The effect of verapamil and amiodarone on bupivacaine cardiotoxicity

In group II, we observed that 1 mg kg-1 iv verapamile enabled the cardiotxicity caused by bupivaciane and 2 rats died 8 minutes after verapamil injection with rapid hypotension and bradicardia and this was seen as synoatrial block on ECG records.Results: In group III we observed that 5 mg kg-1 amiodarone also made the symtoms of cardiotoxicity caused by bupivacaine more serious.Conclusion: In this study, we concluded that verapamil 1 µg kg-1 and amiodarone 5 mg kg-1 have negative effect on bupivacaine cardiotoxicity and made the cardiotoxicity symptoms more serious.

📌 3 Key Takeaways

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Objective & Hypothesis:Aim: Accidentally intravenous injection of bupivaciane can cause sudden cardiovascular collapse.

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Key Findings & Data:In this study, we aimed to investigate the effects of verapamil and amiodarone on cardiotoxicity caused by iv bupivaciane in rats.Materials and Methods: 15 adult female rats were randomised into 3 groups.

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Conclusion & Impact:In group II, we observed that 1 mg kg-1 iv verapamile enabled the cardiotxicity caused by bupivaciane and 2 rats died 8 minutes after verapamil injection with rapid hypotension and bradicardia and this was seen as synoatrial block on ECG records.Results: In group III we observed that 5 mg kg-1 amiodarone also made the symtoms of cardiotoxicity caused by bupivacaine more serious.Conclusion: In this study, we concluded that verapamil 1 µg kg-1 and amiodarone 5 mg kg-1 have negative effect on bupivacaine cardiotoxicity and made the cardiotoxicity symptoms more serious.

🔬Design:Research Article

📍Scope:Comprehensive Sample

⚙️Variables:Domain Parameters

Abstract

Aim: Accidentally intravenous injection of bupivaciane can cause sudden cardiovascular collapse. In this study, we aimed to investigate the effects of verapamil and amiodarone on cardiotoxicity caused by iv bupivaciane in rats.Materials and Methods: 15 adult female rats were randomised into 3 groups. Rats were anesthesized with 1 g kg-1 intraperitoneal urethane and invazively monitorized to record to heart rate (HR), systemic arterial pressure (SAP) and electrocardiography (ECG). In group I, bupivaciane 2 mg kg-1, in group II, bupivacaine 2 mg kg-1 and 2 minutes later verapamil 1 mg kg-1, in group III, bupivacaine 2 mg kg-1 and 2 minutes later amiodarone 5 mg kg-1 were given bolusly. Heart rate, mean arterial pressure, PR interval of D1-D2-D3 derivations and wideness of QRS complex were recorded before drug injection, after drug injection and every 2 minutes for 20 minutes. In group II, we observed that 1 mg kg-1 iv verapamile enabled the cardiotxicity caused by bupivaciane and 2 rats died 8 minutes after verapamil injection with rapid hypotension and bradicardia and this was seen as synoatrial block on ECG records.Results: In group III we observed that 5 mg kg-1 amiodarone also made the symtoms of cardiotoxicity caused by bupivacaine more serious.Conclusion: In this study, we concluded that verapamil 1 µg kg-1 and amiodarone 5 mg kg-1 have negative effect on bupivacaine cardiotoxicity and made the cardiotoxicity symptoms more serious.

Özet

Amaç: Bupivakainin yanlışlıkla intravenöz enjeksiyonu, ani kardiyovasküler kollapsa neden olmaktadır. Çalışmamızda, sıçanlarda verapamil ile amiodaronun, iv. bupivakain ile gelişen kardiyotoksisite üzerine olan etkilerini araştırmayı amaçladık.Gereç ve Yöntem: 15 adet yetişkin dişi sıçan rasgele 3 gruba ayrıldı. Sıçanlar; 1 gr kg-1 intraperitoneal ürethan ile anestetize edildikten sonra, kalp atım hızı (KAH) sistemik arter basıncı (SAB) ve elektrokardiyografi (EKG) kayıtlarının alınabilmesi için invazif monitörizasyon yapıldı. Grup I'de; 2 mg kg-1 iv bupivakain, Grup II’de; 2 mg kg-1 iv bupivakain ve 2 dakika sonra 1 mg kg-1 iv verapamil, Grup III'te 2 mg kg-1 iv bupivakain ve 2 dk. sonra 5 mg kg-1 iv amiodaron bolus olarak uygulandı. İlaç uygulaması öncesi, ilaç uygulaması sonrası ve 2 dk. aralarla 20 dk. kalp atım hızı, orta arter basıncı, EKG'de D1-D2-D3 derivasyonlarında ölçülen PR mesafesi ve QRS kompleksi genişlikleri kaydedildi.Bulgular: Grup II'de 1 mg kg-1 iv verilen verapamilin, bupivakainin neden olduğu kardiyotoksisite kliniğini arttırdığını ve 2 sıçanın verapamil verildikten 8 dk. sonra hızlı seyir gösteren hipotansiyon ve bradikardi nedeniyle öldüğünü, bu durumun da EKG kayıtların “Sinoatriyal blok” olarak yansıdığını saptadık. Grup III'de; 5 mg kg-1 iv verilen amiodaronun da, bupivakainin neden olduğu kardiyotoksisite bulgularını ağırlaştırdığını gördük.Sonuç: Çalışmamızda, sıçanlarda 2 mg kg-1 iv bupivakaini takiben uygulanan 1 mg kg-1 iv verapamilin ve 5 mg kg-1 iv amiodaronun, bupivakain kardiyotoksisitesi üzerine olumsuz yönde etkisinin olduğu ve bupivakaine bağlı olarak ortaya çıkan kardiyotoksisite bulgularını ağırlaştırdığı sonucuna vardık.

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Cite This Article

BELGİ, A., KARSLI, B., TRAKYA, A., BOZTUĞ, N., BÜYÜKGEBİZ, B., YEĞİN, A. (2022). The effect of verapamil and amiodarone on bupivacaine cardiotoxicity. Türk Anestezi ve Reanimasyon Dergisi, Cilt: 34 - Sayı: 4, 211–218. https://ajindex.com/articles/620078

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