Haasio J, Pitkänen M T, Kyttä J, Rosenberg P H
Department of Anaesthesiology, Helsinki University Central Hospital, Surgical Hospital, Finland.
Reg Anesth. 1990 Jul-Aug;15(4):174-9.
The treatment of bupivacaine-induced cardiovascular toxicity with amiodarone or bretylium was studied using anesthetized pigs (n = 30). The pigs were given ketamine, glycopyrrolate, enflurane, and pancuronium and made hypoxic (FiO2, 12%; N2O, 88%) and hypercarbic (end-tidal CO2, 7.3-8.0%) before the administration of bupivacaine (4 mg/kg i.v.). The animals were then treated, in a randomized and double-blind fashion, with either amiodarone (n = 10) 10 mg/kg in 5% dextrose solution i.v. followed by a constant infusion of 15 mg/hour, bretylium (n = 10) 20 mg/kg in 5% dextrose solution i.v. followed by a constant infusion of 90 mg/hour, or 5% dextrose solution (n = 10). The animals were resuscitated, if required. After 30 minutes of recovery, the animals that survived were made hypoxic and hypercarbic again and given a second injection of bupivacaine (2 mg/kg IV). Bupivacaine caused marked changes in the ECG; polymorphic ventricular tachycardia (20 cases) or severe bradycardia that resulted in asystole (10 cases). Nine animals out of ten treated with amiodarone survived (stable sinus rhythm, arterial blood pressure at near control level, normocarbia), whereas six animals in the bretylium group and four in the control group died. The difference in survival between the groups was not, however, statistically significant.
使用麻醉猪（n = 30）研究了用胺碘酮或溴苄铵治疗布比卡因引起的心血管毒性。在静脉注射布比卡因（4 mg/kg）之前，给猪注射氯胺酮、格隆溴铵、恩氟烷和泮库溴铵，并使其处于低氧状态（FiO2，12%；N2O，88%）和高碳酸血症状态（呼气末二氧化碳，7.3 - 8.0%）。然后，动物以随机双盲方式接受治疗，一组静脉注射5%葡萄糖溶液中10 mg/kg的胺碘酮（n = 10），随后以15 mg/小时的速度持续输注；一组静脉注射5%葡萄糖溶液中20 mg/kg的溴苄铵（n = 10），随后以90 mg/小时的速度持续输注；另一组静脉注射5%葡萄糖溶液（n = 10）。如有需要，对动物进行复苏。恢复30分钟后，存活的动物再次被制成低氧和高碳酸血症状态，并静脉注射第二次布比卡因（2 mg/kg）。布比卡因导致心电图出现明显变化；多形性室性心动过速（20例）或严重心动过缓导致心脏停搏（10例）。接受胺碘酮治疗的十只动物中有九只存活（窦性心律稳定，动脉血压接近对照水平，正常碳酸血症），而溴苄铵组有六只动物死亡，对照组有四只动物死亡。然而，各组之间的存活率差异无统计学意义。
