Insulin effect on bupivacaine-induced cardiotoxicity in rabbits.
BACKGROUND
Resuscitation following bupivacaine-induced cardiovascular collapse is difficult and often refractory to conventional treatment. This study was performed to assess the effect of insulin on bupivacaine-induced cardiovascular collapse in pentobarbital-anesthetized rabbits.


METHODS
Bupivacaine was administered at 0.75 mg/kg/min until the heart rate decreased to 65 beats/min. A bolus of regular insulin (2 U/kg) was administered intravenously at the bupivacaine infusion endpoint (BIE) in the insulin group (n = 8), and 2 mL of 0.9% NaCl was administered to the control group (n = 8).


RESULTS
All animals in the insulin group survived and four animals died in the control group. Arrythymia was rare 10 minutes after the BIE in the insulin group.


CONCLUSIONS
Bupivacaine-induced cardiovascular collapse can be effectively reversed with an insulin injection, probably through facilitation of cardiac conduction and contraction.
Deparment of Anesthesiology and Pain Medicine, Jeju National University Hospital, Jeju, Korea.
Yun Suk
YS
Choi
Kook Hyun
KH
Lee