Bupivacaine-induced cardiac arrhythmias in sheep.

Abstract:

:Controversy persists about the cardiac toxicity of bupivacaine if accidentally administered intravenously during regional anesthesia. Using awake, unanesthetized sheep, we evaluated the cardiac effects of low and high equivalent doses of lidocaine and bupivacaine given intravenously over 10 s. All animals convulsed within 30 s of injections. Although both drugs significantly increased heart rate and systemic and pulmonary arterial blood pressure for up to 10 min, cardiac output was affected variably. The magnitude of hemodynamic changes that each drug produced did not differ significantly from each other at either dose level. However, of the sheep receiving intravenous lidocaine, none developed arrhythmias other than mild sinus tachycardia and minimal ST-T wave changes (which occurred in 25% of the animals). After intravenous bupivacaine injection, all sheep had transient changes on the EKG and/or arrhythmias (e.g., supraventricular tachycardia; atrioventricular condition blocks; ventricular tachycardia; multiform premature ventricular contractions; wide QRS complexes; ST-T wave changes; and in one animal, fatal ventricular fibrillation). Normal sinus rhythm usually returned within 8-10 min. Arterial blood gas and acid-base values stayed within the normal range during the studies, and serum potassium did not change significantly from control. In conclusion, in conscious adult sheep, equivalent doses of lidocaine or bupivacaine produced similar central nervous system (CNS) toxicity when rapidly injected intravenously. In the absence of marked hypoxia, respiratory or metabolic acidosis, hyperkalemia, or hypotension, serious cardiac arrhythmias occurred after bupivacaine but not lidocaine.

journal_name

Anesthesiology

journal_title

Anesthesiology

authors

Kotelko DM,Shnider SM,Dailey PA,Brizgys RV,Levinson G,Shapiro WA,Koike M,Rosen MA

doi

10.1097/00000542-198401000-00004

subject

Has Abstract

pub_date

1984-01-01 00:00:00

pages

10-8

issue

1

eissn

0003-3022

issn

1528-1175

journal_volume

60

pub_type

杂志文章
  • Propofol decreases myofilament Ca2+ sensitivity via a protein kinase C-, nitric oxide synthase-dependent pathway in diabetic cardiomyocytes.

    abstract:BACKGROUND:The authors' objective was to assess the role of protein kinase C (PKC) and nitric oxide synthase (NOS) in mediating the effects of propofol on diabetic cardiomyocyte contractility, intracellular free Ca2+ concentration ([Ca2+]i), and myofilament Ca2+ sensitivity. METHODS:Freshly isolated ventricular myocyt...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200605000-00014

    authors: Wickley PJ,Shiga T,Murray PA,Damron DS

    更新日期:2006-05-01 00:00:00

  • Interaction of halothane with alpha- and beta-adrenoceptor stimulations in rat myocardium.

    abstract:BACKGROUND:Halothane induces negative inotropic and lusitropic effects in myocardium. It has been suggested that halothane potentiates beta-adrenoceptor stimulation. However, its effects on the inotropic response to alpha-adrenoceptor stimulation and its effects on the lusitropic effects of alpha- and beta-adrenoceptor...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199701000-00019

    authors: Hanouz JL,Riou B,Massias L,Lecarpentier Y,Coriat P

    更新日期:1997-01-01 00:00:00

  • Barbiturate anesthetics inhibit thromboxane-, potassium-, but not angiotensin-induced pulmonary vasoconstriction.

    abstract::Administration of the oxidant lipid peroxide tertiary butyl hydroperoxide (t-bu-OOH) in the isolated rabbit lung leads to acute pulmonary vasoconstriction, which is caused by the synthesis of thromboxane. The inhalational anesthetics, halothane, nitrous oxide, and cyclopropane, markedly enhance t-bu-OOH-induced pulmon...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198905000-00012

    authors: McShane AJ,Crowley K,Shayevitz JR,Michael JR,Adkinson NF Jr,Traystman RJ,Gurtner GH

    更新日期:1989-05-01 00:00:00

  • A comparative evaluation of the effects of multiple vasodilators on human internal mammary artery.

    abstract:BACKGROUND:Vasospasm of arterial grafts represents an unpredictable complication of coronary artery surgery and may compromise myocardial revascularization, and treatment is based on empirical therapy with nitroglycerin. Because of the potential for tolerance to nitroglycerin to occur, the authors studied different vas...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199806000-00030

    authors: Huraux C,Makita T,Montes F,Szlam F,Levy JH

    更新日期:1998-06-01 00:00:00

  • Use of a chlorhexidine dressing to reduce microbial colonization of epidural catheters.

    abstract::We performed a prospective randomized controlled trial to assess the efficacy of a chlorhexidine dressing in reducing the microbial flora at the insertion site of epidural catheters. These catheters were used for acute pain management and were dressed either by a standardized method or with a CHX/urethane sponge compo...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199010000-00007

    authors: Shapiro JM,Bond EL,Garman JK

    更新日期:1990-10-01 00:00:00

  • Osmolarity determines the solubility of anesthetics in aqueous solutions at 37 degrees C.

    abstract::The authors determined whether they could predict accurately the solubility of anesthetics in aqueous solutions at 37 degrees C, knowing the osmolarity and the pH of the solution and the solute composition. The partition coefficients of the four volatile anesthetics, isoflurane, enflurane, halothane, and methoxyfluran...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198312000-00013

    authors: Lerman J,Willis MM,Gregory GA,Eger EI 2nd

    更新日期:1983-12-01 00:00:00

  • Population pharmacodynamic modeling and covariate detection for central neural blockade.

    abstract:BACKGROUND:In spinal anesthesia, often a large interindividual variability in analgesic response is observed after administration of a certain fixed dose of anesthetic to a patient population. To improve therapeutic outcome it is important to characterize the variability in response by means of a population model (e.g....

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199609000-00009

    authors: Schnider TW,Minto CF,Bruckert H,Mandema JW

    更新日期:1996-09-01 00:00:00

  • AZD-3043: a novel, metabolically labile sedative-hypnotic agent with rapid and predictable emergence from hypnosis.

    abstract:BACKGROUND:Propofol can be associated with delayed awakening after prolonged infusion. The aim of this study was to characterize the preclinical pharmacology of AZD-3043, a positive allosteric modulator of the γ-aminobutyric acid type A (GABA(A)) receptor containing a metabolically labile ester moiety. The authors post...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e31825685a6

    authors: Egan TD,Obara S,Jenkins TE,Jaw-Tsai SS,Amagasu S,Cook DR,Steffensen SC,Beattie DT

    更新日期:2012-06-01 00:00:00

  • Retrograde light-guided laryngoscopy for tracheal intubation: clinical practice and comparison with conventional direct laryngoscopy.

    abstract:BACKGROUND:Tracheal intubation with conventional laryngoscopy requires many trials until beginners are sufficiently skilled in intubating patients safely. To facilitate intubation, the authors used retrograde light-guided laryngoscopy (RLGL) and compared its feasibility with conventional direct laryngoscopy (DL). METH...

    journal_title:Anesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/ALN.0b013e31828877c0

    authors: Yang T,Hou J,Li J,Zhang X,Zhu X,Ni W,Mao Y,Deng X

    更新日期:2013-05-01 00:00:00

  • The effects of epidural morphine on cardiac and renal sympathetic nerve activity in alpha-chloralose-anesthetized cats.

    abstract:BACKGROUND:Epidural morphine yields postoperative pain relief and hemodynamic stability. However, the effects of epidural morphine on sympathetic tone are unclear. This study was designed to elucidate the effects of epidural morphine on cardiac (CSNA) and renal (RSNA) sympathetic nerve activity by direct measurement in...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199806000-00020

    authors: Mori T,Nishikawa K,Terai T,Yukioka H,Asada A

    更新日期:1998-06-01 00:00:00

  • Alveolar-to-arterial-to-venous anesthetic partial pressure differences in humans.

    abstract::To determine the correlation between the partial pressures of anesthetics in venous and arterial blood (Pv and Pa), and to assess whether this correlation was better than that between the partial pressure of anesthetic in alveolar gas (PA) and Pa, isoflurane (n = 4) or halothane (n = 4) was administered to eight patie...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198904000-00014

    authors: Carpenter RL,Eger EI 2nd

    更新日期:1989-04-01 00:00:00

  • A Clinical Trial to Detect Subclinical Transfusion-induced Lung Injury during Surgery.

    abstract:BACKGROUND:Transfusion-related acute lung injury incidence remains the leading cause of posttransfusion mortality. The etiology may be related to leukocyte antibodies or biologically active compounds in transfused plasma, injuring susceptible recipient's lungs. The authors have hypothesized that transfusion could have ...

    journal_title:Anesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/ALN.0000000000000689

    authors: Feiner JR,Gropper MA,Toy P,Lieberman J,Twiford J,Weiskopf RB

    更新日期:2015-07-01 00:00:00

  • The cerebral and systemic hemodynamic and metabolic effects of desflurane-induced hypotension in dogs.

    abstract::The cerebral and systemic hemodynamic and metabolic effects of hypotension induced with desflurane were examined in 11 dogs. During a steady-state baseline period under 1 MAC desflurane (7.2%), the following were measured or derived: arterial, pulmonary artery, and pulmonary artery occlusion pressures; arterial, mixed...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199103000-00021

    authors: Milde LN,Milde JH

    更新日期:1991-03-01 00:00:00

  • Effects of pre- and postischemic administration of thiopental on transmitter amino acid release and histologic outcome in gerbils.

    abstract:BACKGROUND:The mechanism by which barbiturates protect neurons against ischemia is unclear, particularly when they are given after ischemia or reperfusion begins. Because an excess release of excitatory neurotransmitters causes postsynaptic membrane depolarization, which triggers neuronal damage in ischemia, the effect...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199612000-00024

    authors: Amakawa K,Adachi N,Liu K,Ikemune K,Fujitani T,Arai T

    更新日期:1996-12-01 00:00:00

  • Hemodilution with oxyhemoglobin. Mechanism of oxygen delivery and its superaugmentation with a nitric oxide donor (sodium nitroprusside).

    abstract:BACKGROUND:Hemodilution (HD) with oxyhemoglobin colloid (oxyHb) provides a greater arterial oxygen content (CaO2) than HD with conventional colloids; however, oxygen delivery (DO2) is essentially the same, because, in contrast to conventional HD, cardiac output (CO) is not augmented. This study seeks to elucidate the m...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199307000-00011

    authors: Rooney MW,Hirsch LJ,Mathru M

    更新日期:1993-07-01 00:00:00

  • An Introduction to Causal Diagrams for Anesthesiology Research.

    abstract::Making good decisions in the era of Big Data requires a sophisticated approach to causality. We are acutely aware that association ≠ causation, yet untangling the two remains one of our greatest challenges. This realization has stimulated a Causal Revolution in epidemiology, and the lessons learned are highly relevant...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000003193

    authors: Gaskell AL,Sleigh JW

    更新日期:2020-05-01 00:00:00

  • Propofol: its role in changing the practice of anesthesia.

    abstract::Pharmacokinetics and pharmacodynamics of propofol infusions during general anesthesia. By Audrey Shafer, Van A. Doze, Steven L. Shafer, and Paul F. White. Anesthesiology 1988; 69:348-56. Reprinted with permission.The pharmacokinetic and pharmacodynamic properties of propofol (Diprivan) were studied in 50 elective surg...

    journal_title:Anesthesiology

    pub_type: 古典文章,评论,杂志文章

    doi:10.1097/ALN.0b013e31818ddba8

    authors: White PF

    更新日期:2008-12-01 00:00:00

  • A comparison of the posterior versus lateral approaches to the block of the sciatic nerve in the popliteal fossa.

    abstract:BACKGROUND:The main disadvantage of the posterior approach to the block of the sciatic nerve in the popliteal fossa (popliteal block [PB]) is the need to place the patient in the prone position. In this study, the authors examined the clinical utility of a recently described lateral approach to PB that is performed wit...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199806000-00010

    authors: Hadzić A,Vloka JD

    更新日期:1998-06-01 00:00:00

  • Resting metabolic rate of the critically ill patient: measured versus predicted.

    abstract::Critically ill patients requiring mechanical ventilation are particularly susceptible to malnutrition. A knowledge of the energy requirements of these patients is essential in designing nutritional regimens. This study examines 45 resting energy-expenditure measurements performed in a group (n = 40) of postoperative, ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198606000-00001

    authors: Weissman C,Kemper M,Askanazi J,Hyman AI,Kinney JM

    更新日期:1986-06-01 00:00:00

  • Effects of clonidine on postoperative nausea and vomiting in breast cancer surgery.

    abstract:BACKGROUND:Postoperative nausea and vomiting (PONV) is still common, especially among female patients. Our hypothesis is that coinduction with clonidine reduces the incidence of PONV in adult patients undergoing breast cancer surgery. METHODS:Sixty-eight women premedicated with midazolam were randomly allocated to coi...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-200205000-00013

    authors: Oddby-Muhrbeck E,Eksborg S,Bergendahl HT,Muhrbeck O,Lönnqvist PA

    更新日期:2002-05-01 00:00:00

  • Cardiovascular events in the postanesthesia care unit: contribution of risk factors.

    abstract:BACKGROUND:The purpose of this study was to determine the relationship of four postanesthesia care unit (PACU) cardiovascular events to long-term outcomes (unplanned critical care admission or mortality) and to evaluate the contribution of anesthetic management compared with other perioperative factors in predicting th...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199604000-00003

    authors: Rose DK,Cohen MM,DeBoer DP

    更新日期:1996-04-01 00:00:00

  • Sevoflurane Exposure during the Critical Period Affects Synaptic Transmission and Mitochondrial Respiration but Not Long-term Behavior in Mice.

    abstract:BACKGROUND:Anesthesia during the synaptogenic period induces dendritic spine formation, which may affect neurodevelopment. The authors, therefore, evaluated whether changes in synaptic transmission after dendritic spine formation induced by sevoflurane were associated with long-term behavioral changes. The effects of s...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000001470

    authors: Chung W,Ryu MJ,Heo JY,Lee S,Yoon S,Park H,Park S,Kim Y,Kim YH,Yoon SH,Shin YS,Lee WH,Ju X,Kweon GR,Ko Y

    更新日期:2017-02-01 00:00:00

  • Subjective, psychomotor, cognitive, and analgesic effects of subanesthetic concentrations of sevoflurane and nitrous oxide.

    abstract:BACKGROUND:Sevoflurane is a volatile general anesthetic that differs in chemical nature from the gaseous anesthetic nitrous oxide. In a controlled laboratory setting, the authors characterized the subjective, psychomotor, and analgesic effects of sevoflurane and nitrous oxide at two equal minimum alveolar subanesthetic...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章

    doi:10.1097/00000542-199711000-00012

    authors: Galinkin JL,Janiszewski D,Young CJ,Klafta JM,Klock PA,Coalson DW,Apfelbaum JL,Zacny JP

    更新日期:1997-11-01 00:00:00

  • Clinical characteristics and biotransformation of sevoflurane in healthy human volunteers.

    abstract::Sevoflurane was submitted to phase-1 studies in man following extensive testing in animal species during maintenance, was administered with oxygen to produce one hour of anesthesia in six healthy adult male volunteers. Respiratory and cardiovascular functions, the electroencephalogram, arterial blood gases, blood sevo...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198102000-00002

    authors: Holaday DA,Smith FR

    更新日期:1981-02-01 00:00:00

  • ST segment depression during labor and delivery.

    abstract::ECG changes suggestive of myocardial ischemia are common during cesarean delivery under regional anesthesia. To determine the time course, duration, and significance of these ECG changes, we monitored 111 parturients with continuous ambulatory ECG (Holter) during and after cesarean delivery. Twenty-two parturients und...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199210000-00004

    authors: Mathew JP,Fleisher LA,Rinehouse JA,Sevarino FB,Sinatra RS,Nelson AH,Prokop EK,Rosenbaum SH

    更新日期:1992-10-01 00:00:00

  • Effect of antiemetic therapy on recovery and hospital discharge time. A double-blind assessment of ondansetron, droperidol, and placebo in pediatric patients undergoing ambulatory surgery.

    abstract:BACKGROUND:Postoperative nausea and vomiting continue to be a significant problem for pediatric ambulatory surgery patients. Although ondansetron has been demonstrated to be effective in the prophylactic treatment of postoperative nausea and vomiting (surrogate end point) no one has demonstrated a benefit of antiemetic...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199511000-00007

    authors: Davis PJ,McGowan FX Jr,Landsman I,Maloney K,Hoffmann P

    更新日期:1995-11-01 00:00:00

  • Effects of ketamine on cardiovascular responses mediated by N-methyl-D-aspartate receptor in the rat nucleus tractus solitarius.

    abstract:BACKGROUND:Ketamine is often administered to patients in whom hemodynamic instability is suspected. This study was designed to investigate the effect and possible site of action of ketamine on baroreflex response in rats. The site focused upon was the N-methyl-D-aspartate (NMDA) receptor of the nucleus tractus solitari...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199301000-00022

    authors: Ogawa A,Uemura M,Kataoka Y,Ol K,Inokuchi T

    更新日期:1993-01-01 00:00:00

  • No involvement of antidiuretic hormone in acute antidiuresis during PEEP ventilation in humans.

    abstract::Decreased urinary output (Vu ml/min) after institution of PEEP is attributed to a variety of mechanisms including decreased cardiac output and renal blood flow (RBF), activation of neurohormonal reflexes, increased catecholamines, plasma renin activity (PRA), and antidiuretic hormone (ADH) release. To evaluate these f...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198701000-00004

    authors: Payen DM,Farge D,Beloucif S,Leviel F,De La Coussaye JE,Carli P,Wirquin V

    更新日期:1987-01-01 00:00:00

  • Cervical epidural pressure measurement: comparison in the prone and sitting positions.

    abstract:BACKGROUND:The hanging drop technique is used for identifying the cervical epidural space, using its negative pressure. However, it is doubtful whether the epidural space intrinsically exhibits a negative pressure. We designed this study to test the hypothesis that the cervical epidural pressure (CEP) is significantly ...

    journal_title:Anesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/ALN.0b013e3181e898e8

    authors: Moon JY,Lee PB,Nahm FS,Kim YC,Choi JB

    更新日期:2010-09-01 00:00:00

  • Binding of thiopental to plasma proteins: effects on distribution in the brain and heart.

    abstract::Thiopental-14C (30 mg and 10 muCi/kg) was injected intravenously into rats 36-48 hours following bilateral nephrectomy and one minute after pretreatment with sulfadimethoxine (30 mg/kg, iv). Control groups of normal and sham-operated animals were used. The distributions of radioactivity in plasma, brain, and heart 1, ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-197612000-00008

    authors: Ghoneim MM,Pandya HB,Kelley SE,Fischer LJ,Corry RJ

    更新日期:1976-12-01 00:00:00