The Changes of S-wave Amplitude in Lead III for Detecting the Early Bupivacaine-induced Cardiotoxicity. |
Ji Yeon Jeong, Jin Tae Kim, Kook Hyun Lee |
1Department of Aensthesiology and Pain Medicne, Korea Institute of Radiological and Medical Science, Seoul, Korea. 2Department of Aensthesiology and Pain Medicne, The Armed Forces Deok-Jung Hostpital, Seoul, Korea. 3Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, Korea. |
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Abstract |
BACKGROUND To investigate changes of electrocardiogram (ECG) wave amplitudes in dogs with early bupivacaine-induced cardiac depression. METHODS Bupivacaine was infused into pentobarbital-anesthetized mongrel dogs (n = 9) at a rate of 0.5 mg/kg/min for 30 min. R-wave, S-wave, T-wave amplitude in lead II and III, and cardiac output (CO) were measured every 5 min after the initiation of bupivacaine infusion. PR interval, QRS complex duration, corrected QT interval were also measured. MAP (mean arterial blood pressure), HR (heart rate), and cSvO2 (continuous mixed venous oxygen saturation) were recorded at 5 min intervals. Arterial blood gas, serum electrolytes and bupivacaine concentration were measured at 10 min intervals. The relationships between CO and ECG amplitudes, and of CO versus hemodynamic variables were compared by regression analysis. RESULTS With bupivacaine infusion, R-wave amplitude decreased to zero and S-wave amplitude increased negatively in both leads. The best correlation with CO was seen in S-wave (r = 0.751) in lead III among the ECG parameters. CONCLUSIONS Close monitoring of S-wave amplitude in lead III can be helpful for detecting the early Bupivacaine-induced cardiotoxicity. |
Key Words:
bupivacaine; electrocardiogram; cardiac output |
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