Effects of Dexmedetomidine Pretreatment on Bupivacaine Cardiotoxicity in Rats

Background and Objective: We evaluated the effects of dexmedetomidine pretreatment on bupivacaine cardiotoxicity in anesthetized rats. Methods: Sixteen Wistar-Albino male rats (300-400 g) were anesthetized with ketamine. Electrocardiographic and invasive blood pressure monitoring were performed, and the results were continuously recorded. The rats were randomized into 2 groups. In group D, rats were pretreated with intravenous dexmedetomidine at a dose of 10 &mgr;g/kg (n = 8), whereas in group S, rats were pretreated with intravenous saline (n = 8). Fifteen minutes later, bupivacaine was infused at a rate of 3 mg/kg per minute until cardiac asystole occurred. The timing of specific cardiotoxic events (a 25%, 50%, and 75% reductions of mean arterial pressure and heart rate as well as occurrence of the first arrhythmia and asystole) was recorded. Results: Dexmedetomidine pretreatment reduced the heart rates and mean arterial pressures of the rats who received it (P < 0.05). Dexmedetomidine pretreatment before bupivacaine administration also significantly increased the time to the 25%, 50%, and 75% reductions in mean arterial pressure and the time to the 25% and 50% reductions in heart rate (P < 0.05). In addition, dexmedetomidine significantly increased the time to first arrhythmia and time to asystole (P < 0.05) in the rats who received it before receiving bupivacaine. Conclusions: Dexmedetomidine pretreatment delays the effects of bupivacaine cardiotoxicity.

[1]  V. Hancı,et al.  Effects of dexmedetomidine or methylprednisolone on inflammatory responses in spinal cord injury , 2009, Acta anaesthesiologica Scandinavica.

[2]  M. M. Murshidi,et al.  Effect of dexmedetomidine added to spinal bupivacaine for urological procedures. , 2009, Saudi medical journal.

[3]  A. Boker,et al.  Effect of dexmedetomidine on the characteristics of bupivacaine in a caudal block in pediatrics , 2009, Acta anaesthesiologica Scandinavica.

[4]  C. Brummett,et al.  Perineural Administration of Dexmedetomidine in Combination with Bupivacaine Enhances Sensory and Motor Blockade in Sciatic Nerve Block without Inducing Neurotoxicity in Rat , 2008, Anesthesiology.

[5]  K. Morita,et al.  The cardioprotective effect of dexmedetomidine on global ischaemia in isolated rat hearts. , 2007, Resuscitation.

[6]  M. Tekin,et al.  Effects of dexmedetomidine on the duration of anaesthesia and wakefulness in bupivacaine epidural block , 2007, European journal of anaesthesiology.

[7]  M. Davies,et al.  A Comparison of Dexmedetomidine Versus Conventional Therapy for Sedation and Hemodynamic Control During Carotid Endarterectomy Performed Under Regional Anesthesia , 2006, Anesthesia and analgesia.

[8]  A. Baraka,et al.  Effect of low‐dose dexmedetomidine or clonidine on the characteristics of bupivacaine spinal block , 2006, Acta anaesthesiologica Scandinavica.

[9]  S. Wahlander,et al.  A prospective, double-blind, randomized, placebo-controlled study of dexmedetomidine as an adjunct to epidural analgesia after thoracic surgery. , 2005, Journal of cardiothoracic and vascular anesthesia.

[10]  Katsuaki Tanaka,et al.  Dexmedetomidine Decreases the Convulsive Potency of Bupivacaine and Levobupivacaine in Rats: Involvement of &agr;2-Adrenoceptor for Controlling Convulsions , 2005, Anesthesia and analgesia.

[11]  田中 克明 Dexmedetomidine decreases the convulsive potency of bupivacaine and levobupivacaine in rats : involvement of α2-adrenoceptor for controlling convulsions , 2005 .

[12]  B. Yelken,et al.  Effects of clonidine pre-treatment on bupivacaine and ropivacaine cardiotoxicity in rats , 2004, European journal of anaesthesiology.

[13]  F. Prinzen,et al.  Dexmedetomidine Decreases Perioperative Myocardial Lactate Release in Dogs , 2003, Anesthesia and analgesia.

[14]  L. Allanic,et al.  Successful resuscitation of serious bupivacaine intoxication in a patient with pre-existing heart failure , 2003, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[15]  T. Ebert,et al.  The Efficacy, Side Effects, and Recovery Characteristics of Dexmedetomidine Versus Propofol When Used for Intraoperative Sedation , 2002, Anesthesia and analgesia.

[16]  R. Kauppinen,et al.  Neuroprotection by the α2-adrenoceptor agonist, dexmedetomidine, in rat focal cerebral ischemia , 1999 .

[17]  F. Prinzen,et al.  Beneficial effects of dexmedetomidine on ischaemic myocardium of anaesthetized dogs. , 1996, British journal of anaesthesia.

[18]  M. Maze,et al.  Neuroprotection by the α2-Adrenoreceptor Agonist Dexmedetomidine in a Focal Model of Cerebral Ischemia , 1993 .

[19]  M. Maze,et al.  Neuroprotection by the alpha 2-adrenoreceptor agonist dexmedetomidine in a focal model of cerebral ischemia. , 1993, Anesthesiology.

[20]  M. D. De Kock,et al.  Clonidine Pretreatment Reduces the Systemic Toxicity of Intravenous Bupivacaine in Rats , 1993, Anesthesiology.

[21]  M. G. Larach Should we use muscle biopsy to diagnose malignant hyperthermia susceptibility? , 1993, Anesthesiology.

[22]  J. Brugada,et al.  [Cardiotoxicity of local anesthetics]. , 1993, Cahiers d'anesthesiologie.

[23]  J. Brugada,et al.  Reversal of electrophysiologic and hemodynamic effects induced by high dose of bupivacaine by the combination of clonidine and dobutamine in anesthetized dogs. , 1992, Anesthesia and analgesia.

[24]  I. L. Cohen,et al.  ESTIMATION OF O2DEFICIT AND DEBT RESULTING FROM ABDOMINAL AORTIC CROSS-CLAMPING IN HUMANS , 1991 .

[25]  W. Hoffman,et al.  Dexmedetomidine improves neurologic outcome from incomplete ischemia in the rat. Reversal by the alpha 2-adrenergic antagonist atipamezole. , 1991, Anesthesiology.

[26]  M. Maze,et al.  Dexmedetomidine prevents epinephrine-induced arrhythmias through stimulation of central alpha 2 adrenoceptors in halothane-anesthetized dogs. , 1991, Anesthesiology.

[27]  M. Rosen,et al.  Bupivacaine‐Induced Cardiotoxicity in Hypoxic and Acidotic Sheep , 1985, Anesthesia and analgesia.