title: Hemodynamic changes with two lipid emulsions for treatment of bupivacaine toxicity in swines.
abstract: OBJECTIVE
  To compare the hemodynamic changes following two different lipid emulsion therapies after bupivacaine intoxication in swines.
  
  
  METHODS
  Large White pigs were anesthetized with thiopental, tracheal intubation performed and mechanical ventilation 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 three groups and received 4 ml.kg-1 of one of the two different lipid emulsion with standard long-chaim triglyceride, or mixture of long and medium-chain triglyceride, or saline solution. 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. Both emulsion improved arterial blood pressure mainly increasing vascular resistance since the cardiac index had no significant improvement. On the systemic circulation the hemodynamic results were similar with both lipid emulsions.
  
  
  CONCLUSIONS
  Both lipid emulsions were efficient and similar options to reverse hypotension in cases of bupivacaine toxicity.
authors.affiliation: Laboratory of Experimental Anesthesia, Department of Anesthesiology, State University of Campinas, Brazil.
authors.forename: Artur
authors.initials: A
authors.lastname: Udelsmann
authors.affiliation: Hospital, UNICAMP, Campinas, SP, Brazil.
authors.forename: Marcos De Simone
authors.initials: Mde S
authors.lastname: Melo
mesh_terms: D000779:Anesthetics, Local / Q000633:toxicity*; D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D002045:Bupivacaine / Q000633:toxicity*; D000074263:Coconut Oil; D005217:Fat Emulsions, Intravenous / Q000627:therapeutic use*; D006439:Hemodynamics / Q000187:drug effects*; D010938:Plant Oils / Q000627:therapeutic use; D011897:Random Allocation; D015203:Reproducibility of Results; D013024:Soybean Oil / Q000627:therapeutic use; D013552:Swine; D013997:Time Factors; D016896:Treatment Outcome; D014280:Triglycerides / Q000627:therapeutic use; D014655:Vascular Resistance / Q000187:drug effects
chemical_list: D000779:Anesthetics, Local; D005217:Fat Emulsions, Intravenous; D010938:Plant Oils; D014280:Triglycerides; D013024:Soybean Oil; D000074263:Coconut Oil; D002045:Bupivacaine