Abstract
The effects of continuous rate infusion of lidocaine or amiodarone on hemodynamic and arrhythmias induced by epinephrine in dogs anesthetized with halothane were evaluated. Thirty dogs were distributed into three groups: amiodarone group (AG), lidocaine group (LG), or control group (CG). Anesthesia was induced with etomidate and maintained with halothane. Thirty minutes later a bolus and continuous rate infusion (CRI) of amiodarone in AG, lidocaine in LG and NaCl at 0.9% in CG was administered. After 10 minutes, arrhythmias were induced by epinephrine CRI at 0.0001mg/kg/minute, which was increased in 0.0001mg/kg/minute every ten minutes, until 0.0003mg/kg/minute. The measurements were performed 30 minutes after the induction of anesthesia (T0), 10 minutes after beginning the drug CRIs (T1), 10 minutes after beginning epinephrine administration (T2) and 10 minutes after increasing epinephrine CRI (T3 and T4). In CG, at T3 heart rate (HR) was greater than in LG, while at T4, HR in GC was higher than in LG and AG. In LG and CG, from T2, central venous pressure (CVP), cardiac index (CI), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), mean pulmonary arterial pressure (mPAP) increased. In AG, SAP, DAP and MAP it decreased from T1 to T3. The ventricular ectopic beats (VEB) were lower in AG. Amiodarone has better antiarrhythmogenic effects, although it was also associated with hypotension.
Highlights
Cardiac arrhythmias are frequent complications during surgical/anesthetic procedures
Thirty minutes after the induction of anesthesia, a bolus followed by a continuous rate infusion (CRI) of amiodarone (Ancoron, Libbs Farmacêutica, São Paulo, SP, Brazil) in amiodarone group (AG) (5mg/kg and 0.17mg/kg/minute), of lidocaine (Xylestesin, Cristália, Itapira, SP, Brazil) in lidocaine group (LG) (1 mg/kg and 0.075 mg/kg/minute) and NaCl at 0.9% in control group (CG) (1mL and 5mL/hour) was administered
In CG, at T4, the heart rate (HR) value was greater than other times
Summary
Cardiac arrhythmias are frequent complications during surgical/anesthetic procedures. Myocardial sensitization to endogenous and exogenous catecholamines, caused by anesthetic halogenated agents, can contribute to the appearance of arrhythmias (Harvey and Ettinger, 2007). Experimental dog models have been widely used to study atrial and ventricular arrhythmia mechanisms in vivo and the effects of antiarrhythmic and proarrhythmic drugs (Noda and Hashimoto, 2004). In this study we used the combination of halothane with epinephrine as an experimental model for the induction of arrhythmias, because this drug is rarely used as a routine, it is the halogen that causes the greater myocardial sensitization to catecholamines (Harvey and Ettinger, 2007). This study was designed to assess the effects of continuous rate infusion of lidocaine or amiodarone on hemodynamic and arrhythmias induced by epinephrine in dogs anesthetized with halothane
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