Lipid Therapy with Two Agents in Ropivacaine-Induced Toxicity: Experimental Study in Swine

Compare hemodynamic changes after ropivacaine-induced toxicity followed by treatment with two lipid emulsions in swine. Large White pigs were anesthetized with thiopental, followed by intubation, and kept on mechanical ventilation. Hemodynamic variables at rest were recorded with invasive pressure m...

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Bibliographic Details
Published in:Revista brasileira de anestesiologia 2012-09, Vol.62 (5), p.685-695
Main Authors: Bonfim, Matheus Rodrigues, De Simone Melo, Marcos, Dreyer, Elisabeth, Borsoi, Luís Fernando Affini, de Oliveira, Thales Gê, Udelsmann, Artur
Format: Article
Language:English
Subjects:
Accidents
Amides - adverse effects
Anesthetics, Local - adverse effects
Anesthetics, Local/ropivacaine
ANESTÉSICOS, Local, ropivacaína
ANIMAL, Cerdo
ANIMAL, Porco
Animals
COMPLICACIONES, Inyección accidental
COMPLICAÇÕES, Injeção acidental
Drug-Related Side Effects and Adverse Reactions - drug therapy
Emulsiones Grasas Intravenosas
Emulsões Gordurosas Intravenosas
Fat Emulsions, Intravenous
Fat Emulsions, Intravenous - therapeutic use
Swine
Triglycerides - therapeutic use
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Summary:Compare hemodynamic changes after ropivacaine-induced toxicity followed by treatment with two lipid emulsions in swine. Large White pigs were anesthetized with thiopental, followed by intubation, and kept on mechanical ventilation. Hemodynamic variables at rest were recorded with invasive pressure monitoring and pulmonary artery catheterization. After 30 minutes, 7mg.kg−1 ropivacaine were injected intravenously and new hemodynamic measurements were performed within one minute. The animals were then randomly allocated into three groups and received: 4mL.kg−1 saline solution, or 4mL.kg−1 lipid emulsion with long-chain triglycerides, or 4mL.kg−1 lipid emulsion with longand medium-chain triglycerides. Hemodynamic changes were reevaluated at 5, 10, 15, 20 and 30 minutes. Ropivacaine-induced toxicity mainly caused a drop in blood pressure and cardiac index without significant changes in vascular resistance. Therapy with lipid emulsions restored blood pressure primarily through increased vascular resistance, as cardiac index showed no significant improvement. Lipid emulsion with medium-chain triglycerides caused a greater increase in vascular resistance, particularly pulmonary. In groups receiving lipid emulsions, hemodynamic results were better than in control group. There were no differences in systemic arterial pressure and cardiac index between animals receiving lipid emulsion with long-chain triglycerides and mixed long- and medium-chain triglycerides. Comparar alterações hemodinâmicas após intoxicação com ropivacaína seguida de terapia com duas emulsões lipídicas em suínos. Suínos da raça Large White foram anestesiados com tiopental, intubados e mantidos em ventilação mecânica. Variáveis hemodinâmicas de repouso foram registradas através de pressão invasiva e cateterização da artéria pulmonar. Após 30 minutos, 7mg.kg−1 de ropivacaína foram injetados por via venosa e novas medidas hemodinâmicas foram feitas em um minuto; os animais foram então aleatoriamente alocados em três grupos e receberam: 4mL.kg−1 de solução salina, 4mL.kg−1 de solução lipídica com triglicérides de cadeia longa e 4mL.kg−1 de solução lipídica com triglicérides de cadeia média e longa. As alterações hemodinâmicas foram reavaliadas aos cinco, 10, 15, 20 e 30 minutos. A intoxicação pela ropivacaína causou queda da pressão arterial e do índice cardíaco, principalmente, sem importantes alterações das resistências vasculares. A terapia com as emulsões lipídicas restaurou a pressão arterial at
ISSN:0034-7094
1806-907X
DOI:10.1016/S0034-7094(12)70167-8