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Cardiotoxicity of ropivacaine – a new amide local anaesthetic agent
Author(s) -
REIZ S.,
HÄGGMARK S.,
JOHANSSON G.,
NATH S.
Publication year - 1989
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1989.tb02868.x
Subject(s) - ropivacaine , medicine , cardiotoxicity , local anaesthetic , anesthesia , surgery , chemotherapy
Anaesthetically equipotent doses of lidocaine, bupivacaine and a new bupivacaine–like local anaesthetic agent, ropivacaine, were injected into the left anterior descending coronary artery of pentobarbital–anaesthetized pigs. The aim was to study the cardiotoxicity of ropivacaine in relation to the two other drugs. A random, crossover, dose response study design was used. The following doses of the drugs were administered: lidocaine (L): 1,2,4,8 and 16 mg, bupivacaine (B): 0.25, 0.5, 1,2 and 4 mg and ropivacaine (R): 0.33, 0.66 1.33, 2.66 and 5.33 mg. Systemic haemodynamics, left ventricular dP/dT and a 12–lead electrocardiogram were recorded continuously during the study period. The drugs depressed cardiac contractility in relation to their local anaesthetic potency on the isolated nerve–4:3:l(B:R:L). The prolongation of the ECG QRS–interval was regarded as a measure of electrophysiologic toxicity. Comparable prolongation of the QRS–interval was recorded after 2 mg of bupivacaine, 4.5 mg of ropivacaine and 30 mg of lidocaine. Thus, the electrophysiological toxicity ratio was 15:6.7:1 (B:R:L). Provided local anaesthetic potency data can be extrapolated from the isolated nerve preparation to regional anaesthesia in humans, ropivacaine appears to provide a greater margin of safety than bupivacaine, if inadvertently injected into the venous circulation.