Resuscitation from Bupivacaine-Induced Asystole in Rats: Comparison of Different Cardioactive Drugs

• Published in: Anesthesia and analgesia Vol. 80; no. 6; pp. 1134 - 1139
• Main Authors: Heavner, James E., Pitkanen, Mikko T., Shi, Bing, Rosenberg, Per H.
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD International Anesthesia Research Society 01-06-1995; Lippincott
• Subjects: Amrinone - therapeutic use; Animals; Biological and medical sciences; Blood Pressure; Bupivacaine - toxicity; Cardiotonic Agents - therapeutic use; Dopamine - therapeutic use; Drug toxicity and drugs side effects treatment; Electrocardiography; Epinephrine - pharmacology; Heart Arrest - chemically induced; Heart Arrest - drug therapy; Heart Arrest - physiopathology; Isoproterenol - pharmacology; Male; Medical sciences; Norepinephrine - pharmacology; Pharmacology. Drug treatments; Rats; Rats, Sprague-Dawley; Resuscitation; Toxicity: cardiovascular system; Cardiotonic agent; Arrhythmia; Rat; Toxicity; Rodentia; Cardiovascular disease; Excitability disorder; Local anesthetic; Vertebrata; Chemotherapy; Mammalia; Treatment; Heart disease; Animal; Anilide; Asystole; Comparative study
• ISSN: 0003-2999; 1526-7598
• DOI: 10.1097/00000539-199506000-00011

The objective of this study was to compare the success of resuscitation attempts with different cardioactive drugs after bupivacaine-induced asystole. Saline, amrinone (1 mg/kg), dopamine (5 micro gram/kg), norepinephrine (2 micro gram/kg), epinephrine (10 micro gram/kg), or isoproterenol (1 micro gram/kg) were tested. Sixty rats assigned to six treatment groups (n = 10/group) were lightly anesthetized (0.5% halothane, 70% N2 O), paralyzed (doxacurium), and given bupivacaine intravenously at 4 mg centered dot kg centered dot min until asystole. Five seconds later up to three treatment drug doses were given at 30-s intervals. Then external cardiac massage was instituted as needed. Spontaneous heartbeat was restored in all animals given norepinephrine or epinephrine. It was not restored in one saline-treated, one dopamine-treated, one isoproterenol-treated, and three amrinone-treated animals. The highest (best) arbitrary scores for overall resuscitation success were achieved with norepinephrine and the lowest with amrinone (P < 0.05). The incidence of ventricular arrhythmias after resuscitation was significantly higher (P < 0.05) in epinephrine- and isoproterenol-treated animals versus other animals. Cardiac rhythm disturbance disappeared within 20 min after successful resuscitation with norepinephrine. Amrinone was no more effective than saline in treating bupivacaine-induced asystole. A drug such as norepinephrine, which has both cardiostimulator (beta1-receptor agonist) and peripheral vasoconstrictor (alpha1-receptor agonist) activity, may be the drug of choice for treating asystole induced by bupivacaine.(Anesth Analg 1995;80:1134-9)