• Artur Udelsmann and Marcos De Simone Melo.
• Laboratory of Experimental Anesthesia, Department of Anesthesiology, State University of Campinas, Brazil.
• Acta Cir Bras. 2015 Feb 1;30(2):87-93.

PurposeTo compare the hemodynamic changes following two different lipid emulsion therapies after bupivacaine intoxication in swines.MethodsLarge White pigs were anesthetized with thiopental, tracheal intubation performed and mechanical ventilation instituted. Hemodynamic variables were recorded with invasive pressure monitoring and pulmonary artery catheterization (Swan-Ganz catheter). After a 30-minute resting period, 5 mg.kg-1 of bupivacaine by intravenous injection was administered and new hemodynamic measures were performed 1 minute later; the animals were than randomly divided into three groups and received 4 ml.kg-1 of one of the two different lipid emulsion with standard long-chaim triglyceride, or mixture of long and medium-chain triglyceride, or saline solution. Hemodynamic changes were then re-evaluated at 5, 10, 15, 20 and 30 minutes.ResultsBupivacaine intoxication caused fall in arterial blood pressure, cardiac index, ventricular systolic work index mainly and no important changes in vascular resistances. Both emulsion improved arterial blood pressure mainly increasing vascular resistance since the cardiac index had no significant improvement. On the systemic circulation the hemodynamic results were similar with both lipid emulsions.ConclusionBoth lipid emulsions were efficient and similar options to reverse hypotension in cases of bupivacaine toxicity.

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