| Objective:To investigate the effect of lipid emulsion on bupivacain,levobupivacain infusion induced cardiac toxicity and to explore its mechanism.Methods:72SD adult male rats weighting about220-250g were randomly divided into five groups, non-treatment control group(group A)(n=8),bupivacaine control group(group D),bupivacaine+lipid emulsion pretreatment group(group C), levobupivacain control group(group D), levobupivacain+lipid emulsion pretreatment group(group E), ach group of B,C,D,E group are divided into two sub-groups based on the material group (group1) and the death group (group2)(n=8each). The rats were anesthetized with10%chloralic hydras (0.3ml/100g)that was injected by intraperitoneal. Two-lead ECG being monitored by inserting three acupuncture needles into the both upper limbs and left lower limb subcutaneouly. Femoral vein was isolated to pump liquid. The carotid artery was isolated and connected to the pressure transducer to measure blood pressure which was then connected to the computer with BL-420bio-function experimental system.Group A,0.9%normal saline (3ml/kg/min) was pumped in intrvenous injection continuously heart was quickly removed after6minutes.Group B1,0.9%normal saline (3ml/kg/min) was pumped in intravenousinjection continuously for5min, then0.5%bupivacaine (2mg/kg/min)continuous intravenous infusion of1minutes after then rats were killed.Group B2Bubi death group,0.9%saline (3ml/kg/min) continuous intravenous infusion for5minutes and then0.5%bupivacaine (2mg/kg/min) continuous intravenous infusion till rat cardiac arrest.Group C1bupivacaine+lipid emulsion derived group,20%fat emulsion (3ml/kg/min) continuous intravenous infusion for5minutes, then0.5%bupivacaine (2mg/kg/min)a continuous intravenous infusion for1minute then rats were killed.Group C2bupivacaine+intralipid death group,20%fat emulsion (3ml/kg/min) continuous intravenous infusion for5minutes, then0.5%bupivacaine (2mg/kg/min)a continuous intravenous infusion till rat cardiac arrest.Group D10.9%levobupivacaine group derived saline (3ml/kg/min) continuous intravenous infusion for5minutes, then left0.5%bupivacaine (2mg/kg/min) continuous intravenous infusion rats were killed after1minute.Group D2levobupivacaine0.9%saline group died (3ml/kg/min) continuous intravenous infusion for5minutes, then0.5%levobupivacaine (2mg/kg/min) continuous intravenous infusion till rats with cardiac arrest.group E1, drawn levobupivacaine+Intralipid group,20%fat emulsion (3ml/kg/min) continuous intravenous infusion for5minutes, then left0.5%bupivacaine (2mg/kg/min) continuous intravenous infusion of1minute, rats were killed after it.Group E2levobupivacaine+intralipid death group,20%fat emulsion (3ml/kg/min)continuous intravenous infusion for5minutes, then left0.5%bupivacaine (2mg/kg/min) continuous intravenous infusion till rat cardiac arrest.record the basal blood pressure (BP),heart rate(HR),normal ECG and blood waveform, as a reference, and record the time of arrhythmia(as QRS extend to90ms) and cardiac arrest(no more ECG wave after lmin with cardiac arrest showed on ECG) emergence. mean time, to calculated Corresponding phase of bupivacaine. control and derived group killed animal by decapitation,take the heart quickly, then freeze in liquid nitrogen until ATPase concentration tested.Results:1. WeightThere is no significant difference between9groups (P>0.05)(table1)2. Baseline of the hemodynamic,The baseline of the hemodynamic in9groups have no significant difference(P>0.05).(table1)3. The time and dose of the time point in death groups.(1). The emergence time of arrhythmia and cardiac arrest of C2group were delayed compared to group B2(p<0.05) difference is statistically significant, in C2group the dose of the corresponding phase of the bupivacaine is higher than group B2group (p<0.05), the difference was statistically significant.(2) the time of E2gruop rats emerge arrhythmia and cardiac arrest, delay than D2(p<0.05) difference was statistically significant, the dose of the corresponding phase of the bupivacaine group D2higher than E2group (p<0.05), the difference was statistically significant.(3) D2group appeared cardiac arrest than those in B2B2time delay (p<0.05) difference was statistically significant, but the D2group of rats had the time of arrhythmia than B2B2extension (p<0.05) difference statistically significant, the amount of the corresponding phase of the bupivacaine group B2D2group than the high (p<0.05), the difference was statistically significant.(4) B2group’s get rats arrhythmia and cardiac arrest early than group E2(p <0.05) difference was statistically significant, the dose of the corresponding phase of the bupivacaine group B2higher than E2group (p<0.05), the difference was statistically significant.(5) C2group’s arrhythmia and cardiac arrest emerge earlier than D2,(p<0.05) difference was statistically significant, the corresponding phase of the bupivacaine dose in group D2higher than C2group (p<0.05), the difference was statistically significant.(6) In group E2the time of arrhythmia and cardiac arrest delayer than the C2(p <0.05) difference was statistically significant, the corresponding phase of the bupivacaine dose in C2group is higher than the group E2(p<0.05), the difference was statistically significant.There are significant differences statistically in comparison between any two groups (P<0.05).(table2)4. Comparison of ATPase concentrationComparison of ATPase concentration in each group:A> E1> D1> C1> B1, There are significant differences statistically in comparison between any two groups (P<0.05).(table3)Conclusion:The toxicity of levobupivacaine is lower than bupivacaineThe pre-administration of lipid emulsion injection can significantly reduce the cardiotoxicity of levobupivacaine and bupivacaine, mechanism of this effect may related to the increase activity of myocardial ATPase... |
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