Intravenous lipid emulsion is the recommended treatment for severe local anaesthetic intoxication. Lipid emulsion may entrap lipid soluble drugs by functioning as a ‘lipid sink’, but its effect on bupivacaine pharmacokinetics remains unknown. In this randomised, double-blind, crossover study, eight healthy male volunteers were infused bupivacaine 0.5 mg.kg−1 intravenously over 20 min, followed by an infusion of either intravenous lipid emulsion or Hartmann’s solution for 30 min. At 20 and 30 min after the start of the infusion, the total plasma bupivacaine concentration was lower while receiving lipid emulsion than Hartmann’s solution (mean difference 111 (95% CI 55–167) μg.l−1 and 75 (95% CI 26–124 μg.l−1 at 20 and 30 min, respectively; p < 0.02). However, there were no differences in un-entrapped (non-lipid bound) or free (non-protein bound) bupivacaine plasma concentrations during the infusion. Intravenous lipid emulsion infusion reduced the context-sensitive half-life of total plasma bupivacaine from 45 (95% CI 32–76) min to 25 (95% CI 20–33) min; p = 0.0We observed no significant adverse effects of lipid emulsion. In conclusion, lipid emulsion may slightly increase the rate of bupivacaine tissue distribution. No ‘lipid sink’ effect was observed with the non-toxic dose of bupivacaine used.
The reported successful use of IV lipid emulsions in local anesthetic intoxications is thought to be due to lipid sequestration of local anesthetics. However, controlled efficacy studies were lacking, and other mechanisms of action have also been suggested. We investigated the effect of lipid inf...
Patients treated with hemodialysis (HD) have been reported to have decreased levels of -3 polyunsaturated fatty acids (PUFAs) in plasma and cells. The aim of this study was to investigate the effect of -3 PUFAs administered intravenously during HD, as well as the effect of HD treatment, on the fa...
Intravenous lipid emulsion has been used in the resuscitative treatment of intoxications caused by local anaesthetics and tricyclic antidepressants with seemingly beneficial results. We studied the effect of intravenous lipid emulsion on the plasma concentration of amitriptyline, and haemodynamic...
submitted by soteshkappalo 2 years and 5 months ago
Inhibition of the cholesteryl ester transfer protein (CETP), a plasma protein that normally transfers cholesterol from the protective high-density lipoprotein (HDL) fraction to the atherogenic low-density lipoprotein (LDL) fraction, results in an increase in the concentration of HDL cholesterol a...
We investigated the role of glucose-dependent insulintropic polypeptide (GIP) in the regulation of gastric emptying (GE), appetite, energy intake (EI), energy expenditure (EE), plasma levels of triglycerides (TAG), and free fatty acids (FFA) in humans. First, 20 healthy males received intravenous...
To investigate the effects of the intraoperative administration of Ringer's solution with 1% glucose on the metabolism of glucose, lipid and muscle protein during surgery. Thirty-one adult patients, American Society of Anesthesiologists physical status I or II, undergoing elective otorhinolarynge...
Depot formulations prolong the analgesic effect of local anesthetics and reduce peak plasma drug concentration. This allows for safer administration of larger doses of local anesthetics, which further prolongs the duration of analgesic effect. We previously reported the development of large multi...
submitted by incltroflooxac 2 years and 1 month ago
Consumption of foods and supplements enriched with plant sterols/stanols (PS) may help reduce low-density lipoprotein cholesterol (LDL-C) levels. In this review, we consider the effects of PS beyond LDL-C lowering. Plant sterols/stanols exert beneficial effects on other lipid variables, such as a...
Intravenous lipid emulsion is established therapy for bupivacaine induced cardiotoxicity. The benefit of combined hypertonic saline and lipid treatment is unexplored. In this experiment, sedated rabbits were resuscitated from bupivacaine-induced asystole with intravenous lipid according to the As...
Marine n-3 polyunsaturated fatty acids (PUFA) may have antiarrhythmic effects. The aim of this study was to investigate the effect of intravenously administered n-3 PUFA on the inducibility of ventricular tachycardia (VT) in patients with an implantable cardioverter defibrillator (ICD).Methods an...
