ЛЕКЦІЯ
Український журнал екстремальної медицини імені Г.О.Можаєва
Том 12, №2, 2011
5. Фесенко В.С. Интоксикация местными анестетиками: старая опасность, современные мифы, новые препараты и «серебряная пуля» // Біль, знеболювання і інтенсивна терапія. — 2009. — №3. — С. 2-10.
6. Albright G.A. Cardiac Arrest Following Regional Anesthesia with Etidocaine or Bupivacaine // Anesthesiology. — 1979. —
№51 (4). — Р. 285-287.
7. Auroy Y., Narchi P., Messiah A. et al. Serious complications related to regional anesthesia: Results of a prospective survey in France // Anesthesiology. — 1997. — №87. — Р. 479-486.
8. Bonica J., Backup P., Anderson C. Peridural block: Analysis of 3,637 cases and a review // Anesthesiology. — 1957. —
№18. — Р. 723-784.
9. Borgeat A., Ekatodramis G., Kalberer F., Benz C. Acute and nonacute complications associated with interscalene block and shoulder surgery: A prospective study // Anesthesiology. — 2001. — №95. — Р. 875-880.
10. Brown D.L., Ransom D.M., Hall J.A. et al. Regional anesthesia and local anesthetic-induced systemic toxicity: Seizure frequency and accompanying cardiovascular changes // Anesth. Analg. — 1995. — №81. — Р. 321-328.
11. Brull S.J. Lipid emulsion for the treatment of local anesthetic toxicity: patient safety implications // Anesth. Analg. —
2008. — №106. — Р. 9-1337.
12. Castle N. Bupivacaine inhibits the transient outward K+ current but not the inward rectifier in rat ventricular myocytes //
J. Pharmacol. Exp. Ther. — 1990. — №255. — Р. 1038-1046.
13. Cave G., Harvey M. Intravenous lipid emulsion as antidote beyond local anesthetic toxicity: a systematic review // Acad.
Emerg. Med. — 2009. — №16 (9). — Р. 24-815.
14. Cho H., Lee J., Chung I. et al. Insulin Reverses Bupivacaine-Induced Cardiac Depression in Dogs // Anesth Analg. —
2000. — №91. — Р. 1102-1096.
15. Downes M., Page C., Isbister G. Response to «use of lipid emulsion in the resuscitation of a patient with prolonged cardio- vascular collapse after overdose of bupropion and lamotrigine» // Ann. Emerg. Med. — 2008. — №51 (6). — Р. 5-794.
16. Ekberg J., Adams D.J. Neuronal voltage-gated sodium channel subtypes: Key roles in inflammatory and neuropathic pain
// International Journal of Biochemistry & Cell Biology. — 2006. — №38 (12). — Р. 2005-2010.
17. Eledjam J.J., de La Coussaye J.E., Brugada J. et al. In vitro study on mechanisms of bupivacaine-induced depression of myocardial contractility // Anesth. Analg. — 1989. — №69. — Р. 5-732.
18. Feldman H.S., Arthur G.R., Covino B.G. Comparative systemic toxicity of convulsant and supraconvulsant doses of in- travenous ropivacaine, bupivacaine and lidocaine in the conscious dog // Anesth. Analg. — 1989. — №69. — Р. 1-794.
19. Foxall G., McCahon R., Lamb J. et al. Levobupivacaine-induced seizures and cardiovascular collapse treated with Intra- lipid // Anaesthesia. — 2007. — №62. — Р. 516-518.
20. Groban et al. LA blood concentrations producing cardiac arrest in dogs: similar rank order as for potency // Anesth.
Analg. — 2000. — №91. — Р. 11- 1103.
21. Groban L., Deal D.D., Vernon J.C. et al. Cardiac resuscitation after incremental overdosage with lidocaine, bupivacaine, levobupivacaine, and ropivacaine in anesthetized dogs // Anesth. Analg. — 2001. — №92. — Р. 37-43.
22. Groban L., Deal D.D., Vernon J.C., James R.L., Butterworth J. Local Anesthetic Stereoselectivity Or Structure Predict
Myocardial Depression in Anesthetized Canines? // Reg. Anesth. Pain. Med. — 2002. — №27. — Р. 460-468.
23. Harvey M., Cave G. Bupivacaine-induced Cardiac Arrest: Fat Is Good — Is Epinephrine Really Bad? // Anesthesiolo- gy. — 2009. — №111. — Р. 9-467.
24. Heavner J., Pitkдnen M., Shi B., Rosenberg P. Resuscitation from bupivacaine-induced asystole in rats: comparison of different cardioactive drugs // Anesth. Analg. — 1995. — №80 (6). — Р. 9-1134.
25. Hicks S., Salcido D., Logue E. et al. Lipid emulsion combined with epinephrine and vasopressin does not improve surviv- al in a swine model of bupivacaine-induced cardiac arrest // Anesthesiology. — 2009. — №111 (1). — Р. 46-138.
26. Litz R.J., Popp M., Stehr S.N., Koch T. Successful resuscitation of a patient with ropivacaine-induced asystole after axil- lary plexus block using lipid infusion // Anaesthesia. — 2006. — №61. — Р. 1-800.
27. Long W., Rosenblum S., Grady I. Successful resuscitation of bupivacaine-induced cardiac arrest using cardiopulmonary bypass // Anesth. Analg. — 1989. — №69 (3). — Р. 6-403.
28. Ludot H., Tharin J., Belouadah M. et al. Successful Resustitation After Ropivacaine and Lidocaine-Induced Ventricu- lar Arrythmia Following Posterior Lumbar Plexus Block in a Child // Anesth. Analg. — 2008. — №106 (5). — Р. 1572-
1574.
29. Luetsch Y.A., Boni T., Borgeat A. From Cocaine to Ropivacaine: The History of Local Anesthetic Drugs Current Topics in Medicinal Chemistry. — Vol. 1. – Р. 175-182.
30. Lynch C. 3rd. Depression of myocardial contractility in vitro by bupivacaine, etidocaine, and lidocaine // Anesth. Analg. —
1986. — №65 (6). — Р. 9-551.
31. Mather L.E., Copeland S.E., Ladd L.A. Acute toxicity of local anesthetics: underlying pharmacokinetic and pharmacody- namic concepts // Reg. Anesth. Pain. Med. — 2005. — №30. — Р. 66-553.
32. McCutchen T., Gerancher J.C. Early intralipid therapy may have prevented bupivacaine-associated cardiac arrest // Reg.
Anesth. Pain. Med. — 2008. — №33. — Р. 80-178.
33. Moore D.C., Batra M.S. The components of an effective test dose prior to epidural block // Anesthesiology. — 1981. —
№55. — Р. 693-696.
34. Mulroy M.F., Norris M.C., Liu S.S. Safety steps for epidural injection of local anesthetics: Review of the literature and recommendations // Anesth. Analg. — 1997. — №85. — Р. 1346-1356.
35. Neal J., Bernards C., Butterworth J. et al. ASRA Practice Advisory on Local Anesthetic Systemic Toxicity // Regional An- esthesia and Pain Medicine. — 2010. — Vol. 35, №2. — Р. 152-161.
Український журнал екстремальної медицини імені Г.О.Можаєва
Том 12, №2, 2011
5. Фесенко В.С. Интоксикация местными анестетиками: старая опасность, современные мифы, новые препараты и «серебряная пуля» // Біль, знеболювання і інтенсивна терапія. — 2009. — №3. — С. 2-10.
6. Albright G.A. Cardiac Arrest Following Regional Anesthesia with Etidocaine or Bupivacaine // Anesthesiology. — 1979. —
№51 (4). — Р. 285-287.
7. Auroy Y., Narchi P., Messiah A. et al. Serious complications related to regional anesthesia: Results of a prospective survey in France // Anesthesiology. — 1997. — №87. — Р. 479-486.
8. Bonica J., Backup P., Anderson C. Peridural block: Analysis of 3,637 cases and a review // Anesthesiology. — 1957. —
№18. — Р. 723-784.
9. Borgeat A., Ekatodramis G., Kalberer F., Benz C. Acute and nonacute complications associated with interscalene block and shoulder surgery: A prospective study // Anesthesiology. — 2001. — №95. — Р. 875-880.
10. Brown D.L., Ransom D.M., Hall J.A. et al. Regional anesthesia and local anesthetic-induced systemic toxicity: Seizure frequency and accompanying cardiovascular changes // Anesth. Analg. — 1995. — №81. — Р. 321-328.
11. Brull S.J. Lipid emulsion for the treatment of local anesthetic toxicity: patient safety implications // Anesth. Analg. —
2008. — №106. — Р. 9-1337.
12. Castle N. Bupivacaine inhibits the transient outward K+ current but not the inward rectifier in rat ventricular myocytes //
J. Pharmacol. Exp. Ther. — 1990. — №255. — Р. 1038-1046.
13. Cave G., Harvey M. Intravenous lipid emulsion as antidote beyond local anesthetic toxicity: a systematic review // Acad.
Emerg. Med. — 2009. — №16 (9). — Р. 24-815.
14. Cho H., Lee J., Chung I. et al. Insulin Reverses Bupivacaine-Induced Cardiac Depression in Dogs // Anesth Analg. —
2000. — №91. — Р. 1102-1096.
15. Downes M., Page C., Isbister G. Response to «use of lipid emulsion in the resuscitation of a patient with prolonged cardio- vascular collapse after overdose of bupropion and lamotrigine» // Ann. Emerg. Med. — 2008. — №51 (6). — Р. 5-794.
16. Ekberg J., Adams D.J. Neuronal voltage-gated sodium channel subtypes: Key roles in inflammatory and neuropathic pain
// International Journal of Biochemistry & Cell Biology. — 2006. — №38 (12). — Р. 2005-2010.
17. Eledjam J.J., de La Coussaye J.E., Brugada J. et al. In vitro study on mechanisms of bupivacaine-induced depression of myocardial contractility // Anesth. Analg. — 1989. — №69. — Р. 5-732.
18. Feldman H.S., Arthur G.R., Covino B.G. Comparative systemic toxicity of convulsant and supraconvulsant doses of in- travenous ropivacaine, bupivacaine and lidocaine in the conscious dog // Anesth. Analg. — 1989. — №69. — Р. 1-794.
19. Foxall G., McCahon R., Lamb J. et al. Levobupivacaine-induced seizures and cardiovascular collapse treated with Intra- lipid // Anaesthesia. — 2007. — №62. — Р. 516-518.
20. Groban et al. LA blood concentrations producing cardiac arrest in dogs: similar rank order as for potency // Anesth.
Analg. — 2000. — №91. — Р. 11- 1103.
21. Groban L., Deal D.D., Vernon J.C. et al. Cardiac resuscitation after incremental overdosage with lidocaine, bupivacaine, levobupivacaine, and ropivacaine in anesthetized dogs // Anesth. Analg. — 2001. — №92. — Р. 37-43.
22. Groban L., Deal D.D., Vernon J.C., James R.L., Butterworth J. Local Anesthetic Stereoselectivity Or Structure Predict
Myocardial Depression in Anesthetized Canines? // Reg. Anesth. Pain. Med. — 2002. — №27. — Р. 460-468.
23. Harvey M., Cave G. Bupivacaine-induced Cardiac Arrest: Fat Is Good — Is Epinephrine Really Bad? // Anesthesiolo- gy. — 2009. — №111. — Р. 9-467.
24. Heavner J., Pitkдnen M., Shi B., Rosenberg P. Resuscitation from bupivacaine-induced asystole in rats: comparison of different cardioactive drugs // Anesth. Analg. — 1995. — №80 (6). — Р. 9-1134.
25. Hicks S., Salcido D., Logue E. et al. Lipid emulsion combined with epinephrine and vasopressin does not improve surviv- al in a swine model of bupivacaine-induced cardiac arrest // Anesthesiology. — 2009. — №111 (1). — Р. 46-138.
26. Litz R.J., Popp M., Stehr S.N., Koch T. Successful resuscitation of a patient with ropivacaine-induced asystole after axil- lary plexus block using lipid infusion // Anaesthesia. — 2006. — №61. — Р. 1-800.
27. Long W., Rosenblum S., Grady I. Successful resuscitation of bupivacaine-induced cardiac arrest using cardiopulmonary bypass // Anesth. Analg. — 1989. — №69 (3). — Р. 6-403.
28. Ludot H., Tharin J., Belouadah M. et al. Successful Resustitation After Ropivacaine and Lidocaine-Induced Ventricu- lar Arrythmia Following Posterior Lumbar Plexus Block in a Child // Anesth. Analg. — 2008. — №106 (5). — Р. 1572-
1574.
29. Luetsch Y.A., Boni T., Borgeat A. From Cocaine to Ropivacaine: The History of Local Anesthetic Drugs Current Topics in Medicinal Chemistry. — Vol. 1. – Р. 175-182.
30. Lynch C. 3rd. Depression of myocardial contractility in vitro by bupivacaine, etidocaine, and lidocaine // Anesth. Analg. —
1986. — №65 (6). — Р. 9-551.
31. Mather L.E., Copeland S.E., Ladd L.A. Acute toxicity of local anesthetics: underlying pharmacokinetic and pharmacody- namic concepts // Reg. Anesth. Pain. Med. — 2005. — №30. — Р. 66-553.
32. McCutchen T., Gerancher J.C. Early intralipid therapy may have prevented bupivacaine-associated cardiac arrest // Reg.
Anesth. Pain. Med. — 2008. — №33. — Р. 80-178.
33. Moore D.C., Batra M.S. The components of an effective test dose prior to epidural block // Anesthesiology. — 1981. —
№55. — Р. 693-696.
34. Mulroy M.F., Norris M.C., Liu S.S. Safety steps for epidural injection of local anesthetics: Review of the literature and recommendations // Anesth. Analg. — 1997. — №85. — Р. 1346-1356.
35. Neal J., Bernards C., Butterworth J. et al. ASRA Practice Advisory on Local Anesthetic Systemic Toxicity // Regional An- esthesia and Pain Medicine. — 2010. — Vol. 35, №2. — Р. 152-161.
ЛЕКЦІЯ
Український журнал екстремальної медицини імені Г.О.Можаєва
Том 12, №2, 2011
36. Rosenblatt M.A., Abel M. et al. Successful use of a 20% lipid emulsion to resuscitate a patient after a presumed bupiva- caine-related cardiac arrest // Anesthesiology. — 2006. — №105 (1). — Р. 8-217-.
37. Rowlingson J.C. Lipid rescue: a step forward in patient safety? Likely so! // Anesth. Analg. — 2008. — №106. —
Р. 6-1333.
38. Smith H.M., Jacob A.K., Segura L.G. et al. Simulation education in anesthesia training: a case report of successful resus- citation of bupivacaine-induced cardiac arrest linked to recent simulation training // Anesth. Analg. — 2008. — №106. —
Р. 4-1581.
39. Spence A.G. Lipid reversal of central nervous system symptoms of bupivacaine toxicity // Anesthesiology. — 2007. —
№107. — Р. 179-516.
40. Stehr S.N., Pexa A., Hannack S. et al. The effects of lipid infusion on myocardial function and bioenergetics in l-bupiva- caine toxicity in the isolated rat heart // Anesth. Analg. — 2007. — №104. — Р. 92-186.
41. Tanaka K., Watanabe R., Harada T., Dan K. Extensive application of epidural anesthesia and analgesia in a university hospital: Incidence of complications related to technique // Reg. Anesth. — 1993. — №18. — Р. 34-38.
42. The Association of Anaesthetists of Great Britain & Ireland 2007, Guidelines for the Management of Severe Local Anaes- thetic Toxicity: http://www.aagbi.org/ publications/ guidelines/ docs/ latoxicity07.pdf. 2007; accessed July 23, 2008.
43. Warren J.A., Thoma R.B., Georgescu A., Shah S.J. Intravenous lipid infusion in the successful resuscitation of local an- estheticinduced cardiovascular collapse after supraclavicular brachial plexus block // Anesth. Analg. — 2008. — №106. —
Р. 80-1578.
44. Weinberg G., Ripper R., Feinnstein D. et al. Lipid Emulsion Infusion Rescues Dogs From Bupivacaine-Induced Cardiac
Toxity // Reg. Anesth. Pain. Med. — 2003. — №28 (3). — Р. 202-198.
45. Weinberg G.L. Lipid infusion therapy: translation to clinical practice // Anesth .Analg. — 2008. — №106. — Р. 2- 1340.
46. Weinberg G.L., VadeBoncouer T. et al. Pretreatment or resuscitation with a lipid infusion shifts the dose-response to bu- pivacaine-induced asystole in rats // Anesthesiology. — 1998. — №88 (4). — Р. 5-1071.
47. Wood J.N., Boorman J.P., Okuse K. et al. Voltage-gated sodium channels and pain pathways // Journal of Neurobiolo- gy. — 2004. — №61. — Р. 55-71.
48. Wood M.R., May N., Strichartz G., Pfenninger K.H . Two types of sodium channel in growth cone membranes // J. Cell.
Biol. — 1987. — №105. — 143 р.
49. Wood M.R., Strichartz G., Elmer L. et al. Na+ channels in differentiating neurons // Sot. Neurosci. Abstr. — 1988. —
№14. — 834 р.
50. Wood M.R., Strichartz G., Pfenninger K.H. Compartmentalization of Na+ channels in nerve growth cones: channel con- version during plasmalemmal insertion? // J. Cell. Biol. — 1989. — №109. — 335 р.
51. Zimmer C., Piepenbrink K., Riest G., Peters J. Cardiotoxic and neurotoxic effects after accidental intravascular bupiva- caine administration. Therapy with lidocaine propofol and lipid emulsion // Anaesthesist. — 2007. — №56. — Р. 53-449.
Ю.Л.Кучин, М.Н.Пилипенко, Ю.И.Налапко, Р.Крегг. Местные анестетики: механизм действия,
токсические реакции и их профилактика. Киев, Луганск, Украина, Лондон, Великобритания.
Ключевые слова: местные анестетики, токсичность, лечение, профилактика.
Токсичность местных анестетиков остается проблемным вопросом анестезиологии. В обзорной статье
представлены современные взгляды на механизм действия и развитие токсичности местных анестетиков,
особенности сердечно-легочной реанимации при остановке сердца, ассоциированной с интоксикацией мест-
ными анестетиками, и методы профилактики этого осложнения.
Yu.L.Kuchin, M.M.Pylypenko, Yu.I.Nalapko, R.Cregg. Local anesthetics: mechanism of action, toxic re-
actions and its prevention. Kyiv, Lugansk, Ukraine, London, Great Britain.
Key words:local anesthetics, toxicity, treatment, prevention.
Toxicity of local anesthetics remains as the serious problem of the modern anesthesiology. In this review the current
concepts of the mechanism of action and pathways of the toxicity of local anesthetics are discussed. Cardio-pulmonary
resuscitation due to cardiac arrest associated with local anesthetics intoxication are described, and methods of its pre-
vention are shown.
Надійшла до редакції 17.07.2010 р.
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