The use of dye surrogates to illustrate local anesthetic drug sequestration by lipid emulsion: a visual demonstration of the lipid sink effect

Regional Anesthesia and Pain Medicine
Aikaterini PapadopoulouDavid R Uncles

Abstract

We hypothesized that by substituting a dye surrogate in place of local anesthetic, we could visually demonstrate dye sequestration by lipid emulsion that would be dependent on both dye lipophilicity and the amount of lipid emulsion used. We selected 2 lipophilic dyes, acid blue 25 and Victoria blue, with log P values comparable to lidocaine and bupivacaine, respectively. Each dye solution was mixed with combinations of lipid emulsion and water to emulate "lipid rescue" treatment at dye concentrations equivalent to fatal, cardiotoxic, and neurotoxic local anesthetic plasma concentrations. The lipid emulsion volumes added to each dye solution emulated equivalent intravenous doses of 100, 500, and 900 mL of 20% Intralipid in a 75-kg adult. After mixing, the samples were separated into a lipid-rich supernatant and a lipid-poor subnatant by heparin flocculation. The subnatants were isolated, and their colors compared against a graduated dye concentration scale. Lipid emulsion addition resulted in significant dye acquisition by the lipid compartment accompanied by a reduction in the color intensity of the aqueous phase that could be readily observed. The greatest amount of sequestration occurred with the dye possessing the higher log...Continue Reading

References

Jul 15, 1992·Proceedings of the National Academy of Sciences of the United States of America·J M HuangM Bacaner
Jul 1, 1986·British Journal of Anaesthesia·G T Tucker
Aug 15, 1974·Experientia·J KrieglsteinD H Niemeyer
Feb 26, 2000·Anesthesiology·G L WeinbergC L Hoppel
Jan 1, 1965·The American Journal of Clinical Nutrition·H H LeveenA Johnson
Feb 17, 2009·Anesthesiology
Aug 19, 2009·Anaesthesia·P WattL Dyson
Oct 23, 2009·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Grant Cave, Martyn Harvey
Oct 30, 2009·Critical Care Medicine·York A ZausigWolfgang Zink
Mar 11, 2010·Regional Anesthesia and Pain Medicine·Joseph M NealGuy L Weinberg
Mar 11, 2010·Regional Anesthesia and Pain Medicine·Guy L Weinberg
Oct 21, 2010·Critical Care Medicine·Guy WeinbergDouglas Feinstein
Oct 22, 2010·European Journal of Anaesthesiology·Yuka MatsukiKenji Shigemi
Feb 18, 2011·Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology·UNKNOWN American College of Medical Toxicology
Apr 15, 2011·Emergency Medicine Australasia : EMA·Grant CaveAndis Graudins
May 14, 2011·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Deborah FrenchAlan H B Wu
Aug 10, 2011·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Yeon Young KyongKyoung Uk Lee
Aug 13, 2011·Biomedical Optics Express·Paola Di NinniGiovanni Zaccanti
Oct 11, 2011·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Deborah FrenchAlan H B Wu
Mar 1, 2010·Expert Opinion on Drug Discovery·Michael J Waring

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Citations

Jun 24, 2014·Annales Françaises D'anesthèsie Et De Rèanimation·K Nouette-GaulainH Beloeil
Sep 5, 2012·Expert Review of Clinical Pharmacology·W Stephen Waring
Jun 1, 2017·Current Opinion in Anaesthesiology·Lotte C G Hoegberg, Sophie Gosselin
Apr 11, 2020·Clinical Case Reports·Nathan S ChumblerMark G Papich

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