Research Article
Year 2018,
Volume: 40 Issue: 2, 184 - 193, 28.06.2018
Abstract
Introduction: Local anesthetics are also
considered to be potentially toxic to the cardiovascular system since they act
on ion channels in nerve cell membranes as well as in other tissues that can be
stimulated.
Aim: In this study we aimed to compare
cardiotoxicity levels of both drugs with brain natriuretic peptide (BNP)
protein level in patients undergoing combined spinal epidural anesthesia and
postoperative analgesia when given bupivacaine and levobupivacaine at
equipotent doses.
Materyal
and Method: In this prospective, randomized, double-blind study a total of
30 patients, aged 25-70 years, who were included in the American Society of
Anesthesiologists (ASA) I-III risk class and underwent total knee arthroplasty
surgery, were included in the study. Patients were randomized as Group I (n =
15) Levobupivacaine and Group II (n = 15) bupivacaine and combined spinal-epidural
anesthesia was administered. The operation follow-up of patients were evaluated
with the systolic arterial pressure (SAB), the diastolic arterial pressure
(DAB), the mean arterial pressure (MAP) and the heart rate (HR), and
postoperative follow-up with SAB, DAB, KH, visual analogue scale (VAS) values
were monitored at zero minute, 1st, 6th, 12th and 24th hour. BNP levels were
measured at 5th minute after spinal anesthesia, sensory block at thoracal level
10 and post-operative 24th hour.
Results:
A statistically significant difference was found in the VAS values measured
at postoperative 12th hour and 24th hour in favor of levobupivacaine group (p
<0.05). In the comparison of BNP levels between the groups, there was no
statistically significant difference between the two groups at all measurement
times (p> 0.05).
Conclusion: Similar results were obtained
in intraoperative and postoperative BNP levels when using levobupivacaine and
bupivacaine in equal doses for both spinal anesthesia and epidural analgesia.
References
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- 7. Casati A, Moizo E, Marchetti C, Vinciguerra F. A prospective, randomized, double-blind comparison of unilateral spinal anesthesia with hyperbaric bupivacaine, ropivacaine, or levobupivacaine for inguinal herniorrhaphy. Anesth Analg. 2004; 99:1387-92.
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- 11. Cuvas O, Er AE, Ongen E, Basar H. Spinal anesthesia for transurethral resection operations: bupivacaine versus levobupivacaine. Minerva Anestesiol. 2008;74:697-701.
- 12. Fatorini F, Ricci Z, Rocco A, et al. Levobupivacaine versus racemic bupivacaine for spinal anaesthesia in orthopaedic major surgery. Minerva Anesttesiol. 2006; 72: 637-44.
- 13. Groban L, Deal DD, Vernon JC, James R L, Butterworth J. Cardiac resuscitation after incremental overdosage with lidocaine, bupivacaine, levobupivacaine, and ropivacaine in anesthetized dogs. Anesth Analg. 2001; 92: 37–43.
- 14. Groban L, Deal DD, Vernon JC, James RL, Butterworth J. Ventricular arrhythmias with or without programmed electrical stimulation after incremental overdosage with lidocaine, bupivacaine, levobupivacaine, and ropivacaine. Anesth Analg. 2000; 91: 1103-11.
- 15. Ohmura S, Kawada M, Ohta T, Kobayashi T. Systemic toxicity and resuscitation in bupivacaine, levobupivacaine or ropivacaine infused rats. Anesth Analg 2001; 93: 743-8.
- 16. Mazoit JX, Decaux A, Bouaziz H, Eduard A. Comparative ventricular electrophysiologic effect of rasemic bupivacaine, levobupivacaine and ropivacaine on the isolated rabbit heart. Anesthesiology 2000; 93: 784-92.
- 17. Stewart J, Kellett N, Castro D. The central nervous system and cardiovascular effects of levobupivacaine and ropivacaine in healthy volunteers. Anesth Analg. 2003;97: 4126.
- 18. Bardsley H, Griswood R, Baker H, Nimmo W. A comparison of the cardiovasculer effects of levobupivacaine and rac-bupivakaine following intravenous administration to healty volunteers. Br J Clin Pharmacol 1998; 46: 245-9.
- 19. Salomaki TE, Laurilla PA, Ville J. Succesfull resuscitation after cardiovaskular collaps following accidental intravenous infusion of levobupivacaine during general anesthesia. Anesthesiology 2005; 103: 1095-6.
- 20. Karakılıç E, M Ali Karaca, Bozkurt Ş, Coşkun F, Sivri B. BNP Nedir? Acil Serviste Beyin Natriüretik Faktör (BNP) Kullanımı. Akademik Acil Tıp dergisi. 2005; 3: 7-10.
- 21. Mahla E, Baumann A, Rehak P, et al. N-terminal pro-brain natriuretic peptide identifies patients at high risk for adverse cardiac outcome after vascular surgery. Anesthesiology. 2007; 106:1088-95.
- 22. Terasako K. Perioperative plasma concentrations of atrial and brain natriuretic peptides in patients undergoing hip arthroplasty. Anaesth Intensive Care. 2002; 30: 588-90.
- 23. Pongprot Y, Sittiwangkul R, Charoenkwan P, Silvilairat S. Use of Cardiac Markers for Monitoring of Doxorubixin-induced Cardiotoxicity in Children With Cancer. Journal of Pediatric Hematology/Oncology. 2012; 34: 589-95.
- 24. Cuthbertson BH, Card G, Croal BL, McNeilly J, Hillis GS. The utility of B-type natriuretic peptide in predicting postoperative cardiac events and mortality in patients undergoing major emergency non-cardiac surgery. Anaesthesia. 2007; 62: 875-81. 25. Vetrugno L, Langian N, Gisonni R, et al. Prediction of early postoperative major cardiac events after elective orthopedic surgery: the role of B-type natriuretic peptide, the revised cardiac risk index, and ASA class. BMC Anesthesiology. 2014; 14: 20.
Year 2018,
Volume: 40 Issue: 2, 184 - 193, 28.06.2018
Abstract
References
- 1. Erdine S, Özyalçın SN, Raj PP, et al. Rejyonal Anestezi. İstanbul: Nobel Tıp Kitabevleri;2005; p.185-91.
- 2. Rawal N, Holmstrom B, Crowhurst JA, Van Zundert A. The combined spinal- epidural technique anesthesiology. Anesthesiol Clin North America. 2000; 18: 267-95.
- 3. Collins JV. Principles of Anaesthesiology. Third Edition. Philadelphia Lea and Febiger; 1993; p.1445-97.
- 4. Chester C, Bleckner LL. Anaesthetic agents for advanced regional anaesthesia. Drug. 2005; 65: 745-59.
- 5. Kayhan Z. Klinik Anestezi. 2. Baskı. İstanbul Logos Yayıncılık; 2004; p. 503-23.
- 6. Bader AM, Tsen LC, Camann WR, Nephew E, Datta S. CIinical effects and maternal and fetal plasma concentrations of %0,5 epidural levobupivacaine versus bupivacaine for cesarean delivery. Anesthesiology. 1999; 90: 1596-601.
- 7. Casati A, Moizo E, Marchetti C, Vinciguerra F. A prospective, randomized, double-blind comparison of unilateral spinal anesthesia with hyperbaric bupivacaine, ropivacaine, or levobupivacaine for inguinal herniorrhaphy. Anesth Analg. 2004; 99:1387-92.
- 8. Suttner SW, Boldt J. Natriuretic peptide system: physiology and clinical utility. Curr Opin Crit Care. 2004;10: 336–41.
- 9. Valenzuela C, Snyders DJ, Bennett PB, Tamargo J, Hondeghem LM. Stereoselective block of cardiac sodium channels by bupivacaine in guinea pig ventricular myocytes. Circulation.1995; 92: 3014-24.
- 10. Kawano T, Oshita S, Takahashi A, et al. Molecular mechanisms of the inhibitory effects of bupivacaine, levobupivacaine, and ropivacaine on sarcolemmal adenosine triphosphate-sensitive potassium channels in the cardiovascular system. Anesthesiology. 2004; 101: 390-8.
- 11. Cuvas O, Er AE, Ongen E, Basar H. Spinal anesthesia for transurethral resection operations: bupivacaine versus levobupivacaine. Minerva Anestesiol. 2008;74:697-701.
- 12. Fatorini F, Ricci Z, Rocco A, et al. Levobupivacaine versus racemic bupivacaine for spinal anaesthesia in orthopaedic major surgery. Minerva Anesttesiol. 2006; 72: 637-44.
- 13. Groban L, Deal DD, Vernon JC, James R L, Butterworth J. Cardiac resuscitation after incremental overdosage with lidocaine, bupivacaine, levobupivacaine, and ropivacaine in anesthetized dogs. Anesth Analg. 2001; 92: 37–43.
- 14. Groban L, Deal DD, Vernon JC, James RL, Butterworth J. Ventricular arrhythmias with or without programmed electrical stimulation after incremental overdosage with lidocaine, bupivacaine, levobupivacaine, and ropivacaine. Anesth Analg. 2000; 91: 1103-11.
- 15. Ohmura S, Kawada M, Ohta T, Kobayashi T. Systemic toxicity and resuscitation in bupivacaine, levobupivacaine or ropivacaine infused rats. Anesth Analg 2001; 93: 743-8.
- 16. Mazoit JX, Decaux A, Bouaziz H, Eduard A. Comparative ventricular electrophysiologic effect of rasemic bupivacaine, levobupivacaine and ropivacaine on the isolated rabbit heart. Anesthesiology 2000; 93: 784-92.
- 17. Stewart J, Kellett N, Castro D. The central nervous system and cardiovascular effects of levobupivacaine and ropivacaine in healthy volunteers. Anesth Analg. 2003;97: 4126.
- 18. Bardsley H, Griswood R, Baker H, Nimmo W. A comparison of the cardiovasculer effects of levobupivacaine and rac-bupivakaine following intravenous administration to healty volunteers. Br J Clin Pharmacol 1998; 46: 245-9.
- 19. Salomaki TE, Laurilla PA, Ville J. Succesfull resuscitation after cardiovaskular collaps following accidental intravenous infusion of levobupivacaine during general anesthesia. Anesthesiology 2005; 103: 1095-6.
- 20. Karakılıç E, M Ali Karaca, Bozkurt Ş, Coşkun F, Sivri B. BNP Nedir? Acil Serviste Beyin Natriüretik Faktör (BNP) Kullanımı. Akademik Acil Tıp dergisi. 2005; 3: 7-10.
- 21. Mahla E, Baumann A, Rehak P, et al. N-terminal pro-brain natriuretic peptide identifies patients at high risk for adverse cardiac outcome after vascular surgery. Anesthesiology. 2007; 106:1088-95.
- 22. Terasako K. Perioperative plasma concentrations of atrial and brain natriuretic peptides in patients undergoing hip arthroplasty. Anaesth Intensive Care. 2002; 30: 588-90.
- 23. Pongprot Y, Sittiwangkul R, Charoenkwan P, Silvilairat S. Use of Cardiac Markers for Monitoring of Doxorubixin-induced Cardiotoxicity in Children With Cancer. Journal of Pediatric Hematology/Oncology. 2012; 34: 589-95.
- 24. Cuthbertson BH, Card G, Croal BL, McNeilly J, Hillis GS. The utility of B-type natriuretic peptide in predicting postoperative cardiac events and mortality in patients undergoing major emergency non-cardiac surgery. Anaesthesia. 2007; 62: 875-81. 25. Vetrugno L, Langian N, Gisonni R, et al. Prediction of early postoperative major cardiac events after elective orthopedic surgery: the role of B-type natriuretic peptide, the revised cardiac risk index, and ASA class. BMC Anesthesiology. 2014; 14: 20.
There are 24 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Surgical Science Research Articles |
| Authors | |
| Publication Date | June 28, 2018 |
| Acceptance Date | June 21, 2018 |
| Published in Issue | Year 2018Volume: 40 Issue: 2 |