Alterações hemodinâmicas do tratamento da intoxicação da bupivacaína com lipídeo : estudo experimental em suínos / Hemodynamic changes in lipid emulsion therapy for bupivacaine toxicity : experimental study in swines

AUTOR(ES)
FONTE

IBICT - Instituto Brasileiro de Informação em Ciência e Tecnologia

DATA DE PUBLICAÇÃO

16/12/2011

RESUMO

Introduction: local anesthetics are drugs that reversibly block the conduction of impulses along the nerve fibers. They are widely used in loco-regional anesthesia and in pain treatment, however its uses is not without risks. Cardiotoxicity is the most worrisome complication in cases of inadvertent intravascular injection of large doses and until recently with no specific treatment. In 1998 Weinberg et al. demonstrated that the lipid emulsion (EL) was effective for the cardiotoxicity of local anesthetics and since then these agents have been used with success. Purpose: to compare the hemodynamic changes following SMOF lipid emulsion therapy with after bupivacaine intoxication in swines. Methods: Large White pigs were anesthetized with thiopental, tracheal intubation was performed and mechanical ventilation was instituted. Hemodynamic variables were recorded with invasive pressure monitoring and pulmonary artery catheterization (Swan-Ganz catheter). After a 30-minute resting period, 5 mg.kg POT. -1 of bupivacaine by intravenous injection was administered and new hemodynamic mesures were performed 1 minute later; the animals were than randomly divided into two groups and received 4 ml.kg POT. -1 of saline solution or 4 ml.kg POT. -1 of SMOF lipid emulsion 20%. Hemodynamic changes were then re-evaluated at 5, 10, 15, 20 and 30 minutes. Results: bupivacaine intoxication caused fall in arterial blood pressure, cardiac output and ventricular function and mainly important changes in vascular resistances. SMOF lipid emulsion therapy was able to improve blood pressure mainly by increasing vascular resistance since the cardiac output had no significant improvement in our study. The hemodynamic results with the use of lipid emulsion in bupivacaine intoxication were better than in the control group. Conclusion: The SMOF lipid emulsion is an interesting option to reverse the hemodynamic changes in case of bupivacaine intoxication

ASSUNTO(S)

anestesia local bupivacaina toxicidade lipídios hemodinâmica anesthesia local bupivacaine toxicity lipid hemodynamic

ACESSO AO ARTIGO

Documentos Relacionados