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Cardiotoxicity of ropivacaine--a new amide local anaesthetic agent
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Anaesthesiology.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Anaesthesiology.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Anaesthesiology.ORCID iD: 0000-0002-5325-2688
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Anaesthesiology.
1989 (English)In: Acta Anaesthesiol Scand, Vol. 33, no 2, 93-8 p.Article in journal (Refereed) Published
Abstract [en]

Anaesthetically equipotent doses of lidocaine, bupivacaine and a new bupivacaine-like local anaesthetic agent, ropivacaine, were injected into the left anterior descending coronary artery of pentobarbital-anaesthetized pigs. The aim was to study the cardiotoxicity of ropivacaine in relation to the two other drugs. A random, crossover, dose response study design was used. The following doses of the drugs were administered: lidocaine (L): 1,2,4,8 and 16 mg, bupivacaine (B): 0.25, 0.5, 1,2 and 4 mg and ropivacaine (R): 0.33, 0.66 1.33, 2.66 and 5.33 mg. Systemic haemodynamics, left ventricular dP/dT and a 12-lead electrocardiogram were recorded continuously during the study period. The drugs depressed cardiac contractility in relation to their local anaesthetic potency on the isolated nerve-4:3:1 (B:R:L). The prolongation of the ECG QRS-interval was regarded as a measure of electrophysiologic toxicity. Comparable prolongation of the QRS-interval was recorded after 2 mg of bupivacaine, 4.5 mg of ropivacaine and 30 mg of lidocaine. Thus, the electrophysiological toxicity ratio was 15:6.7:1 (B:R:L). Provided local anaesthetic potency data can be extrapolated from the isolated nerve preparation to regional anaesthesia in humans, ropivacaine appears to provide a greater margin of safety than bupivacaine, if inadvertently injected into the venous circulation.

Place, publisher, year, edition, pages
1989. Vol. 33, no 2, 93-8 p.
Keyword [en]
Amides/*toxicity, Anesthetics, Local/*toxicity, Animals, Arrhythmias, Cardiac/chemically induced, Bupivacaine/toxicity, Depression, Chemical, *Electrocardiography, Heart/*drug effects/physiopathology, Hemodynamics/drug effects, Lidocaine/toxicity, Myocardial Contraction/*drug effects, Swine
National Category
Anesthesiology and Intensive Care
Identifiers
URN: urn:nbn:se:umu:diva-66537ISBN: 0001-5172 (Print) OAI: oai:DiVA.org:umu-66537DiVA: diva2:607328
Note

Reiz, S Haggmark, S Johansson, G Nath, S Comparative Study Research Support, Non-U.S. Gov't Denmark Acta anaesthesiologica Scandinavica Acta Anaesthesiol Scand. 1989 Feb;33(2):93-8.

Available from: 2013-02-22 Created: 2013-02-22 Last updated: 2015-09-15

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