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Cardiac Electrophysiologic Effects of Lidocaine and Bupivacaine

Department of Anesthesia, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Abstract

The cardiac electrophysiologic effects of bupivacaine (B) and lidocaine (L) were evaluated in an isolated rabbit Purkinje fiber-ventricular muscle model to determine the effects of a) progressively increasing and b) decreasing concentrations of B and L on transmembrane action potentials. Bupivacaine (3 and 5 µg/ml) signifcantly decreased diastolic resting potential, maximum rate of depolarization, and action potential amplitude. Lidocaine (10–20µg/ml) also decreased maximum rate of depolarization and action potential amplitude, but the decreases were significantly different from those produced by B. High concentrations of B (30µg/ml) and L (100µg/ml) resulted in delayed conduction between Purkinje fibers and ventricular muscle cells and, ultimately, conduction blockade. The duration of conduction blockade was significantly longer with B than with L. The results of this study indicate that B produces electrophysiologic changes in cardiac tissue that may produce ventricular arrhythmias of a reentrant type.

Key Words: ANESTHETICS, LOCAL–-bupivacaine, lidocaine. • HEART—bupivacaine, lidocaine.

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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