Cardiotoxicity from local anesthetics, study protocol in a porcine experimental model
Abstract
Local anesthetics such as bupivacaine are widely used in clinical practice; however accidental intravascular injection causes cardiovascular toxicity of difficult resuscitation. This cardiotoxicity is manifested by severe electrocardiographic changes; typically in the QRS interval. Our aim was to develop non-lethal bupivacaine-intoxication model and correlate toxic bupivacaine levels with the QRS interval as a marker of intoxication. Fourteen pigs were studied; which after anesthesia and instrumentalization received 4 mg.kg-1 of bupivacaine. Bupivacaine serial determinations; which were correlated with QRS´s changes; were made. Results showed a maximum increase of 159% in the QRS interval which was related with bupivacaine plasma levels (P=0;017). We conclude that our model has showed that the QRS interval lengthening has been correlated with plasma levels of bupivacaine. This parameter could be a useful clinical marker to evaluate an accidental serious bupivacaine intoxication.
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