Isoproterenol corrects the effects of bupivacaine on the electrophysiologic properties of the isolated rabbit heart.
The purpose of this study was to test the hypothesis that isoproterenol could reverse bupivacaine toxicity. In eight isolated rabbit hearts an electrophysiologic evaluation was performed then repeated during infusion of bupivacaine (1 microgram/mL) alone and bupivacaine plus isoproterenol (1-2 micrograms/mL). Bupivacaine alone increased electrocardiographic intervals (P wave, QRS complex, PR, AV, and QTc interval) and refractory periods of the myocardium and atrioventricular junction as well as the Wenckebach cycle and pacing thresholds. The addition of isoproterenol corrected partially or completely all bupivacaine-induced abnormalities, and decreased sinus cycle length, suggesting a potential therapeutic value in the treatment of bupivacaine intoxication.
Lacombe
P
P
Department of Cardiology, Notre-Dame Hospital, University of Montreal, Quebec, Canada.
Blaise
G
G
Hollmann
C
C
Tanguay
M
M
Loulmet
D
D
D000200:Action Potentials / Q000187:drug effects / Q000502:physiology; D000818:Animals; D002045:Bupivacaine / Q000037:antagonists & inhibitors*; D002304:Cardiac Pacing, Artificial; D004562:Electrocardiography; D006329:Heart Conduction System / Q000187:drug effects* / Q000502:physiology; D066298:In Vitro Techniques; D007545:Isoproterenol / Q000494:pharmacology*; D011817:Rabbits
D007545:Isoproterenol; D002045:Bupivacaine