Electrocardiographic changes during continuous intravenous application of bupivacaine in neonatal pigs

British Journal of Anaesthesia

Volumn 105, Issue 4, 2010, Pages 437-441

  Mauch, J ^a,b   Kutter, A P N ^c   Madjdpour, C ^b   Spielmann, N ^b   Balmer, C ^b   Frotzler, A ^b   Bettschart Wolfensberger, R ^c   Weiss, M ^b  

^a CANTONAL HOSPITAL AARAU   (Switzerland)

^b UNIVERSITY CHILDREN S HOSPITAL   (Switzerland)

^c UNIVERSITY OF ZURICH   (Switzerland)

Author keywords

anaesthetics local, bupivacaine; heart, conduction; heart, heart rate; toxicity, local anaesthetics

Indexed keywords

BUPIVACAINE; LOCAL ANESTHETIC AGENT;

ANIMAL; DOSE RESPONSE; DRUG EFFECTS; ELECTROCARDIOGRAPHY; FEMALE; HEART RATE; INTRAVENOUS DRUG ADMINISTRATION; MALE; NEWBORN; SWINE;

ANESTHETICS, LOCAL; ANIMALS; ANIMALS, NEWBORN; BUPIVACAINE; DOSE-RESPONSE RELATIONSHIP, DRUG; ELECTROCARDIOGRAPHY; FEMALE; HEART RATE; INFUSIONS, INTRAVENOUS; MALE; SUS SCROFA;

EID: 77956944524     PISSN: 00070912     EISSN: 14716771     Source Type: Journal    
DOI: 10.1093/bja/aeq197     Document Type: Article

References (21)

1. Polaner DM, Suresh S, Coté CJ. Regional anesthesia. In: Coté CJ, Lerman J, Todres ID, eds. A Practice of Anesthesia for Infants and Children. Philadelphia: Saunders Elsevier, 2009; 867
2. Freid EB, Bailey AG, Valley RD. Electrocardiographic and hemodynamic changes associated with unintentional intravascular injection of bupivacaine with epinephrine in infants. Anesthesiology 1993; 79: 394-398
3. FisherQA, Shaffner DH,Yaster M. Detectionof intravascular injection of regional anaesthetics in children. Can J Anaesth 1997; 44: 592-598
4. Tobias JD. Caudal epidural block: a review of test dosing and recognition of systemic injection in children. Anesth Analg 2001; 93: 1156-1161
5. Mauch J, Kutter APN, Madjdpour C, et al. Electrocardiographic alterations during intravascular application of three different test doses of bupivacaine and epinephrine: experimental study in neonatal pigs. Br J Anaesth 2010; 104: 94-97
6. Tanaka M, Nitta R, Nishikawa T. Increased T-wave amplitude after accidental intravascular injection of lidocaine plus bupivacaine without epinephrine in sevoflurane-anesthetized child. Anesth Analg 2001; 92: 915-917
7. Ogasawara K, Tanaka M, Nishikawa T. Choice of electrocardiography lead does not affect the usefulness of the T-wave criterion for detecting intravascular injection of an epinephrine test dose in anesthetized children. Anesth Analg 2003; 97: 372-376
8. Tanaka M, Nishikawa T. Evaluating T-wave amplitude as guide for detecting intravascular injection of a test dose in anesthetized children. Anesth Analg 1999; 88: 754-758
9. Rosenberg PH, Veering BT, Urmey WF. Maximum recommended doses of local anesthetics: a multifactorial concept. Reg Anesth Pain Med 2004; 29: 564-575
10. Polaner DM, Suresh S, Coté CJ. Regional anesthesia. In: Coté CJ, Lerman J, Todres ID, eds. A Practice of Anesthesia for Infants and Children. Philadelphia: Saunders Elsevier, 2009; 871
11. Tanaka M, Nishikawa T. The efficacy of a simulated intravascular test dose in sevoflurane-anesthetized children: a dose-response study. Anesth Analg 1999; 89: 632-637
12. Sparks JW, Seefelder C. Neonatal T-wave elevation from a positive epidural test dose. Paediatr Anaesth 2005; 15: 706-707
13. Nyström EUM, Heavner JE, Buffington CW. Blood pressure is maintained despite profound myocardial depression during acute bupivacaine overdose in pigs. Anesth Analg 1999; 88: 1143-1148
14. Antzelevitch C. Cellular basis and mechanism underlying normal and abnormal myocardial repolarization and arrhythmogensis. Ann Med 2004; 36: 5-14
15. Clarkson CW, Hondeghem LM. Mechanism for bupivacaine depression of cardiac conduction: fast block of sodium channels during the action potential with slow recovery from block during diastole. Anesthesiology 1985; 62: 396-405
16. Berde C. Toxicity of local anesthetics in infants and children. J Pediatr 1993; 122: 14-20
17. Morrison SG, Dominguez JJ, Frascarolo P, Reiz S. A comparison of the electrocardiographic cardiotoxic effects of racemic bupivacaine, levobupivacaine, and ropivacaine in anesthetized swine. Anesth Analg 2000; 90: 1308-1314
18. Palazzo MG, Kalso E, Argiras E, Madgwick R, Sear J. The uptake of bupivacaine in an in situ isolated perfused rabbit lung preparation. Pharmacol Toxicol 1991; 69: 107-111
19. Palazzo MG, Kalso EA, Argiras E, Madgwick R, Sear JW. First pass lung uptake of bupivacaine: effect of acidosis in an intact rabbit lung model. Br J Anaesth 1991; 67: 759-763
20. Stoelting RK. Local anesthetics. Handbook of Pharmacology & Physiology in Anesthetic Practice. Philadelphia: Lippincott Williams & Wilkins, 1995; 135
21. Shah S, Gopalakrishnan S, Apuya J, Shah S, Martin T. Use of intralipid in an infant with impending cardiovascular collapse due to local anesthetic toxicity. J Anesth 2009; 23: 439-441