title: Lipid emulsion-mediated reversal of toxic-dose aminoamide local anesthetic-induced vasodilation in isolated rat aorta.
abstract: BACKGROUND
  Intravenous lipid emulsion has been used to treat systemic toxicity of local anesthetics. The goals of this in vitro study were to determine the ability of two lipid emulsions (Intralipid® and Lipofundin® MCT/LCT) to reverse toxic dose local anesthetic-induced vasodilation in isolated rat aortas.
  
  
  METHODS
  Isolated endothelium-denuded aortas were suspended for isometric tension recording. Vasodilation was induced by bupivacaine (3 × 10(-4) M), ropivacaine (10(-3) M), lidocaine (3 × 10(-3) M), or mepivacaine (7 × 10(-3) M) after precontraction with 60 mM KCl. Intralipid® and Lipofundin® MCT/LCT were then added to generate concentration-response curves. We also assessed vasoconstriction induced by 60 mM KCl, 60 mM KCl with 3 × 10(-4) M bupivacaine, and 60 mM KCl with 3 × 10(-4) M bupivacaine plus 1.39% lipid emulsion (Intralipid® or Lipofundin® MCT/LCT).
  
  
  RESULTS
  The two lipid emulsions reversed vasodilation induced by bupivacaine, ropivacaine, and lidocaine but had no effect on vasodilation induced by mepivacaine. Lipofundin® MCT/LCT was more effective than Intralipid® in reversing bupivacaine-induced vasodilation. The magnitude of lipid emulsion-mediated reversal of vasodilation induced by high-dose local anesthetics was as follows (from highest to lowest): 3 × 10(-4) M bupivacaine-induced vasodilation, 10(-3) M ropivacaine-induced vasodilation, and 3 × 10(-3) M lidocaine-induced vasodilation.
  
  
  CONCLUSIONS
  Lipofundin® MCT/LCT-mediated reversal of bupivacaine-induced vasodilation was greater than that of Intralipid®; however, the two lipid emulsions equally reversed vasodilation induced by ropivacaine and lidocaine. The magnitude of lipid emulsion-mediated reversal of vasodilation appears to be correlated with the lipid solubility of the local anesthetic.
authors: Department of Anesthesiology and Pain Medicine, Gyeongsang National University School of Medicine, Jinju, Korea.
authors: Seong-Ho
authors: SH
authors: Ok
authors: Jeong Yeol
authors: JY
authors: Han
authors: Soo Hee
authors: SH
authors: Lee
authors: Il-Woo
authors: IW
authors: Shin
authors: Heon Keun
authors: HK
authors: Lee
authors: Young-Kyun
authors: YK
authors: Chung
authors: Mun-Jeoung
authors: MJ
authors: Choi
authors: Ju-Tae
authors: JT
authors: Sohn
keywords: Aorta; Bupivacaine; Lipid emulsion; Systemic toxicity; Vasodilation
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