The effect of levosimendan combined with 20% lipid emulsion treatment on survival from bupivacaine induced toxicity in experiment.
BACKGROUND
Recent reports demonstrated that levosimendan improved post-resuscitation myocardial function in rat and pig models.


METHODS
Rabbits were randomized into 4 groups as 12 rabbits in each group. Bupivacaine 10 mg/kg was injected as an intravenous bolus to all groups. Basic life support was performed by mechanical ventilation and manual external chest compressions. After 1 min, animals in the group 1 received 1.5 ml/ kg saline 0.9% solution, and animals in the groups 2 and 4 received 5 ml/kg 20% lipid emulsion for 1 min through the ear vein followed by continuous infusion at 0.25 ml/kg/min. Three additional boluses of 1.5 ml/ kg lipid emulsion were repeated at 5-min intervals. The group 3 received fluid resuscitation plus levosimendan (3 µg/kg/min) 1 min after asystole and the group 4 received both levosimendan and lipid emulsion treatment. Return of spontaneous circulation and hemodynamic metrics were obtained in 20 minutes.


RESULTS
The number of rabbits that survived after cardiac resuscitation was lower in the Groups 1 (0%) and 3 (33.3%) than in the Group 4 (91.7%) with a statistically significant difference (p < 0.001). The number of rabbits that survived resuscitation was higher in the Group 4 than in the Group 2 (66.7%), though not with a statistically significant difference (p = 0.317). The median duration of cardiac arrest in the Group 4 was significantly shorter than that in the other three groups (p < 0.001).


CONCLUSIONS
In this rabbit model of bupivacaine-induced cardiac arrest, resuscitation with combined iv lipid emulsion and levosimendan was more efficacious than lipid alone (Tab. 3, Ref. 24).
G
G
Gokahmetoglu
R
R
Aksu
C
C
Bicer
K
K
Darcin
F
F
Ugur
D000818:Animals; D002045:Bupivacaine / Q000008:administration & dosage / Q000633:toxicity*; D016887:Cardiopulmonary Resuscitation; D004562:Electrocardiography; D005217:Fat Emulsions, Intravenous / Q000494:pharmacology*; D005260:Female; D005440:Fluid Therapy; D006323:Heart Arrest / Q000628:therapy*; D006835:Hydrazones / Q000494:pharmacology*; D007275:Injections, Intravenous; D008297:Male; D011724:Pyridazines / Q000494:pharmacology*; D011817:Rabbits; D011897:Random Allocation; D000077464:Simendan
D005217:Fat Emulsions, Intravenous; D006835:Hydrazones; D011724:Pyridazines; D000077464:Simendan; D002045:Bupivacaine