title: Efficacy of resuscitation with Intralipid in a levobupivacaine-induced cardiac arrest model.
abstract: OBJECTIVE
  Cardiac toxicity due to the administration of local anesthetics may be fatal. In this study, we evaluated the efficacy of a 20% lipid solution combined with epinephrine in a levobupivacaine-induced cardiac arrest model.
  
  
  METHODS
  A total of 14 New Zealand rabbits were sedated and mechanically ventilated. Asystole was induced with intravenous levobupivacaine injection. The rabbits were randomized into groups receiving the same volume of either 0.9% saline (CR group) or a 20% lipid solution (LE group) along with a 100 μg/kg epinephrine bolus, which were administered immediately upon asystole. Standard advanced cardiac life support protocols were performed.
  
  
  RESULTS
  Four subjects in the LE group as well as 3 subjects in the CR group had a spontaneous recovery (P = 0.592). In the 20th minute after arrest, 3 subjects in the LE group had maintained spontaneous circulation, while there was only 1 subject from the CR group with the same outcome.
  
  
  CONCLUSIONS
  We found that adding a lipid solution to epinephrine for the resuscitation of rabbits that underwent levobupivacaine- induced cardiac arrest increased recovery rates of circulation and therefore the likelihood of survival. Further studies are needed to develop clinical therapies for the systemic toxicity of local anesthetics.
authors.forename: Murat
authors.initials: M
authors.lastname: Karcioğlu
authors.forename: Kasim
authors.initials: K
authors.lastname: Tuzcu
authors.forename: Fatih
authors.initials: F
authors.lastname: Sefil
authors.forename: Işil
authors.initials: I
authors.lastname: Davarci
authors.forename: Suzan
authors.initials: S
authors.lastname: Aydin
authors.forename: Ali
authors.initials: A
authors.lastname: Sari
authors.forename: Akin
authors.initials: A
authors.lastname: Aydoğan
authors.forename: Raif
authors.initials: R
authors.lastname: Özden
mesh_terms: D000779:Anesthetics, Local / Q000009:adverse effects; D000818:Animals; D002045:Bupivacaine / Q000009:adverse effects / Q000031:analogs & derivatives; D003326:Coronary Circulation; D004195:Disease Models, Animal; D004359:Drug Therapy, Combination; D004655:Emulsions / Q000008:administration & dosage; D004837:Epinephrine / Q000008:administration & dosage*; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage*; D006323:Heart Arrest / Q000139:chemically induced / Q000188:drug therapy*; D000077554:Levobupivacaine; D010743:Phospholipids / Q000008:administration & dosage*; D011817:Rabbits; D011897:Random Allocation; D012151:Resuscitation / Q000379:methods*; D013024:Soybean Oil / Q000008:administration & dosage*; D014662:Vasoconstrictor Agents / Q000008:administration & dosage*
chemical_list: D000779:Anesthetics, Local; D004655:Emulsions; D005217:Fat Emulsions, Intravenous; D010743:Phospholipids; D014662:Vasoconstrictor Agents; C545823:soybean oil, phospholipid emulsion; D013024:Soybean Oil; D000077554:Levobupivacaine; D002045:Bupivacaine; D004837:Epinephrine