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Effects of bupivacaine used with sevoflurane on the rhythm and contractility in the isolated rat heart

Published online by Cambridge University Press:  02 June 2005

P. Bozkurt ,
Ö. Süzer ,
E. Ekici ,
Ö. Demirci ,
G. Kaya  and
M. Hacibekiroğlu
P. Bozkurt
Affiliation:
Istanbul University Cerrahpaşa Medical Faculty, Department of Anaesthesiology, Istanbul, Turkey
Ö. Süzer
Affiliation:
Istanbul University Cerrahpaşa Medical Faculty, Department of Pharmacology and Clinical Pharmacology, Istanbul, Turkey
E. Ekici
Affiliation:
Istanbul University Cerrahpaşa Medical Faculty, Department of Pharmacology and Clinical Pharmacology, Istanbul, Turkey
Ö. Demirci
Affiliation:
Istanbul University Cerrahpaşa Medical Faculty, Metropolitan Florence Nightingale Hospital, Istanbul, Turkey
G. Kaya
Affiliation:
Istanbul University Cerrahpaşa Medical Faculty, Department of Anaesthesiology, Istanbul, Turkey
M. Hacibekiroğlu
Affiliation:
Istanbul University Cerrahpaşa Medical Faculty, Fikret Biyal Laboratory, Istanbul, Turkey
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Extract

Summary

Background and objective: The effects of sevoflurane on bupivacaine cardiotoxicity are mainly attributed to systemic effects. The purpose of this study was to investigate the direct myocardial effects of sevoflurane on bupivacaine toxicity.

Methods: Hearts of 30 Wistar albino rats were isolated and mounted on a Langendorff apparatus perfused by modified Tyrode solution. Experimental groups were: a sevoflurane group (Group S, n = 10) – following baseline and 20 min (Stage 1) recordings, sevoflurane was added in doses of 1.4% (1 MAC) and 2.8% (2 MAC). In the two bupivacaine groups, bupivacaine 5 μmol (Group B5, n = 10) and bupivacaine 10 μmol (Group B10, n = 10) was added to the solution at Stage 1, and sevoflurane was added to the system as in Group S. Haemodynamic variables, i.e. heart rate, PR interval, QRS duration, left ventricular systolic pressure, contractility (+dp/dtmax), relaxation, time to reach peak systolic pressure, change in left ventricular diastolic pressure from baseline, and rate–pressure product were recorded.

Results: In Group S, there was no change in cardiac rhythm. In bupivacaine groups, severe rhythm disturbances occurred and both the PR intervals and QRS complexes were prolonged significantly. All contractility variables deteriorated and the rate–pressure product decreased by 67–90% with the addition of bupivacaine. In all groups, 2 MAC sevoflurane lowered +dp/dtmax further.

Conclusions: Sevoflurane does not have any untoward effect on bupivacaine-induced cardiotoxicity in clinically relevant doses in the isolated rat heart.

Keywords

ANAESTHETICS, INHALATION, sevofluraneANAESTHETICS, LOCAL, bupivacaineCARDIOVASCULAR SYSTEM, HEART, heart conduction systemHEART DISEASES, arrhythmia
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 20 , Issue 3 , March 2003 , pp. 199 - 204
Copyright
© 2003 European Society of Anaesthesiology

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