Comparative Cardiotoxicity of Bupivacaine and Lidocaine in the Isolated Perfused Mammalian Heart

Tanzs, Ralph D.; Heskett, Tammy; Loehning, Robert W.; Fairfax, Charles A.

doi:10.1213/00000539-198406000-00001

Cited by 6 publications

(9 citation statements)

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“…One explanation for this increased need for vasoactive support after LIDO may be that the absence of lethal arrhythmias (18) permits a relatively larger amount of LIDO (compared with the other drugs) to be infused, approaching that required for contractile failure. Interestingly, concentrations of LIDO necessary to produce depression of cardiac contractility have been 10 times larger than BUP in in vitro studies (23,24). Nevertheless, similar to the findings of Chadwick (25), all of the LIDO animals survived whereas only half of the BUP-intoxicated animals survived, despite the increased need for continued vasoactive support after LIDO.…”

Section: Discussionmentioning

confidence: 55%

Cardiac Resuscitation After Incremental Overdosage with Lidocaine, Bupivacaine, Levobupivacaine, and Ropivacaine in Anesthetized Dogs

Groban

Deal

Vernon

et al. 2001

Anesthesia &Amp; Analgesia

247

117

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There were consistent differences among the local anesthetics, the sum of which suggests that larger doses and blood concentrations of ropivacaine (ROP) and lidocaine will be tolerated as compared with bupivacaine (BUP) and levobupivacaine (LBUP). Lidocaine intoxication results in myocardial depression from which resuscitation is consistently successful but will require continuing drug support. After BUP, LBUP, or ROP, resuscitation is not always successful, and the administration of epinephrine may lead to severe arrhythmias. The unbound plasma concentrations at collapse were larger for ROP compared with BUP, whereas the concentrations of LBUP and BUP were not significantly different from each other. Furthermore, larger plasma concentrations of ROP than BUP are present after resuscitation, suggesting a wider margin of safety when large volumes and large concentrations are used to establish upper or lower extremity nerve blocks for surgical anesthesia and during long-term infusions for pain management.

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Section: Discussionmentioning

confidence: 55%

Cardiac Resuscitation After Incremental Overdosage with Lidocaine, Bupivacaine, Levobupivacaine, and Ropivacaine in Anesthetized Dogs

Groban

Deal

Vernon

et al. 2001

Anesthesia &Amp; Analgesia

247

117

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“…Tanz et al (11) used the isolated guinea pig Langendorff preparation to compare the toxicities of bupivacaine and lidocaine. Their tabulated data on mechanical function and oxygen consumption indicated that 3 mg/L bupivacaine was more cardiodepressant than 30 mg/L lidocaine.…”

Section: E C H I I Ics Ii Izd Oxyyeiz Constimp Tioizmentioning

confidence: 99%

“…Our data showed a calculated 63.2% and 85.6% control for bupivacaine and lidocaine, respectively (at 15 minutes). We compared the two drugs at 15 minutes, while Tanz et al (11) compared them at 30, 60, and 90 minutes. Thus, our protocol differed in two major respects.…”

Section: E C H I I Ics Ii Izd Oxyyeiz Constimp Tioizmentioning

confidence: 99%

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Functional and Metabolic Effects of Bupivacaine and Lidocaine in the Perfused Working Rat Heart

Cronau¹,

Merin²,

Abouleish³

et al. 1988

Anesthesia & Analgesia

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STEENBERG M, MELGAREJO AB. Functional and metabolic effects of bupivacaine and lidocaine in the perfused working rat heart. Anesth Analg 1988;67:929-35.The effects of bupiuacaine (2 5, 5, 10, and 12.5 ingIL) and lidociline (12 5, 25, 40, and 50 mglL), on spontaneous lieart rate, mean pvessure development, cardiac output, a i d coronary flow were compared aftev 15 miiutes' exposure i n tlie isolated perfused working rat heart preparation In addition, myocardial oxygen consurription, glucose utilization, lactate production, tissue content of < y l y c o p , adenine nucleotides, and creatiiie phosphate content zueri' measured The relatiue potency of bupiz~acaine to lidocaine, calculntcd froin slopes of regression equatiotis, as indicated l~y tlie four rnechan ical var iabl er n rid oxygen coiisu in p t ion, z t m 4.59.When the bupiuacaine concentration Z L J~S "rioriiinlizcd" using tkis zmlile, bupiuocaiiie and lidocairie shouied i d i stinguishable c$ects on glucose utilization, lactate production, and tissue SlycoScn. Neitkcr of the local anesthetics had any influence on energy cliiirge or creatiiie pliosplunte con tent.

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“…Ziel unserer Studie war es, die zerebral induzierten Wirkungen einer Bupivacaininfusion in den SeitenUnerwünschte Wirkungen der Lokalanästhetika betreffen neben dem Zentralnervensystem vor allem das HerzKreislaufsystem. Die elektrophysiologischen und arrhythmogenen Wirkungen des Bupivacain sind gut dokumentiert [7,9,18,20,25,27]. Sie können durch eine Reihe von pharmakologischen und endogenen Faktoren verändert werden [3,5,11,12,19,23] …”

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Hämodynamische Effekte einer ventrikulo-zisternalen Perfusion mit Bupivacain im Tiermodell

et al. 1999

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Our results demonstrate that bupivacaine initiates an indirect cardiovascular stimulating effect of a VCP with 500 micrograms of bupivacaine via the central nervous system. The intravenous administration of the same dose had no effect. The centrally mediated cardiovascular effect of bupivacaine was reversed by wash-out with mock-CSF. The cardiovascular stimulation observed in this animal experiment may be of clinical relevance as a potential sign of toxic effects of bupivacaine on the CNS.

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Comparative Cardiotoxicity of Bupivacaine and Lidocaine in the Isolated Perfused Mammalian Heart

Cited by 6 publications

References 0 publications

Cardiac Resuscitation After Incremental Overdosage with Lidocaine, Bupivacaine, Levobupivacaine, and Ropivacaine in Anesthetized Dogs

Cardiac Resuscitation After Incremental Overdosage with Lidocaine, Bupivacaine, Levobupivacaine, and Ropivacaine in Anesthetized Dogs

Functional and Metabolic Effects of Bupivacaine and Lidocaine in the Perfused Working Rat Heart

Hämodynamische Effekte einer ventrikulo-zisternalen Perfusion mit Bupivacain im Tiermodell

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