Lipid Emulsions Enhance the Norepinephrine-mediated Reversal of Local Anesthetic-induced Vasodilation at Toxic Doses

Overview

Journal Yonsei Med J

Specialty General Medicine

Date 2013 Oct 22

PMID 24142661

Citations 4

Authors

Soo Hee Lee

Hui-Jin Sung

Seong-Ho Ok

Jongsun Yu

Mun-Jeoung Choi

Jin Soo Lim

Ju-Tae Sohn

Affiliations

Soon will be listed here.

Abstract

Purpose: Intravenous lipid emulsions have been used to treat the systemic toxicity of local anesthetics. The goal of this in vitro study was to examine the effects of lipid emulsions on the norepinephrine-mediated reversal of vasodilation induced by high doses of levobupivacaine, ropivacaine, and mepivacaine in isolated endothelium-denuded rat aorta, and to determine whether such effects are associated with the lipid solubility of local anesthetics.

Materials And Methods: The effects of lipid emulsions (0.30, 0.49, 1.40, and 2.61%) on norepinephrine concentration-responses in high-dose local anesthetic (6×10(-4) M levobupivacaine, 2×10(-3) M ropivacaine, and 7×10(-3) M mepivacaine)-induced vasodilation of isolated aorta precontracted with 60 mM KCl were assessed. The effects of lipid emulsions on local anesthetic- and diltiazem-induced vasodilation in isolated aorta precontracted with phenylephrine were also assessed.

Results: Lipid emulsions (0.30%) enhanced norepinephrine-induced contraction in levobupivacaine-induced vasodilation, whereas 1.40 and 2.61% lipid emulsions enhanced norepinephrine-induced contraction in both ropivacaine- and mepivacaine-induced vasodilation, respectively. Lipid emulsions (0.20, 0.49 and 1.40%) inhibited vasodilation induced by levobupivacaine and ropivacaine, whereas 1.40 and 2.61% lipid emulsions slightly attenuated mepivacaine (3×10(-3) M)-induced vasodilation. In addition, lipid emulsions attenuated diltiazem-induced vasodilation. Lipid emulsions enhanced norepinephrine-induced contraction in endothelium-denuded aorta without pretreatment with local anesthetics.

Conclusion: Taken together, these results suggest that lipid emulsions enhance the norepinephrine-mediated reversal of local anesthetic-induced vasodilation at toxic anesthetic doses and inhibit local anesthetic-induced vasodilation in a manner correlated with the lipid solubility of a particular local anesthetic.

Citing Articles

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.

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.

Lipid Emulsion Inhibits Vasodilation Induced by a Toxic Dose of Bupivacaine via Attenuated Dephosphorylation of Myosin Phosphatase Target Subunit 1 in Isolated Rat Aorta.

Ok S, Byon H, Kwon S, Park J, Lee Y, Hwang Y Int J Med Sci. 2015; 12(12):958-67.

PMID: 26664257 PMC: 4661294. DOI: 10.7150/ijms.13299.

Differential effects of short- and long-term bupivacaine treatment on α1-adrenoceptor-mediated contraction of isolated rat aorta rings and the reversal effect of lipid emulsion.

Guo H, Zhang H, Xu W, Du Q, Zhao J, Ren L Acta Pharmacol Sin. 2015; 36(8):976-86.

PMID: 26073324 PMC: 4564882. DOI: 10.1038/aps.2015.40.

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