Electrocardiographic and Hemodynamic Effects of Intravenous Infusion of Bupivacaine, Ropivacaine, Levobupivacaine, and Lidocaine In Anesthetized Ewes

• DOI: 10.1097/aap.0b013e31819338e2
• Publication Date: 2009-03-05T23:18:02Z
• Authors: Patrick Guinet; Jean-Pierre Estebe; Maja Ratajczak-En...; Jean-Yves Bansard; François Chevanne; David Bec; Pascal Lecorre; Eric Wodey; Claude Ecoffey
• Keywords: Ropivacaine; Levobupivacaine

<h3>Background and Objectives:</h3> Neural blockade techniques are associated with a risk of acute cardiac toxicity after accidental intravenous (IV) injection local anesthetics. The aim this study was to compare electrocardiographic (ECG) hemodynamic (HEM) effects induced by IV infusion anesthetics in an anesthetized ewe model. <h3>Methods:</h3> Thirty-two ewes received bupivacaine (BUPI), ropivacaine (ROPI), or levobupivacaine (S-BUPI) at equimolar dose, lidocaine (LIDO) 3-fold higher rate (n = 8 each group). RR, PR, QRS, QT intervals (QT_c), changes (Δ) systolic diastolic arterial pressure (SAP DAP), myocardial contractility (dP/dt), were assessed every 30 seconds for 7 minutes. From main ECG variables (RR, QT), we proposed use multiple correspondence analysis hierarchical ascending classification explore the structure statistical dependencies among those measurements, determine different patterns HEM BUPI, ROPI, S-BUPI, LIDO. <h3>Results:</h3> Graphic representation BUPI most pronounced modifications variables, followed decreasing order Comparisons clusters identified confirmed variables. Ventricular tachycardia occurred only group. <h3>Conclusions:</h3> In our model, high dose marked QT, QT_c intervals, ΔSAP, ΔdP/dt. ROPI altered less than but more S-BUPI. LIDO smallest changes.