Regional Myocardial Lidocaine Concentration Determines the Antidysrhythmic Effect in Dogs after Coronary Artery Occlusion
作者:
Richard Davis,
Lawrence DeBoer,
Tsunehiro Yasuda,
Robert Rude,
Lair Ribeiro,
Peter Maroko,
期刊:
Anesthesiology
(OVID Available online 1985)
卷期:
Volume 62,
issue 2
页码: 155-160
ISSN:0003-3022
年代: 1985
出版商: OVID
关键词: Anesthetics, local: lidocaine.;Complications: dysrhythmia.;Heart: dysrhythmia, lidocaine; ventricular tachycardia; treatment; ischemia.
数据来源: OVID
摘要:
Ischemic ventricular dysrhythmias were produced in 40 of 47 anesthetized mongrel dogs by high ligation of the left anterior descending coronary artery. Dysrhythmias were treated with a single iv bolus of 20, 40, 80, or 120 mg of lidocaine (L) in order to determine the dose at which approximately 50% of animals had an antidysrhythmic response. Cardiac output and regional myocardial blood flow (RMBF) were measured by using radionuclide labeled microspheres. Lidocaine concentration ([L]) was measured from samples of arterial and venous blood and normal and ischemic myocardium. All dogs treated with 40, 80, or 120 mg of L had an antidysrhythmic effect. However, with 20 mg of L the dysrhythmia persisted in 12 and resolved in 14. With 20 mg of L, ischemic myocardial [L] was greater in dogs with an antidysrhythmic effect than in those with persistent dysrhythmias (1.14 ± 0.12vs. 0.76 ± 0.04 μg · g−1), but no difference was seen for arterial, venous, and normal myocardial [L]. Ischemic RMBF was higher in the dogs that had an antidysrhythmic effect than in those that did not, 9.8 ± 1.5versus, 6.9 ± 1.3% of normal. With 20 mg of L, [L] in ischemic myocardium correlated well with ischemic RMBF. The antidysrhythmic response to L had a threshold at a tissue concentration of greater than or equal to 1.0 μg · g−1(chisquare = 8.55,P< 0.005). For this model, the [L] in ischemic myocardium during acute ischemia correlates with the antidysrhythmic response to L, while the concentration in normal myocardium or blood does not.
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