Comparison of effects of two different lipid regimens in the resuscitation of bupivacaine-induced cardiac arrest in rats
LIU Le1, JIN Zhousheng1, NAN Fubei1, DONG Jiaojiao1, XIANG Saiqiong2, WANG Quanguang1.
1.Department of Anesthesiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325015; 2.The Second Clinical Medical College of Wenzhou Medical University, Wenzhou, 32503
LIU Le,JIN Zhousheng,NAN Fubei, et al. Comparison of effects of two different lipid regimens in the resuscitation of bupivacaine-induced cardiac arrest in rats[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2017, 47(7): 514-518.
Abstract：Objective: To observe the effects of the two different lipid regimens via peripheral venous administration in the resuscitation of bupivacaine-induced cardiac arrest in rats. Methods: Twenty-four adult male Sprague-Dawley rats were subjected to bupivacaine-induced cardiac arrest and were then randomly divided into two groups: the guideline group and the modified group, twelve rats per group. In the guideline group, lipid emusion was administered according to guidelines (Association of Anaesthetists of Great Britain and Ireland, AAGBI; American Society of Regional Anesthesia and Pain Medicine, ASRA), while in the modified group, lipid emusion was administered with the improved regimen of early administration of large and rapid lipid infusion. Successful resuscitation was represented by a return of spontaneous circulation (ROSC) as demonstrated by a native rate-pressure product (RPP) more than 20% of baseline value that was sustained for more than 1 minute. The time of recovery of heart beating and the time of ROSC between two groups were compared. Hemodynamic parameters during the course of resuscitation were recorded in both groups. The cardiac apex of each heart was taken for measurement of the bupivacaine content by liquid chromatography-tandem mass spectrometry at the end of the experiment. Results: The recovery rate in the modified group was significantly higher than those in the guideline group (P<0.05). The time of recovery of heart beating and the time of ROSC in the modified group was significantly shorter than that in the guideline group (P<0.05). SBP, HR, RPP, CPP during 2~40 min in the modified group were equally higher than those in the guideline group (P<0.01). The cardiac tissue bupivacaine content in the modified group was significantly less than that in the guideline group (P<0.05). Conclusion:
Peripheral intravenous injection of early and large dose lipid emulsion can speed up decreasing the cardiac tissue bupivacaine content, which resulted in better resuscitation than the way of early small dose lipid emulsion injection in the resuscitation of bupivacaine-induced cardiac arrest in rats.
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