两种脂肪乳剂输注方案治疗布比卡因诱导的大鼠心脏停搏的效果比较

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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.

Key words： bupivacaine lipid emulsions heart toxicity rats

Received: 01 December 2016

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	LIU Le
	JIN Zhousheng
	NAN Fubei
	DONG Jiaojiao
	XIANG Saiqiong
	WANG Quanguang

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https://xb.wmu.edu.cn/EN/ OR https://xb.wmu.edu.cn/EN/Y2017/V47/I7/514

[1] LITZ R J, ROESSEL T, HELLER A R, et al. Reversal of central nervous system and cardiac toxicity after local anesthetic intoxication by lipid emulsion injection[J]. Anesth Analg, 2008, 106(5): 1575-1577.
[2] FETTIPLACE M R, WEINBERG G. Past, present, and future of lipid resuscitation therapy[J]. JPEN, 2015, 39(1 Suppl): 72S-83S.
[3] 刘乐, 陈莺, 徐旭仲, 等. 脂肪乳剂对布比卡因诱导的离体大鼠心脏停搏的复苏作用[J]. 温州医学院学报, 2009, 39 (1): 31-35.
[4] 王权光, 刘乐, 徐旭仲, 等. 脂肪乳剂对布比卡因心脏抑制犬血压、心率和心电图的影响[J]. 温州医学院学报, 2009, 39(3): 220-222.
[5] WEINBERG G L. Treatment of local anesthetic systemic toxicity (LAST)[J]. Reg Anesth Pain Med, 2010, 35(2): 188-193.
[6] NEAL J M, MULROY M F, WEINBERG G L. American Society of Regional Anesthesia and Pain Medicine checklist for managing local anesthetic systemic toxicity: 2012 Version[J]. Reg Anesth Pain Med, 2012, 37(1): 16-18.
[7] LI B, YAN J, SHEN Y, et al. Association of sustained cardiovascular recovery with epinephrine in the delayed lipid-based resuscitation from cardiac arrest induced by bupivacaine overdose in rats[J]. Br J Anaesth, 2012, 108(5): 857-863.
[8] LI Z, XIA Y, DONG X, et al. Lipid resuscitation of bupivacaine toxicity: long-chain triglyceride emulsion provides benefits over long- and medium-chain triglyceride emulsion [J]. Anesthesiology, 2011, 115(6): 1219-1228.
[9] GREGORIO G D, SCHWARTZ D, RIPPER R, et al. Lipid emulsion is superior to vasopressin in a rodent model of resuscitation from toxin-induced cardiac arrest[J]. Crit Care Med, 2009, 37(3): 993-999.
[10] JIN Z, XIA Y, XIA F, et al. Epinephrine administration in lipid-based resuscitation in a rat model of bupivacaine-induced cardiac arrest: optimal timing[J]. Reg Anesth Pain Med, 2015, 40(3): 223-231.
[11] LIU L, XIA Y, CHEN Y, et al. The comparative effects of lipid, epinephrine, and their combination in the reversal of bupivacaine-induced asystole in the isolated rat heart[J]. Anesth Analg, 2012, 114(4): 886-893.
[12] WEINBERG G L, GREGORIO G D, RIPPER R, et al. Resuscitation with lipid versus epinephrine in a rat model of bupivacaine overdose[J]. Anesthesiology, 2008, 108(5): 907-913.
[13] HILLER D B, GREGORIO G D, RIPPER R, et al. Epinephrine impairs lipid resuscitation from bupivacaine overdose: a threshold effect[J]. Anesthesiology, 2009, 111(3): 498-505.
[14] GADDIS G M, DOLISTER M, GADDIS M L. Mock drug
delivery to the proximal aorta during cardiopulmonary resuscitation: central vs peripheral intravenous infusion with varying flush volumes[J]. Acad Emerg Med, 1995, 2(12): 1027-1033.
[15] CAVE G, HARVEY M G, WINTERBOTTOM T. Evaluation of the Association of Anaesthetists of Great Britain and Ireland lipid infusion protocol in bupivacaine induced cardiac arrest in rabbits[J]. Anaesthesia, 2009, 64(7): 732-737.