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BMC Anesthesiology
Published in: BMC Anesthesiology 1/2018

Open Access 01-12-2018 | Research article

Levosimendan is superior to epinephrine on coronary flow for lipid-base resuscitation of bupivacaine-induced asystole in the isolated rat heart

Authors: Hongfei Chen, Fangfang Xia, Zhousheng Jin, Kejian Shi, Yun Xia, Le Liu, Thomas J. Papadimos, Xuzhong Xu, Limei Chen

Published in: BMC Anesthesiology | Issue 1/2018

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Abstract

Background

Successful resuscitation from asystole induced by bupivacaine requires the reestablishment of a sufficient coronary flow (CF) quickly. This study was designed to test whether levosimendan was superior to epinephrine in the reestablishment of crucial coronary flows after bupivacaine-induced asystole.

Methods

The isolated, perfused, nonrecirculating, Langendorff rat heart preparation was used. Bupivacaine 100 μmol/L was perfused into rat hearts to induce asystole, and then for 3 min thereafter. Three experimental groups were assessed after asystole with infusions as follow: (1) a mixture of 2% lipid emulsion and 40 μmol/L bupivacaine (control group), (2) a mixture of 0.15 μg/mL epinephrine combined with 2% lipid emulsion and 40 μmol/L bupivacaine (epinephrine group), and (3) a mixture of 5 μmol/L levosimendan combined with a 2% lipid emulsion and 40 μmol/L bupivacaine mixture (levosimendan group). Coronary flow (CF), the time to recovery (Trecovery), the number of ventricular arrhythmias, and cardiac function parameters were recorded for 40 min after heartbeat recovery.

Results

All hearts in the control, epinephrine and levosimendan groups had heartbeat recovery. The rank order of the mean CF from highest to lowest was the levosimendan group > the epinepgrine group > the control group (P < 0.05). The rank order of Trecovery from shortest to longest was the levosimendan group < the epinephrine group < the control group (P < 0.01). During the recovery phase, isolated rat hearts developed more ventricular arrhythmias in the epinephrine group than in the levosimendan group (P = 0.01).

Conclusion

Levosimendan is superior to epinephrine in producing higher CFs and faster recovery when reversing bupivacaine-induced asystole in the isolated rat hearts.
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Metadata
Title
Levosimendan is superior to epinephrine on coronary flow for lipid-base resuscitation of bupivacaine-induced asystole in the isolated rat heart
Authors
Hongfei Chen
Fangfang Xia
Zhousheng Jin
Kejian Shi
Yun Xia
Le Liu
Thomas J. Papadimos
Xuzhong Xu
Limei Chen
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Anesthesiology / Issue 1/2018
Electronic ISSN: 1471-2253
DOI
https://doi.org/10.1186/s12871-018-0627-0

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