Department of Anesthesiology, 89657First Affiliated Hospital, Wenzhou Medical University, Zhejiang, China.
Department of Pain Management, 66555Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Hum Exp Toxicol. 2021 Oct;40(10):1796-1802. doi: 10.1177/09603271211010912. Epub 2021 Apr 23.
Bupivacaine is frequently used for regional anesthesia and postoperative analgesia. However, an inadvertent intravenous injection can cause severe cardiotoxicity, manifesting as arrhythmia, hypotension, and even cardiac asystole. The mechanism of bupivacaine-mediated cardiotoxicity remains unclear. SK2 knockout mice (SK) and wild-type mice (WT) were divided into four groups, with 12 mice per group. We determined the difference in bupivacaine cardiotoxicity between SK2 knockout and WT mice by measuring the time to the first arrhythmia (T) and the time to asystole (T). Secondary indicators of cardiotoxicity were the time from the beginning of bupivacaine infusion to 20% prolongation of the QT interval (T) and the time to 20% widening of the QRS complex (T). T and T were significantly longer in the SK-bupi group than in the WT-bupi group (both < 0.05). T and T were longer in the SK-bupi group than in the WT-bupi group (all < 0.05). The time to 25%, 50%, and 75% reduction in HR in the SK-bupi group was significantly longer than in the WT-bupi group (all < 0.05). Knocking out the SK2 channel can reduce bupivacaine-induced cardiotoxicity in the mouse.
布比卡因常用于区域麻醉和术后镇痛。然而,意外的静脉注射会导致严重的心脏毒性,表现为心律失常、低血压,甚至心脏停搏。布比卡因介导的心脏毒性的机制尚不清楚。将 SK2 敲除小鼠(SK)和野生型小鼠(WT)分为四组,每组 12 只。通过测量首次心律失常的时间(T)和心脏停搏的时间(T),我们确定了 SK2 敲除和 WT 小鼠之间布比卡因心脏毒性的差异。心脏毒性的次要指标包括从布比卡因输注开始到 QT 间期延长 20%的时间(T)和 QRS 波群增宽 20%的时间(T)。SK-bupi 组的 T 和 T 均明显长于 WT-bupi 组(均<0.05)。SK-bupi 组的 T 和 T 均长于 WT-bupi 组(均<0.05)。SK-bupi 组 HR 降低 25%、50%和 75%的时间明显长于 WT-bupi 组(均<0.05)。敲除 SK2 通道可减轻小鼠中布比卡因引起的心脏毒性。