title: Hemodynamic changes in lipid emulsion therapy (SMOFlipid) for bupivacaine toxicity in swines.
abstract: OBJECTIVE
  To evaluate the hemodynamic changes following SMOFlipid emulsion therapy with after bupivacaine intoxication in swines.
  
  
  METHODS
  Large White pigs were anesthetized with thiopental, tracheal intubation was performed and mechanical ventilation was instituted. Hemodynamic variables were recorded with invasive pressure monitoring and pulmonary artery catheterization (Swan-Ganz catheter). After a 30-minute resting period, 5 mg.kg(-1) of bupivacaine by intravenous injection was administered and new hemodynamic measures were performed 1 minute later; the animals were than randomly divided into two groups and received 4 ml.kg(-1) of saline solution or 4 ml.kg(-1) of SMOFlipid emulsion 20%. Hemodynamic changes were then re-evaluated at 5, 10, 15, 20 and 30 minutes.
  
  
  RESULTS
  Bupivacaine intoxication caused fall in arterial blood pressure, cardiac index, ventricular systolic work index mainly and no important changes in vascular resistances. SMOFlipid emulsion therapy was able to improve blood pressure mainly by increasing vascular resistance since the cardiac index had no significant improvement in our study. Hemodynamic results of the use of lipid emulsion in bupivacaine intoxication were better than the control group.
  
  
  CONCLUSIONS
  The SMOFlipid emulsion is a option for reversing hypotension in cases of intoxication by bupivacaine.
authors.affiliation: Surgery Sciences Postgraduate Program, Department of Surgery, School of Medicine, UNICAMP, Campinas, SP, Brazil.
authors.forename: Marcos De Simone
authors.initials: Mde S
authors.lastname: Melo
authors.forename: Matheus Rodrigues
authors.initials: MR
authors.lastname: Bonfim
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Dreyer
authors.forename: Betina Silvia Beozzo
authors.initials: BS
authors.lastname: Bassanezi
authors.forename: Artur
authors.initials: A
authors.lastname: Udelsmann
mesh_terms: D000779:Anesthetics, Local / Q000633:toxicity*; D000818:Animals; D002045:Bupivacaine / Q000633:toxicity*; D005217:Fat Emulsions, Intravenous / Q000627:therapeutic use*; D006439:Hemodynamics / Q000187:drug effects*; D013552:Swine
chemical_list: D000779:Anesthetics, Local; D005217:Fat Emulsions, Intravenous; D002045:Bupivacaine