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A Retrospective Study on the Cardiotoxicity of Bupivacaine

Hydrochloride

Zhi-yang Chen, Jian-ming Xu, Hua Yin, Yun-kai Cao, Fei-fei Lou, Hui Jiang, Rui Huang,

Xu-qin Zhu

Department of Anesthesiology, Fudan University Shanghai Cancer Center, Shanghai, China, 200032

Abstract

Background. Bupivacaine is the cheap and very effective local anesthetics, but the employment of bupivacaine
hydrochloride has been reduced gradually since its cardiotoxicity had been reported.

Methods. As one of the most frequently used local anesthetics, bupivacaine hydrochloride has been used in 125736
cases for more than 20 years in our hospital.

Results. Its side effects include temporarily bradycardia, conscious disturbance, hyperspasmia, no serious
cardiotoxicity which lead to shock and death.

Conclusion. The severe cardiotoxicity of bupivacaine hydrochloride maybe very scarce, the dosage and concentration
as recommended maybe very safe.

Key Words: Bupivacaine; Side effect; Cardiotoxicity
Corresponding Author: Zhi-yang Chen, E-mail: chzhygg@sina.cn

Although show its block effects slightly slowly, nerve block(T2-5) for small nonmalignant tumor of lacteal
bupivacaine hydrochloride possess perfect clinical gland, cervical plexus nerve block in pate operations,
effects and cheapness. The employment of bupivacaine epidural block in breast cancer, and all kinds of operations
hydrochloride has been reduced gradually since in thoracic and abdominal region, spinal anesthesia.
its cardiotoxicity had been reported. Bupivacaine The concentration of bupivacaine hydrochloride used in
hydrochloride have been used in our department for 20 different kinds of operations can be seen in Table 1. We
years, we have a retrospective study on the side effects, have made a summary on the side effects of bupivacaine
especially cardiotoxicity of it here. hydrochloride here.

Materials and methods Results

From 1989 to 2008, bupivacaine hydrochloride had In all of our patients who were used bupivacaine
been used as the main local anesthetics in the 125736 hydrochloride used, the side effects of non-mistakenly
patients of our anesthesia department, which were used injected into blood vessels mainly include temporarily
as local infiltration anesthetics in simple operations of bradycardia, no allergic responses had been observed,
out-patient department, local anesthetics in intercostal but the side effects of mistakenly injected into blood
vessels have conscious disturbance, spasm, no serious
Table 1 the concentration of bupivacaine hydrochloride used cardiotoxicity which lead to shock and death had not be
in different kinds of anesthesia seen Table 2.

Intercostal nerve block 0.25% 0.3% 0.375% 0.5% 0.75% Discussion
Cervical plexus nerve block + - - - -
+ + + - - Acute cardiovascular collapse has been reported
Epidural block + + + + +
Spinal anesthesia - - - - -
Local infiltration anesthesia + + - - -

Laboratory and ClinicalCInovveesrtTighaetsioisn 22 FAM 2014 Jan/Feb Vol.21 Issue 1
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