This Article Résumé de cet Article Full Text Full Text (PDF) Additional Material Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Barel, C. Articles by Timour, Q. Search for Related Content PubMed PubMed Citation Articles by Barel, C. Articles by Timour, Q.

Ropivacaine combined with various anti-arrhythmic drugs results in mild alterations in myocardial contractility in pigs

[La ropivacaïne, combinée à divers médicaments anti-arythmiques, provoque de légères modifications de la contractilité myocardique chez le porc]

Cécile Barel, MD^*,, Majda Belkhiria, PHARM D^*,, Bernard Bui-Xuan, MD PhD, Jacques Descotes, MD PhD^*, Philippe Chevalier, MD PhD^¶, Marie-Claude Gagnieu, PhD^||, Florence Arnal^*, Panayota Tsibiribi^* and Quadiri Timour, PhD^*

^* From the Laboratory of Medical Pharmacology, Claude Bernard University, Lyon, France;
the Department of Internal Medicine, Hôtel Dieu, Lyon, France;
the Department of Pharmacology, Monastir, Tunis, Tunisia;
the Department of Anesthesia and Resuscitation, E. Herriot Hospital, Lyon, France;
^¶ the Department of Cardiology, Louis Pradel Hospital, Bron, France;
and the Department of Biochemistry, E. Herriot Hospital, Lyon, France.

Address correspondence to: Dr. Q. Timour, Laboratoire de Pharmacologie Médicale, 8, Avenue Rockefeller, 69373 Lyon cedex 08, France. Phone: +33 4 78 77 71 88; Fax: +33 4 78 77 71 85; E-mail: timour.quadiri{at}rockefeller.univ-lyon1.fr

Purpose: The present study was undertaken following the observation of a marked decrease in myocardial contractility after ropivacaine in a patient on amiodarone, in order to investigate the cardiovascular effects of combining ropivacaine with anti-arrhythmic drugs (AARD).

Methods: Anesthetized domestic pigs were treated with disopyramide, flecainide, atenolol, amiodarone, diltiazem or nicardipine at a dose leading to blood levels obtained in treated patients, then received 1 mg•kg^-1 ropivacaine. Blood pressure (BP), left venticular (LV) dP/dt max, sinus heart rate, and intraventricular conduction time were measured before and following the administration of AARD, and following ropivacaine at different time points.

Results: All tested AARD induced the expected hemodynamic and electrophysiologic effects. Following ropivacaine, a 20 to 35% decrease in LV dP/dt max of prolonged duration was observed with amiodarone only. A brief 10 to 20% decrease in mean BP was observed in all animals, except those treated with nicardipine who sustained an important and prolonged decrease in BP. All other variables were not significantly affected.

Discussion: The combination of ropivacaine with AARD was always associated with a slight drop in LV dP/dt max. The effect on mean BP was slight, except with nicardipine. Clinicians should be aware of the interactions of ropivacaine with AARD, especially amiodarone and nicardipine.