Levosimendan is superior to epinephrine on coronary flow for lipid-base resuscitation of bupivacaine-induced asystole in the isolated rat heart.

Abstract

BACKGROUND:

Successful resuscitation from asystole induced by bupivacaine requires the reestablishment of a sufficient coronary flow (CF) quickly. This study was designed to test whether levosimendan was superior to epinephrine in the reestablishment of crucial coronary flows after bupivacaine-induced asystole.

METHODS:

The isolated, perfused, nonrecirculating, Langendorff rat heart preparation was used. Bupivacaine 100 μmol/L was perfused into rat hearts to induce asystole, and then for 3 min thereafter. Three experimental groups were assessed after asystole with infusions as follow: (1) a mixture of 2% lipid emulsion and 40 μmol/L bupivacaine (control group), (2) a mixture of 0.15 μg/mL epinephrine combined with 2% lipid emulsion and 40 μmol/L bupivacaine (epinephrine group), and (3) a mixture of 5 μmol/L levosimendan combined with a 2% lipid emulsion and 40 μmol/L bupivacaine mixture (levosimendan group). Coronary flow (CF), the time to recovery (Trecovery), the number of ventricular arrhythmias, and cardiac function parameters were recorded for 40 min after heartbeat recovery.

RESULTS:

All hearts in the control, epinephrine and levosimendan groups had heartbeat recovery. The rank order of the mean CF from highest to lowest was the levosimendan group > the epinepgrine group > the control group (P < 0.05). The rank order of Trecovery from shortest to longest was the levosimendan group < the epinephrine group < the control group (P < 0.01). During the recovery phase, isolated rat hearts developed more ventricular arrhythmias in the epinephrine group than in the levosimendan group (P = 0.01).

CONCLUSION:

Levosimendan is superior to epinephrine in producing higher CFs and faster recovery when reversing bupivacaine-induced asystole in the isolated rat hearts.

• Authors: Hongfei Chen, Fangfang Xia, Zhousheng Jin, Kejian Shi, Yun Xia, Le Liu, Thomas J Papadimos, Xuzhong Xu, Limei Chen
• Journal: BMC anesthesiology (BMC Anesthesiol) Vol. 18 Issue 1 Pg. 174 (11 20 2018) ISSN: 1471-2253 [Electronic] England
• PMID: 30458723 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anesthetics, Local
• Fat Emulsions, Intravenous
• Simendan
• Bupivacaine
• Epinephrine

Topics

• Anesthetics, Local (administration & dosage)
• Animals
• Blood Flow Velocity (drug effects)
• Bupivacaine (administration & dosage)
• Coronary Circulation (drug effects)
• Drug Therapy, Combination
• Epinephrine (administration & dosage)
• Fat Emulsions, Intravenous (administration & dosage)
• Heart Arrest (drug therapy, physiopathology)
• Isolated Heart Preparation (methods)
• Male
• Rats
• Rats, Sprague-Dawley
• Resuscitation (methods)
• Simendan (administration & dosage)