Lipid Emulsion-mediated Reversal of Toxic-dose Aminoamide Local Anesthetic-induced Vasodilation in Isolated Rat Aorta

Overview

Journal Korean J Anesthesiol

Specialty Anesthesiology

Date 2013 May 7

PMID 23646246

Citations 12

Authors

Seong-Ho Ok

Jeong Yeol Han

Soo Hee Lee

Il-Woo Shin

Heon Keun Lee

Young-Kyun Chung

Mun-Jeoung Choi

Ju-Tae Sohn

Affiliations

Soon will be listed here.

Abstract

Background: Intravenous lipid emulsion has been used to treat systemic toxicity of local anesthetics. The goals of this in vitro study were to determine the ability of two lipid emulsions (Intralipid® and Lipofundin® MCT/LCT) to reverse toxic dose local anesthetic-induced vasodilation in isolated rat aortas.

Methods: Isolated endothelium-denuded aortas were suspended for isometric tension recording. Vasodilation was induced by bupivacaine (3 × 10(-4) M), ropivacaine (10(-3) M), lidocaine (3 × 10(-3) M), or mepivacaine (7 × 10(-3) M) after precontraction with 60 mM KCl. Intralipid® and Lipofundin® MCT/LCT were then added to generate concentration-response curves. We also assessed vasoconstriction induced by 60 mM KCl, 60 mM KCl with 3 × 10(-4) M bupivacaine, and 60 mM KCl with 3 × 10(-4) M bupivacaine plus 1.39% lipid emulsion (Intralipid® or Lipofundin® MCT/LCT).

Results: The two lipid emulsions reversed vasodilation induced by bupivacaine, ropivacaine, and lidocaine but had no effect on vasodilation induced by mepivacaine. Lipofundin® MCT/LCT was more effective than Intralipid® in reversing bupivacaine-induced vasodilation. The magnitude of lipid emulsion-mediated reversal of vasodilation induced by high-dose local anesthetics was as follows (from highest to lowest): 3 × 10(-4) M bupivacaine-induced vasodilation, 10(-3) M ropivacaine-induced vasodilation, and 3 × 10(-3) M lidocaine-induced vasodilation.

Conclusions: Lipofundin® MCT/LCT-mediated reversal of bupivacaine-induced vasodilation was greater than that of Intralipid®; however, the two lipid emulsions equally reversed vasodilation induced by ropivacaine and lidocaine. The magnitude of lipid emulsion-mediated reversal of vasodilation appears to be correlated with the lipid solubility of the local anesthetic.

Citing Articles

Mechanisms underlying lipid emulsion resuscitation for drug toxicity: a narrative review.

Lee S, Sohn J Korean J Anesthesiol. 2023; 76(3):171-182.

PMID: 36704816 PMC: 10244607. DOI: 10.4097/kja.23031.

Involvement of TREK-1 Channel in Cell Viability of H9c2 Rat Cardiomyoblasts Affected by Bupivacaine and Lipid Emulsion.

Yang J, Siregar A, Kim E, Nyiramana M, Shin E, Han J Cells. 2019; 8(5).

PMID: 31091801 PMC: 6563050. DOI: 10.3390/cells8050454.

Lipid Emulsion for Treating Local Anesthetic Systemic Toxicity.

Ok S, Hong J, Lee S, Sohn J Int J Med Sci. 2018; 15(7):713-722.

PMID: 29910676 PMC: 6001420. DOI: 10.7150/ijms.22643.

A Lipid Emulsion Reverses Toxic-Dose Bupivacaine-Induced Vasodilation during Tyrosine Phosphorylation-Evoked Contraction in Isolated Rat Aortae.

Ok S, Lee S, Kwon S, Choi M, Shin I, Kang S Int J Mol Sci. 2017; 18(2).

PMID: 28208809 PMC: 5343929. DOI: 10.3390/ijms18020394.

Lipid emulsion inhibits vasodilation induced by a toxic dose of bupivacaine by suppressing bupivacaine-induced PKC and CPI-17 dephosphorylation but has no effect on vasodilation induced by a toxic dose of mepivacaine.

Cho H, Ok S, Kwon S, Lee S, Baik J, Kang S Korean J Pain. 2016; 29(4):229-238.

PMID: 27738501 PMC: 5061639. DOI: 10.3344/kjp.2016.29.4.229.

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