Je. Heavner et al., RESUSCITATION FROM BUPIVACAINE-INDUCED ASYSTOLE IN RATS - COMPARISON OF DIFFERENT CARDIOACTIVE DRUGS, Anesthesia and analgesia, 80(6), 1995, pp. 1134-1139
The objective of this study was to compare the success of resuscitatio
n attempts with different cardioactive drugs after bupivacaine-induced
asystole. Saline, amrinone (1 mg/kg), dopamine (5 (mu g/kg), norepine
phrine (2 mu g/kg), epinephrine (10 mu g/kg), or isoproterenol (1 mu g
/kg) were tested. Sixty rats assigned to six treatment groups (n = 10/
group) were Lightly anesthetized (0.5% halothane, 70% N2O), paralyzed
(doxacurium), and given bupivacaine intravenously at 4 mg . kg(-1). mi
n(-1) until asystole. Five seconds later up to three treatment drug do
ses were given at 30-s intervals. Then external cardiac massage was in
stituted as needed. Spontaneous heartbeat was restored in all animals
given norepinephrine or epinephrine. It was not restored in one saline
-one dopamine-treated, one isoproterenol-treated and three amrinone-tr
eated animals. The highest (best) arbitrary scores for overall resusci
tation success were achieved with norepinephrine and the lowest with a
mrinone (P < 0.05). The incidence of ventricular arrhythmias after res
uscitation was significantly higher (P < 0.05) in epinephrine- and iso
proterenol-treated animals versus other animals. Cardiac rhythm distur
bance disappeared within 20 min after successful resuscitation with no
repinephrine. Amrinone was no more effective than saline in treating b
upivacaine-induced asystole. A drug such as norepinephrine, which has
both cardiostimulator (beta(1)-receptor agonist) and peripheral vasoco
nstrictor (alpha(1)-receptor agonist) activity, may be the drug of cho
ice for treating asystole induced by bupivacaine.