RT Journal Article
T1 Sodium bicarbonate reverts electrophysiologic cardiotoxicity of ropivacaine faster than lipid emulsions in a porcine model
A1 Zaballos García, Matilde
A1 Fernández, Ignacio
A1 Melone, Arturo
A1 Rodríguez, Lucía
A1 Varela, Olalla
A1 García, Sergio
A1 Quintela Jorge, Oscar
A1 Vazquez, Elena
A1 Anadón Baselga, María José
A1 Almendral, Jesús
AB Ropivacaine 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.
PB Wiley
SN 1742-7835
YR 2022
FD 2022-12-08
LK https://hdl.handle.net/20.500.14352/72826
UL https://hdl.handle.net/20.500.14352/72826
LA eng
NO CRUE-CSIC (Acuerdos Transformativos 2022)
DS Docta Complutense
RD 15 may 2024