title: Ropivacaine may have advantages compared to bupivacaine in porcine endotoxemic shock.
abstract: Patients that undergo major abdominal surgery often receive epidural postoperative analgesia. Septic complications are frequently seen in this cohort. In a porcine model of endotoxemic shock, resembling human gram-negative septic shock, we evaluated the effects of two widely used local anaesthetics, bupivacaine and ropivacaine given intravenously. In the endotoxin-ropivacaine group mixed venous saturation and platelet count were higher as compared to endotoxemic controls. Mean arterial blood pressure and platelet count were higher in ropivacaine-endotoxin pigs than in bupivacaine-endotoxin ones. Bupivacaine augmented endotoxin-mediated decrease in left ventricular stroke work index. Ropivacaine displays pathophysiological advantages compared to bupivacaine in septic shock, which may be explained by improved tissue perfusion by ropivacaine.
authors.affiliation: Department of Surgical Sciences, Anaesthesia and Intensive Care, Uppsala University Hospital, SE-751 85 Uppsala, Sweden.
authors.forename: Diana K
authors.initials: DK
authors.lastname: Mutschler
authors.forename: Urban
authors.initials: U
authors.lastname: Gustafsson
authors.forename: Samar
authors.initials: S
authors.lastname: Basu
authors.forename: Anders O
authors.initials: AO
authors.lastname: Larsson
authors.forename: Mats B
authors.initials: MB
authors.lastname: Eriksson
mesh_terms: D000577:Amides / Q000494:pharmacology / Q000627:therapeutic use*; D000779:Anesthetics, Local / Q000494:pharmacology / Q000627:therapeutic use*; D000818:Animals; D001792:Blood Platelets / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D002045:Bupivacaine / Q000494:pharmacology / Q000627:therapeutic use; D004195:Disease Models, Animal; D019446:Endotoxemia / Q000188:drug therapy*; D015227:Lipid Peroxidation / Q000187:drug effects; D010976:Platelet Count; D020011:Protective Agents / Q000494:pharmacology / Q000627:therapeutic use*; D000077212:Ropivacaine; D012772:Shock, Septic / Q000188:drug therapy*; D013318:Stroke Volume / Q000187:drug effects; D034421:Sus scrofa; D016277:Ventricular Function, Left / Q000187:drug effects
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D020011:Protective Agents; D000077212:Ropivacaine; D002045:Bupivacaine