Transmission of mepivacaine hydrochloride (carbocaine) across the human placenta

Lidocaine administered at a continuous rate infusion does not impair left ventricular systolic and diastolic function of healthy rabbits sedated with midazolam.

Differential effects of four xylidine derivatives in the model of ischemia- and re-perfusion-induced arrhythmias in rats in vivo.

Un pavé dans la mare des bêtabloquants

The potential mechanism of mepivacaine’s myocardial depressant effect observed in papillary muscle has not yet been investigated at cellular level. Therefore, we evaluated mepivacaine’s effects on Ca2+ transient in isolated adult mouse cardiomyocytes. Single ventricular myocytes were enzymatically isolated from wild-type C57Bl/6 mice and loaded with 10 μM fluorescent Ca2+ indicator Fluo-4-AM to record intracellular Ca2+ transients upon electrical stimulation. The mepivacaine effects at half-maximal inhibitory concentration (IC50) was determined on calibrated cardiomyocytes’ Ca2+ transients by non-parametric statistical analyses on biophysical parameters. Combination of mepivacaine with NCX blockers ORM-10103 or NiCl2 were used to test a possible mechanism to explain mepivacaine-induced Ca2+ transients’ reduction. A significant inhibition at mepivacaine’s IC50 (50 μM) on Ca2+ transients was measured in biophysical parameters such as peak (control: 528.6 ± 73.61 nM vs mepivacaine: 130.9 ± 15.63 nM; p < 0.05), peak area (control: 401.7 ± 63.09 nM*s vs mepivacaine: 72.14 ± 10.46 nM*s; p < 0.05), slope (control: 7699 ± 1110 nM/s vs mepivacaine: 1686 ± 226.6 nM/s; p < 0.05), time to peak (control: 107.9 ± 8.967 ms vs mepivacaine: 83.61 ± 7.650 ms; p < 0.05) and D50 (control: 457.1 ± 47.16 ms vs mepivacaine: 284.5 ± 22.71 ms; p < 0.05). Combination of mepivacaine with NCX blockers ORM-10103 or NiCl2 showed a significant increase in the baseline of [Ca2+] and arrhythmic activity upon electrical stimulation. At cellular level, mepivacaine blocks Na+ channels, enhancing the reverse mode activity of NCX, leading to a significant reduction of Ca2+ transients. These results suggest a new mechanism for the mepivacaine-reduction contractility effect.

/pdf/mepivacaine-reduces-calcium-transients-in-isolated-murine-3m3kpbtcyo.pdf

Mepivacaine reduces calcium transients in isolated murine ventricular cardiomyocytes.

Background and objective: To compare the inotropic and lusitropic effect of lidocaine and mepivacaine on rat papillary muscle. Methods: Effects of lidocaine and mepivacaine (10 -8 -10 -3 M) were studied in rat left ventricular papillary muscles in vitro at a calcium concentration of 1 mmol, under low (isotonic) and high (isometric) loads. Results: Lidocaine induced a significant negative inotropic effect in isotonic and isometric conditions whereas mepivacaine did not. Mepivacaine only induced a negative inotropic effect when added as a bolus for the highest concentration and this effect was significantly more pronounced with lidocaine than with mepivacaine (active force at 10 -3 M: 63 ± 10 vs. 84 ± 10% of baseline, P < 0.05). Increasing calcium concentration resulted in a greater positive inotropic effect in the control (199 ± 11% of baseline) and mepivacaine groups (197 ± 22% of baseline) when compared to the lidocaine group (163 ± 19% of baseline, P < 0.05 vs. lidocaine and control groups), suggesting an impairment on intracellular Ca 2+ handling by lidocaine. A negative lusitropic effect under low load was observed only for mepivacaine and suggested an impairment of sarcoplasmic reticulum function. Lidocaine and mepivacaine did not modify postrest potentiation but significantly depressed the force-frequency relationship. Conclusions: The negative inotropic and lusitropic effects induced by lidocaine were more important than that of mepivacaine and may involve an impairment of intracellular Ca 2+ handling.

Comparison of the effects of mepivacaine and lidocaine on rat myocardium.

Resume Objectif Verifier si les frequences cardiaques des patients prenant un traitement par betabloquants (BB) au long cours ou en peri-operatoire etaient optimales lors de la periode peri-operatoire. Methodes Les frequences cardiaques (FC) observees lors de la consultation d'anesthesie, avant l'induction d'anesthesie, et en peroperatoire (FC maximale et minimale) ont ete comparees chez trois groupes de patients repartis en fonction de la prise peri-operatoire de BB, de la prise chronique de BB, ou de l'absence de prise de BB. Les valeurs de FC sont exprimees sous forme de moyenne avec deviation standard. Resultats Au total, 406 patients ont ete inclus : 181 recevaient des BB de facon chronique, 20 ont beneficie d'une introduction preoperatoire et 205 ne prenaient pas de BB. Les FC des patients prenant des BB au long cours etaient plus basses que celles des patients du groupe temoin au repos (67 ± 11 vs 76 ± 12 b/min ; p  Conclusion Les ΒΒ prescrits une semaine avant l'intervention chirurgicale sont plus efficaces pour ralentir la FC que les BB administres de facon chronique.

Analyse des fréquences cardiaques durant la période péri-opératoire chez des patients prenant des bêtabloquants : réalité et efficacité du traitement

position. Data was analyzed with the t-test, and the results adjusted for multiple comparisons using the Bonferroni adjustment. Results: Significant p-values (less than 0.0001): Supine MAP (least square mean) 94.2 mmHg lower than pneumoperitoneum MAP (least mean square) 112.7 mmHg, Supine MAP 94.2 mmHg higher than end of surgery supine MAP 76.5 mmHg, Supine SVR 1441.5 dynes-sec/cm5 lower than pneumoperitoneum SVR 2014.1 dynes-sec/cm5, Supine aortic diameter 26.7 mm higher than pneumoperitoneum aortic diameter 25.1 mm. Conclusions: Pneumoperitoneum and trendelenburg position significantly increases MAP and SVR. There is also a significant decrease of aortic diameter, and these may reflect the impact of intrabdominal pressure on intrathoracic pressure. There are not significant changes in CO or SV during pneumoperitoneum.

Incidence of postoperative myocardial infarction in non cardiovascular surgery: A-208

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Comparison of the effects of mepivacaine and lidocaine on rat myocardium.

Analyse des fréquences cardiaques durant la période péri-opératoire chez des patients prenant des bêtabloquants : réalité et efficacité du traitement

Incidence of postoperative myocardial infarction in non cardiovascular surgery: A-208