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Influence of Lidocaine and Bupivacaine on Isolated Guinea Pig Atria in the Presence of Acidosis and Hypoxia

Received from the Department of Anesthesia Research Laboratories, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Abstract

In an isolated guinea pig atrial preparation, the bathing solution pH, Po₂, and Pco₂ were manipulated to mimic normal, acidotic, and hypoxic conditions. The effect of lidocaine and bupivacaine on spontaneous heart rate (HR) and contractile force (CF) was determined for 60 min under conditions of normal pH, Po₂, and Pco₂. Lidocaine (50 µg/ml) reduced HR by a maximum of 34.2 ± 1.5% and CF by 38.9 ± 8.1% (mean ± sem). Bupivacaine (5 µg/ml) reduced HR by a maximum of 30.1 ± 1.9% and CF by 48.0 ± 6.5%. Bupivacaine (10 µg/ml) caused a maximum HR reduction of 61.7 ± 9.5% and CF reduction of 66.0 ± 8.6%. Hypoxia or metabolic or respiratory acidosis did not further enhance the local anesthetic induced atrial depression. However, conditions of combined acidosis/hypoxia, while not significantly altering the HR and CF depression caused by lidocaine, did enhance bupivacaine-induced depression of HR and CF (93.6 ± 6.3% and 95.2 ± 4.8%, respectively). The effect of a protein-free bathing solution on the relative toxicities of lidocaine and bupivacaine is discussed.

Key Words: ANESTHETICS • LOCAL—bupivacaine • lidocaine • HEART—myocardial infarction • TOXICITY—local anesthetics

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Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999