Giving Priority to Lipid Administration Can Reduce Lung Injury Caused by Epinephrine in Bupivacaine-Induced Cardiac Depression

Luo, Mengxu; Xia, Yun; Chen, Chaoxing; Bao, Nana; Feng, Xia‐Ting; Pan, Linmin; Jin, Zhousheng; Wu, Changcheng; Wang, Xianqin; Papadimos, Thomas J.; Xu, Xuzhong

doi:10.1097/aap.0000000000000424

Cited by 10 publications

(4 citation statements)

References 24 publications

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“…These results suggest that high doses of epinephrine and vasopressin inhibit lipid emulsion-mediated resuscitation because high-dose epinephrine causes acidosis and less sustained ROSC 86 - 88 . Epinephrine administration immediately after lipid emulsion-mediated resuscitation or after the bolus administration of lipid emulsion in a bupivacaine-induced cardiac arrest rat model decreased the lung injury caused by epinephrine and improved survival compared with epinephrine administration before the bolus administration of lipid emulsion 89 , 90 . Lipid emulsion alone (4 ml/kg) followed by continuous infusion of lipid emulsion (0.25 ml/kg/min), combined treatment with lipid emulsion (4 ml/kg followed by 0.25 ml/kg/min) and epinephrine (10 µg/kg, repeated every 3 min) or epinephrine (10 µg/kg, repeated every 3 min) alone equally improved ROSC following levobupivacaine-induced cardiovascular collapse in newborn piglets compared with controls 91 .…”

Section: The Effect Of Epinephrine On Lipid Emulsion-mediated Resuscimentioning

confidence: 98%

Lipid Emulsion for Treating Local Anesthetic Systemic Toxicity

Ok¹,

Hong²,

Lee³

et al. 2018

Int. J. Med. Sci.

103

133

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Lipid emulsion has been shown to be an effective treatment for systemic toxicity induced by local anesthetics, which is reflected in case reports. A systemic review and meta-analysis confirm the efficacy of this treatment. Investigators have suggested mechanisms associated with the lipid emulsion-mediated recovery of cardiovascular collapse caused by local anesthetic systemic toxicity; these mechanisms include lipid sink, a widely accepted theory in which highly soluble local anesthetics (particularly bupivacaine) are absorbed into the lipid phase of plasma from tissues (e.g., the heart) affected by local-anesthetic-induced toxicity; enhanced redistribution (lipid shuttle); fatty acid supply; reversal of mitochondrial dysfunction; inotropic effects; glycogen synthase kinase-3β phosphorylation associated with inhibition of the mitochondrial permeability transition pore opening; inhibition of nitric oxide release; and reversal of cardiac sodium channel blockade. The current review includes the following: 1) an introduction, 2) a list of the proposed mechanisms, 3) a discussion of the best lipid emulsion treatment for reversal of local anesthetic toxicity, 4) a description of the effect of epinephrine on lipid emulsion-mediated resuscitation, 5) a description of the recommended lipid emulsion treatment, and 6) a conclusion.

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Section: The Effect Of Epinephrine On Lipid Emulsion-mediated Resuscimentioning

confidence: 98%

Lipid Emulsion for Treating Local Anesthetic Systemic Toxicity

Ok¹,

Hong²,

Lee³

et al. 2018

Int. J. Med. Sci.

103

133

View full text Add to dashboard Cite

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“…BDT may play an antidepressant role by modulating levels of these metabolites (Supporting information Figure S8). We also discovered metabolic pathways related to potential markers, including d-glutamine and d-glutamate metabolism, purine metabolism, phenylalanine metabolism, retinol metabolism, primary bile acid biosynthesis, and arginine and proline metabolism [26][27][28]. Figure 5 illustrates the relationship between potential biomarkers and metabolic pathways.…”

Section: Discussionmentioning

confidence: 99%

Develop a stepwise integrated method to screen biomarkers of Baihe‐Dihuang Tang on the treatment of depression in rats applying with composition screened, untargeted, and targeted metabolomics analysis

Mou

Chen

et al. 2022

J of Separation Science

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Baihe‐Dihuang Tang is a commonly prescribed remedy for depression. In this study, component screening with untargeted and targeted metabolomics was used to identify potential biomarkers for depression in chronic unpredictable mildly stressed rats. Using this novel identification method, the screening of organic acids, lily saponins, iridoids, and other ingredients formed the basis for subsequent metabolomics research. Baihe‐Dihuang Tang supplementation in chronic unpredictable mild‐stress‐induced depression models, increased their body weight, sucrose preference, brain‐derived neurotrophic factor deposition, and spatial exploring. Untargeted metabolomics revealed that Baihe‐Dihuang Tang exerts its antidepressant effects by regulating the levels of lipids, organic acids, and its derivatives, and benzenoids in the brain, plasma, and urine of the depressed rats. Moreover, it also modulates the d‐glutamine and d‐glutamate metabolism and purine metabolism. Targeted metabolomics demonstrated significant reduction in l‐glutamate levels in the brains of depressed rats. This could be a potential biomarker for depression. Baihe‐Dihuang Tang alleviated depression by regulating the levels of l‐glutamate, xanthine, and adenine in the brains of depressed rats. Together, these findings conclusively established the promising therapeutic effect of Baihe‐Dihuang Tang on depression and also unraveled the underlying molecular mechanism of its potential antidepressant function.

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“…The ventilator settings are as follows: respiratory rate 60 breaths/min, tidal volume 2 ml/100 g, and inspiratory to expiratory ratio 1:2. Sevoflurane (1-2%) in 30% O 2 was started before the median incision in the neck was made [12]. The right jugular vein and the left carotid artery were intubated with a silastic tube (external diameter × internal diameter = 1.0 × 0.5 mm).…”

Section: Anesthesia and Monitoringmentioning

confidence: 99%

Effects of delta-opioid receptor agonist pretreatment on the cardiotoxicity of bupivacaine in rats

et al. 2022

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Background Delta-opioid receptor is widely expressed in human and rodent hearts, and has been proved to protect cardiomyocytes against ischemia/reperfusion and heart failure. The antagonist of delta-opioid receptor could block the rescue effect of lipid emulsion against local anesthetic cardiotoxicity. However, no evidence is available for the direct effect of delta-opioid-receptor agonists on the cardiotoxicity of local anesthetics. Methods Anesthetized Sprague Dawley rats were divided into five groups. Group NS received 2 ml·kg−1·min−1 normal saline, group LE received 2 ml·kg−1·min−1 30% lipid emulsion and group BW received 0.1, 1.0, or 5.0 mg/kg BW373U86, a delta-opioid-receptor agonist, for 5 min. Then 0.5% bupivacaine was infused intravenously at a rate of 3.0 mg·kg−1·min−1 until asystole. The time of arrhythmia, 50% mean arterial pressure-, 50% heart rate-reduction and asystole were recorded, and the dose of bupivacaine at each time point was calculated. Results All three different doses of BW373U86 did not affect the arrhythmia, 50% mean arterial pressure-reduction, 50% heart rate-reduction and asystole dose of bupivacaine compared with group NS. 30% LE significantly increased the bupivacaine threshold of 50% mean arterial pressure-reduction (17.9 [15.4–20.7] versus 7.2 [5.9–8.7], p = 0.018), 50% heart rate-reduction (18.7 ± 4.2 versus 8.8 ± 1.7, p < 0.001) and asystole (26.5 [21.0–29.1] versus 11.3 [10.7–13.4], p = 0.008) compared with group NS. There was no difference between group LE and group NS in the arrhythmia dose of bupivacaine (9.9 [8.9–11.7] versus 5.6 [4.5–7.0], p = 0.060). Conclusions Our data show that BW373U86 does not affect the cardiotoxicity of bupivacaine compared with NS control in rats. 30% LE pretreatment protects the myocardium against bupivacaine-induced cardiotoxicity.

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Giving Priority to Lipid Administration Can Reduce Lung Injury Caused by Epinephrine in Bupivacaine-Induced Cardiac Depression

Abstract: Giving priority to the administration of a lipid emulsion before the administration of epinephrine can reduce lung injury in bupivacaine-induced cardiac depression in rats.

Cited by 10 publications

References 24 publications

Lipid Emulsion for Treating Local Anesthetic Systemic Toxicity

Lipid Emulsion for Treating Local Anesthetic Systemic Toxicity

Develop a stepwise integrated method to screen biomarkers of Baihe‐Dihuang Tang on the treatment of depression in rats applying with composition screened, untargeted, and targeted metabolomics analysis

Effects of delta-opioid receptor agonist pretreatment on the cardiotoxicity of bupivacaine in rats

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