Sodium bicarbonate reverts electrophysiologic cardiotoxicity of ropivacaine faster than lipid emulsions in a porcine model

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dc.contributor.authorZaballos García, Matilde
dc.contributor.authorFernández, Ignacio
dc.contributor.authorMelone, Arturo
dc.contributor.authorRodríguez, Lucía
dc.contributor.authorVarela, Olalla
dc.contributor.authorGarcía, Sergio
dc.contributor.authorQuintela Jorge, Oscar
dc.contributor.authorVazquez, Elena
dc.contributor.authorAnadón Baselga, María José
dc.contributor.authorAlmendral, Jesús
dc.date.accessioned2023-06-22T12:33:33Z
dc.date.available2023-06-22T12:33:33Z
dc.date.issued2022-12-08
dc.descriptionCRUE-CSIC (Acuerdos Transformativos 2022)
dc.description.abstractRopivacaine has been described as a safer local anaesthetic (LA); however, serious cardiotoxic accidents have been reported. Intravenous-lipid-emulsion (ILE) therapy during LA intoxication seems to act as an antidote. Sodium bicarbonate is the standard treatment for sodium channel blocker drug toxicity. We compared both antidotes on the reversion of electrophysiologic toxicity induced by ropivacaine. Ropivacaine 5 mg kg1 was administered in 24 pigs, and 3 min later, the animals received ILE: 1.5 ml kg1 + 0.25 ml kg1 min1 (ILE group); sodium bicarbonate: 2 mEq kg1 + 1 mEq kg1 h1 (NaHCO3 group); saline solution (CTL group). Electrophysiological parameters were evaluated for 30 min. The area under the curve (AUC) for the first 5 or 30 min was compared between groups. Ropivacaine induced a lengthening of the PR interval by 17% (P = 0.0001), His-ventricle-interval by 58% (P = 0.001), sinus QRS complex by 56% (P = 0.0001), paced QRS at 150 bpm by 257% (P = 0.0001), and at 120 bpm by 143% (P = 0.0001) in all groups. At 5 min after treatment, sinus QRS in the NaHCO3 group was shorter than that in the CTL group (AUCQRS5, P = 0.003) or ILE group (AUCQRS5, P = 0.045). During the first minute, seven of the animals in the NaHCO3 group vs. two in the ILE or 0 in the CTL group recovered more than 30% of the sinus QRS previously lengthened by ropivacaine (P = 0.003). Sodium bicarbonate reversed the electrophysiological toxicity of ropivacaine faster than ILE and control groups.
dc.description.departmentDepto. de Medicina Legal, Psiquiatría y Patología
dc.description.facultyFac. de Medicina
dc.description.refereedTRUE
dc.description.statuspub
dc.eprint.idhttps://eprints.ucm.es/id/eprint/76055
dc.identifier.doi10.1111/bcpt.13822
dc.identifier.issn1742-7835
dc.identifier.officialurlhttps://doi.org/10.1111/bcpt.13822
dc.identifier.urihttps://hdl.handle.net/20.500.14352/72826
dc.journal.titleBasic & Clinical Pharmacology & Toxicology
dc.language.isoeng
dc.publisherWiley
dc.rightsAtribución-NoComercial-SinDerivadas 3.0 España
dc.rights.accessRightsopen access
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/3.0/es/
dc.subject.keywordcardiotoxicity
dc.subject.keywordlipid emulsions
dc.subject.keywordropivacaine
dc.subject.keywordsodium bicarbonate
dc.subject.ucmCardiología
dc.subject.ucmMedicina legal (Medicina)
dc.subject.unesco3205.01 Cardiología
dc.titleSodium bicarbonate reverts electrophysiologic cardiotoxicity of ropivacaine faster than lipid emulsions in a porcine model
dc.typejournal article
dspace.entity.typePublication
relation.isAuthorOfPublicationf82fc0ce-f307-4374-b641-4658ff8d503d
relation.isAuthorOfPublication5e0eedb6-ac54-4712-85be-f766f0bfa397
relation.isAuthorOfPublication.latestForDiscoveryf82fc0ce-f307-4374-b641-4658ff8d503d
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