149
更新日期:1997-02-01 00:00:00
abstract::Midazolam is often used for paediatric premedication. We have compared two methods of administering midazolam intranasally in 44 surgical day-case children allocated randomly to receive midazolam 0.2 mg kg-1 as drops or midazolam 0.1 mg kg-1 from an intranasal spray device. Behaviour was recorded on a four-point scale...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1998-12-01 00:00:00
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journal_title:British journal of anaesthesia
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更新日期:2015-07-01 00:00:00
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journal_title:British journal of anaesthesia
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doi:10.1093/bja/62.4.429
更新日期:1989-04-01 00:00:00
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journal_title:British journal of anaesthesia
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journal_title:British journal of anaesthesia
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aei182
更新日期:2005-09-01 00:00:00
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pub_type: 临床试验,杂志文章
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pub_type: 杂志文章,随机对照试验
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更新日期:1981-04-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/60.1.18
更新日期:1988-01-01 00:00:00
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doi:10.1093/bja/aep102
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journal_title:British journal of anaesthesia
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更新日期:1993-04-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
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更新日期:2006-09-01 00:00:00