Is Cardiolipin the Target of Local Anesthetic Cardiotoxicity?

Shen, Xiaofeng; Xu, Shiqin; Qian, Yanning; Liu, Yusheng; Yuan, Hongmei; Zhao, Qingsong; Shi, Feng; Guo, Xirong; Xu, Jianguo; Yang, Jie

doi:10.1016/s0034-7094(10)70055-6

Cited by 8 publications

(12 citation statements)

References 70 publications

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“…We developed a rabbit model, in which cardiac dysrhythmias resulted from intracerebroventricular (icv) ropivacaine administration. Based on our results and a review of the relevant literature (Bilir et al, 2006;Shen et al, 2010), we propose a model to explain the mechanism by which icv ropivacaine acts within the CNS to produce cardiotoxicity.…”

Section: Introductionmentioning

confidence: 73%

Midazolam in rabbits terminates dysrhythmias caused by intracerebroventricular ropivacaine

Zhu

Yuan

et al. 2011

J. Zhejiang Univ. Sci. B

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Abstract:The current study was designed to investigate the mechanisms by which ropivacaine may act within the central nervous system (CNS) to produce cardiotoxicity. Eighty New Zealand rabbits were divided into four groups randomly. In Group 1, 20 rabbits received intracerebroventricular (icv) saline, and then received icv ropivacaine 30 min later. In Group 2, 20 rabbits received icv ropivacaine. Whenever dysrhythmias continued for more than 5 min, 0.1 ml saline was administered into the left cerebral ventricle. Ten minutes later, 0.1 ml midazolam was given into the left lateral ventricle. In Group 3, 20 rabbits received icv ropivacaine, and once the dysrhythmias developed, the inspired isoflurane concentration was increased from 0.75% to 1.50%. In Group 4, 20 animals received an intravenous (iv) phenylephrine infusion until dysrhythmias occurred. In Group 1, the rabbits did not develop dysrhythmias in response to icv saline, whereas dysrhythmias did develop in these animals after icv ropivacaine. In Group 2, icv saline had no effect on the dysrhythmias; however, icv midazolam terminated cardiac dysrhythmias. In Group 3, an increase in the concentration of the inspired isoflurane had no effect on dysrhythmias. In Group 4, icv midazolam had no effect on dysrhythmias in response to iv phenylephrine. Ropivacaine administered directly into the CNS is capable of producing cardiac dysrhythmias; midazolam terminated dysrhythmias presumably by potentiation of γ-aminobutyric acid (GABA) receptor activity. Our results suggest that ropivacaine produces some of its cardiotoxicity not only by the direct cardiotoxicity of the drug, but also by the CNS effects of ropivacaine.

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Section: Introductionmentioning

confidence: 73%

Midazolam in rabbits terminates dysrhythmias caused by intracerebroventricular ropivacaine

Zhu

Yuan

et al. 2011

J. Zhejiang Univ. Sci. B

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“…Devido à sua rápida implementação, sensibilidade, sondas fluorescentes como a fluoresceína e Cumarina, (Figura 14), são empregadas para avaliar a atividade da ALP em fluídos biológicos. 46,38 Figura 14. Estrutura química da Fluoresceína e Cumarina Essas duas sondas são empregadas devido a sua alta sensibilidade, porém, elas são excretadas da célula reduzindo a aplicação endógena.…”

Section: Sondas Empregadas No Diagnóstico De Doençasunclassified

Intramolecular Proton Transfer in the Excited State (ESIPT) Process: Applications in Fluorescent Probes

Rocha

Ramalho

2016

Revista Virtual De Química

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Currently the opportune diagnosis of cancer has shown a great importance, mainly by decreasing the mortality rate. Among the techniques employed to achieve the diagnosis, spectroscopy has been highlighted for presenting safe and highly accurate diagnoses. The Fluorescence Spectroscopy has become very important in cancer diagnosis, being employed in breast, oral cavity and esophagus cancer testing. The technique employs fluorophore which in many cases have groups capable of carrying out the intramolecular proton transfer in the excited state (ESIPT). These compounds may be used for various molecular targets such as cations, anions and proteins detection, besides the diagnosis of diseases. Spectroscopic probes have an important role in the development of more accurate diagnosing diseases methods, which may influence the treatment and avoid the risks of further surgery and patient death.

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“…Importantly, inhibition of the respiratory chain complexes was prevented by antioxidant treatment and reversed following removal of the anesthetic thereby suggesting an oxidant-mediated feedback mechanism reinforcing the primary inhibitory action of the anesthetic. Recent developments implicate the mitochondrial phospholipid cardiolipin, involved in respiration, to be the major determinant of LA cardiotoxicity, established by means of theoretic and structural biological methods [47]. …”

Section: Local Anesthetic Systemic Toxicitymentioning

confidence: 99%

Lipid Emulsion for Local Anesthetic Systemic Toxicity

Ciechanowicz¹,

Patil²

2012

Anesthesiology Research and Practice

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The accidental overdose of local anesthetics may prove fatal. The commonly used amide local anesthetics have varying adverse effects on the myocardium, and beyond a certain dose all are capable of causing death. Local anesthetics are the most frequently used drugs amongst anesthetists and although uncommon, local anaesthetic systemic toxicity accounts for a high proportion of mortality, with local anaesthetic-induced cardiac arrest particularly resistant to standard resuscitation methods. Over the last decade, there has been convincing evidence of intravenous lipid emulsions as a rescue in local anesthetic-cardiotoxicity, and anesthetic organisations, over the globe have developed guidelines on the use of this drug. Despite this, awareness amongst practitioners appears to be lacking. All who use local anesthetics in their practice should have an appreciation of patients at high risk of toxicity, early symptoms and signs of toxicity, preventative measures when using local anesthetics, and the initial management of systemic toxicity with intravenous lipid emulsion. In this paper we intend to discuss the pharmacology and pathophysiology of local anesthetics and toxicity, and the rationale for lipid emulsion therapy.

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Is Cardiolipin the Target of Local Anesthetic Cardiotoxicity?

Abstract: The interaction between local anesthetic and mitochondrial cardiolipin may be the underlying mechanism for cardiotoxicity affecting its energy metabolism and electrostatic status.

Cited by 8 publications

References 70 publications

Midazolam in rabbits terminates dysrhythmias caused by intracerebroventricular ropivacaine

Midazolam in rabbits terminates dysrhythmias caused by intracerebroventricular ropivacaine

Intramolecular Proton Transfer in the Excited State (ESIPT) Process: Applications in Fluorescent Probes

Lipid Emulsion for Local Anesthetic Systemic Toxicity

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