Korean J Anesthesiol.  2000 Mar;38(3):503-508. 10.4097/kjae.2000.38.3.503.

The Effects of Midazolam and Droperidol Pretreatment on the Cardiac Toxicity of Bupivacaine in Rabbits

• Kim YS
• Kang YJ
• Kim DW
• In JH
• Yang SY
• Lim YG

• KMID: 2237291
• DOI: http://doi.org/10.4097/kjae.2000.38.3.503

Abstract

BACKGROUND: Unintended intravenous injection of bupivacaine causes severe cardiovascular complication, which is known for its difficulty in resuscitation. This study was performed to evaluate the effects of pretreatment with midazolam and droperidol in the cardiac toxicity caused by intravenous infusion of bupivacaine.
METHODS
Thirty rabbits were divided into three groups; saline- as a control, midazolam, and droperidol pretreated group. We observed the time intervals for the arrhythmia, 25% and 50% reduction in baseline mean arterial blood pressure, and arrest. We also checked the dose of infused bupivacaine to be required for arrest during continuous intravenous infusion of bupivacaine at the rate of 1 mg/kg/min.
RESULTS
The onset of dysrhythmia and the time to 50% reduction in baseline mean arterial blood pressure and arrest were significantly more delayed in the midazolam group than the control group (P < 0.05). With respect to the time to 25%, 50% reduction in baseline mean arterial blood pressure and arrest, the data of the droperidol group was significantly shorter than that of the control group (P < 0.05).
CONCLUSIONS
Droperidol pretreatment hastened bupivacaine induced cardiac arrest in rabbits. Midazolam pretreatment exerted protective effects on arrhythmia and cardiac arrest. Thus midazolam would be a preferable agent as a supplement for regional anesthesia using bupivacaine.

Keyword

Anesthetics, intravenous: midazolam; droperidol; Anesthetics, local: bupivacaine

MeSH Terms

Anesthesia, Conduction
Arrhythmias, Cardiac
Arterial Pressure
Bupivacaine*
Droperidol*
Heart Arrest
Heart Arrest, Induced
Infusions, Intravenous
Injections, Intravenous
Midazolam*
Rabbits*
Resuscitation
Bupivacaine
Droperidol
Midazolam