SavedAdd your journal

Journals / Turkish Journal of Medical Sciences / 2014 / Cilt: 44 - Sayı: 2

Efficacy of resuscitation with Intralipid in a levobupivacaine-induced cardiac arrest model

Murat KARCIOĞLU
Kasım TUZCU
Fatih SEFİL
Işıl DAVARCI
Suzan AYDIN
Ali SARI
Akın AYDOĞAN
Raif ÖZDEN
Pages
330–336
Publication Date
2014-05-18
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Further studies are needed to develop clinical therapies for the systemic toxicity of local anesthetics.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Cardiac toxicity due to the administration of local anesthetics may be fatal.
📊
Key Findings & Data:In this study, we evaluated the efficacy of a 20% lipid solution combined with epinephrine in a levobupivacaine-induced cardiac arrest model.
💡
Conclusion & Impact:Further studies are needed to develop clinical therapies for the systemic toxicity of local anesthetics.
🔬Design:Modeling & Simulation
📍Scope:Comprehensive Sample
⚙️Variables:Key words: Levobupivacaine · lipid emulsion · epinephrine

Abstract

Cardiac toxicity due to the administration of local anesthetics may be fatal. In this study, we evaluated the efficacy of a 20% lipid solution combined with epinephrine in a levobupivacaine-induced cardiac arrest model. Materials and methods: A total of 14 New Zealand rabbits were sedated and mechanically ventilated. Asystole was induced with intravenous levobupivacaine injection. The rabbits were randomized into groups receiving the same volume of either 0.9% saline (CR group) or a 20% lipid solution (LE group) along with a 100 µg/kg epinephrine bolus, which were administered immediately upon asystole. Standard advanced cardiac life support protocols were performed. Results: Four subjects in the LE group as well as 3 subjects in the CR group had a spontaneous recovery (P = 0.592). In the 20th minute after arrest, 3 subjects in the LE group had maintained spontaneous circulation, while there was only 1 subject from the CR group with the same outcome. Conclusion: We found that adding a lipid solution to epinephrine for the resuscitation of rabbits that underwent levobupivacaine-induced cardiac arrest increased recovery rates of circulation and therefore the likelihood of survival. Further studies are needed to develop clinical therapies for the systemic toxicity of local anesthetics.

Özet

Cardiac toxicity due to the administration of local anesthetics may be fatal. In this study, we evaluated the efficacy of a 20% lipid solution combined with epinephrine in a levobupivacaine-induced cardiac arrest model. Materials and methods: A total of 14 New Zealand rabbits were sedated and mechanically ventilated. Asystole was induced with intravenous levobupivacaine injection. The rabbits were randomized into groups receiving the same volume of either 0.9% saline (CR group) or a 20% lipid solution (LE group) along with a 100 µg/kg epinephrine bolus, which were administered immediately upon asystole. Standard advanced cardiac life support protocols were performed. Results: Four subjects in the LE group as well as 3 subjects in the CR group had a spontaneous recovery (P = 0.592). In the 20th minute after arrest, 3 subjects in the LE group had maintained spontaneous circulation, while there was only 1 subject from the CR group with the same outcome. Conclusion: We found that adding a lipid solution to epinephrine for the resuscitation of rabbits that underwent levobupivacaine-induced cardiac arrest increased recovery rates of circulation and therefore the likelihood of survival. Further studies are needed to develop clinical therapies for the systemic toxicity of local anesthetics.

🔖

Cite This Article

KARCIOĞLU, M., TUZCU, K., SEFİL, F., DAVARCI, I., AYDIN, S., SARI, A., AYDOĞAN, A., ÖZDEN, R. (2014). Efficacy of resuscitation with Intralipid in a levobupivacaine-induced cardiac arrest model. Turkish Journal of Medical Sciences, Cilt: 44 - Sayı: 2, 330–336. https://ajindex.com/articles/394074

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (13)

  1. Cave G, Harvey MG, Winterbottom T. Evaluation of the Association of Anaesthetists of Great Britain and Ireland lipid infusion protocol in bupivacaine induced cardiac arrest in rabbits. Anaesthesia 2009; 64: 732–737.
  2. Litz RJ, Popp M, Stehr SN, Koch T. Successful resuscitation of a patient with ropivacaine-induced asystole after axillary plexus block using lipid infusion. Anaesthesia 2006; 61: 800–801.
  3. Rosenblatt MA, Abel M, Fischer GW, Itzkovich CJ, Eisenkraft JB. Successful use of a 20% lipid emulsion to resuscitate a patient after a presumed bupivacaine-related cardiac arrest. Anesthesiology 2006; 105: 217–218.
  4. Foxall G, McCahon R, Lamb J, Hardman JG, Bedforth NM. Levobupivacaine-induced seizures and cardiovascular collapse treated with Intralipid. Anaesthesia 2007; 62: 516–518.
  5. McCutchen T, Gerancher JC. Early Intralipid therapy may have prevented bupivacaine-associated cardiac arrest. Reg Anesth Pain Med 2008; 33: 178–180.
  6. Warren JA, Thoma RB, Georgescu A, Shah SJ. Intravenous lipid infusion in the successful resuscitation of local anestheticinduced cardiovascular collapse after supraclavicular brachial plexus block. Anesth Analg 2008; 106: 1578–1580.
  7. Ludot H, Tharin JY, Belouadah M, Mazoit JX, Malinovsky JM. Successful resuscitation after ropivacaine and lidocaineinduced ventricular arrhythmia following posterior lumbar plexus block in a child. Anesth Analg 2008; 106: 1572–1574.
  8. Weinberg GL, VadeBoncouer T, Ramaraju GA, Garcia-Amaro MF, Cwik MJ. Pretreatment or resuscitation with a lipid infusion shifts the dose-response to bupivacaine-induced asystole in rats. Anesthesiology 1998; 88: 1071–1075.
  9. Weinberg G, Ripper R, Feinstein DL, Hoffman W. Lipid emulsion infusion rescues dogs from bupivacaine-induced cardiac toxicity. Reg Anesth Pain Med 2003; 28: 198–202.
  10. Stehr SN, Ziegeler JC, Pexa A, Oertel R, Deussen A, Koch T, Hubler M. The effects of lipid infusion on myocardial function and bioenergetics in l-bupivacaine toxicity in the isolated rat heart. Anesth Analg 2007; 104: 186–192.
  11. Litz RJ, Roessel T, Heller AR, Stehr SN. Reversal of central nervous system and cardiac toxicity after local anesthetic intoxication by lipid emulsion injection. Anesth Analg 2008; 106: 1575–1577.
  12. Neal JM, Bernards CM, Butterworth JFT, Di Gregorio G, Drasner K, Hejtmanek MR, Mulroy MF, Rosenquist RW, Weinberg GL. ASRA practice advisory on local anesthetic systemic toxicity. Reg Anesth Pain Med 2010; 35: 152–161.
  13. Penson PE, Ford WR, Broadley KJ. Vasopressors for cardiopulmona