TY - JOUR
T1 - Milrinome is superior to epinephrine as treatment of myocardial depression due to ropivacaine in pigs
AU - Neustein, Steven
AU - Sampson, I.
AU - Dimich, Ivan
AU - Shiang, Howard
AU - Tatu, Juvonen
PY - 2000
Y1 - 2000
N2 - Purpose: To determine whether milrinone is more effective than epinephrine in the resuscitation of ropivacaine induced cardiotoxicity in pigs. Methods: Arterial, pulmonary, and LVdP/dt catheters were placed in 12 anesthetized, intubated and mechanically ventilated pigs. They received ropivacaine iv to cardiovascular toxicity: 50% decrease in LVdP/dt, cardiac output and mean arterial pressure (MAP). Group 1 (n=6) was treated with 100 μg·kg-1 milrinone iv, and Group II (n=6) received 0.5 mg epinephrine iv. Resuscitation was successful if cardiac output returned to baseline, and MAP reached 80% of baseline. Results: After ropivacaine, MAP decreased from 88 ± 7 to 49 ± 8 mmHg (P < 0.05), CO decreased from 2.8 ± 0.4 to 1.2 ± 0.2 L·min-1 (P < .05), HR decreased from 103 ± 8 to 74 ± 7 beats·min (P < 0.05) and LVdp/dt decreased from 1950 ± 130 to 755 ± 125 mmHg (P < 0.05). The LV EDP increased from 5 ± 1 to 8 ± 1 mmHg (P < 0.05) and SVR from 2317 to 3000 ± 120 developed arrhythmias. In contrast, epinephrine produced severe hypertension and tachycardia. There was no improvement in CO or SV, and SVR increased. Epinephrine caused A-V dissociation and ventricular arrhythmias in three animals. [[Conclusion: Milrinone, was more successful than epinephrine in resuscitating anesthetized pigs from ropivacaine-induced cardiovascular toxicity.
AB - Purpose: To determine whether milrinone is more effective than epinephrine in the resuscitation of ropivacaine induced cardiotoxicity in pigs. Methods: Arterial, pulmonary, and LVdP/dt catheters were placed in 12 anesthetized, intubated and mechanically ventilated pigs. They received ropivacaine iv to cardiovascular toxicity: 50% decrease in LVdP/dt, cardiac output and mean arterial pressure (MAP). Group 1 (n=6) was treated with 100 μg·kg-1 milrinone iv, and Group II (n=6) received 0.5 mg epinephrine iv. Resuscitation was successful if cardiac output returned to baseline, and MAP reached 80% of baseline. Results: After ropivacaine, MAP decreased from 88 ± 7 to 49 ± 8 mmHg (P < 0.05), CO decreased from 2.8 ± 0.4 to 1.2 ± 0.2 L·min-1 (P < .05), HR decreased from 103 ± 8 to 74 ± 7 beats·min (P < 0.05) and LVdp/dt decreased from 1950 ± 130 to 755 ± 125 mmHg (P < 0.05). The LV EDP increased from 5 ± 1 to 8 ± 1 mmHg (P < 0.05) and SVR from 2317 to 3000 ± 120 developed arrhythmias. In contrast, epinephrine produced severe hypertension and tachycardia. There was no improvement in CO or SV, and SVR increased. Epinephrine caused A-V dissociation and ventricular arrhythmias in three animals. [[Conclusion: Milrinone, was more successful than epinephrine in resuscitating anesthetized pigs from ropivacaine-induced cardiovascular toxicity.
UR - http://www.scopus.com/inward/record.url?scp=0034353751&partnerID=8YFLogxK
U2 - 10.1007/BF03027965
DO - 10.1007/BF03027965
M3 - Article
C2 - 11097543
AN - SCOPUS:0034353751
SN - 0832-610X
VL - 47
SP - 1114
EP - 1118
JO - Canadian Journal of Anaesthesia
JF - Canadian Journal of Anaesthesia
IS - 11
ER -