Association of sustained cardiovascular recovery with epinephrine in the delayed lipid-based resuscitation from cardiac arrest induced by bupivacaine overdose in rats

British Journal of Anaesthesia
B LiZ Ma

Abstract

The role of epinephrine combined with lipid emulsion in rescuing cardiovascular collapse induced by local anaesthetic overdose remains unclear. The objective of this study was to explore the effect of epinephrine on delayed lipid-based treatment for bupivacaine-induced cardiac arrest in rats. Thirty-two rats were subjected to bupivacaine to induce asystole. Basic life support was performed for 10 min before the rats received saline, epinephrine alone, or 20% lipid emulsion bolus with or without epinephrine pretreatment. ECG and invasive arterial pressure were monitored continuously. Arterial blood gas was analysed at 25 min; the right lungs and hearts of rats were harvested for measurement of dry-to-wet lung weight ratio and myocardial bupivacaine content, respectively. In the rats treated with epinephrine plus lipid emulsion, there was a marked improvement in haemodynamic parameters at 25 min compared with rats treated with lipid alone, P<0.05. The coronary perfusion pressure immediately after lipid rescue was higher in the epinephrine/lipid-treated rats when compared with rats given lipid only (70 and 24 mm Hg, respectively, P<0.05). The myocardial bupivacaine content was lower (8.34 nM g(-1)) in the epinephrine/lipid group r...Continue Reading

References

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Apr 24, 2008·Anesthesiology·Guy L WeinbergDouglas L Feinstein
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Aug 26, 2009·Anesthesiology·David B HillerGuy L Weinberg
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Dec 22, 2010·British Journal of Anaesthesia·B Kilpatrick, P Slinger
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Sep 3, 2011·Paediatric Anaesthesia·Jacqueline MauchMarkus Weiss

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Citations

Feb 19, 2014·British Journal of Anaesthesia·M Harvey, G Cave
Feb 9, 2016·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Lotte C G HoegbergUNKNOWN Lipid Emulsion Workgroup
Sep 25, 2016·Acupuncture in Medicine : Journal of the British Medical Acupuncture Society·Jun-Long GaoDong-Hang Zhang
Jun 1, 2017·Current Opinion in Anaesthesiology·Lotte C G Hoegberg, Sophie Gosselin
Mar 28, 2017·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Michael R Fettiplace, Daniel J McCabe
Oct 8, 2020·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Michael R Fettiplace, Adrian B Pichurko

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