title: Effect of 50% enantiomeric excess bupivacaine mixture combined with pancuronium on neuromuscular transmission in rat phrenic nerve-diaphragm preparation; a pilot study.
abstract: OBJECTIVE
  Local anaesthetics are drugs that are widely used in clinical practice. However, the effects of these drugs on the neuromuscular junction and their influence on the blockade produced by non-depolarising neuromuscular blocking drugs are still under investigation. The aim of this study was to evaluate, in vitro, the influence of a 50% enantiomeric excess bupivacaine mixture on neuromuscular transmission and neuromuscular block produced by pancuronium.
  
  
  METHODS
  Rats were distributed into three groups (n = 5) according to the drug studied namely, 50% enantiomeric excess bupivacaine mixture (5 μg/mL); pancuronium (2 μg/mL); 50% enantiomeric excess bupivacaine mixture + pancuronium. The following parameters were evaluated: (1) Effects of a 50% enantiomeric excess bupivacaine mixture on membrane potential (MP) and miniature endplate potentials (MEPPs); (2) amplitude of diaphragmatic response before and 60 min after the addition of a 50% enantiomeric excess bupivacaine mixture; the degree of neuromuscular block with pancuronium and pancuronium combined with a 50% enantiomeric excess bupivacaine mixture.
  
  
  RESULTS
  A 50% enantiomeric excess bupivacaine mixture did not alter the amplitude of muscle response (MP) but decreased the frequency and amplitude of MEPP. The block produced by pancuronium was potentiated by a 50% enantiomeric excess bupivacaine mixture.
  
  
  CONCLUSIONS
  A 50% enantiomeric excess bupivacaine mixture used alone did not affect neuromuscular transmission, but potentiated the neuromuscular block produced by pancuronium. No action was shown on the muscle fibre, and alterations on MEPPs demonstrated a presynaptic action.
authors.affiliation: Department of Anaesthesiology, School of Medicine, UNICAMP, Campinas, São Paulo, Brazil.
authors.forename: Angelica de Fátima
authors.initials: Ade F
authors.lastname: de Assunção Braga
authors.affiliation: Department of Anaesthesiology, School of Medicine, UNICAMP, Campinas, São Paulo, Brazil.
authors.forename: Vanessa Henriques
authors.initials: VH
authors.lastname: Carvalho
authors.affiliation: Department of Anaesthesiology, School of Medicine, UNICAMP, Campinas, São Paulo, Brazil.
authors.forename: Franklin Sarmento
authors.initials: FS
authors.lastname: da Silva Braga
authors.affiliation: Department of Anaesthesiology, School of Medicine, UNICAMP, Campinas, São Paulo, Brazil.
authors.forename: Gloria Maria Braga
authors.initials: GM
authors.lastname: Potério
authors.affiliation: Department of Anaesthesiology, School of Medicine, UNICAMP, Campinas, São Paulo, Brazil.
authors.forename: Filipe Nadir Caparica
authors.initials: FN
authors.lastname: Santos
authors.affiliation: Department of Anaesthesiology, School of Medicine, UNICAMP, Campinas, São Paulo, Brazil.
authors.forename: Fernando Eduardo Féres
authors.initials: FE
authors.lastname: Junqueira
keywords: 50% enantiomeric excess bupivacaine mixture; animals; local anaesthetics; neuromuscular blockers; non-depolarising; pancuronium; rats