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Ventilation Prevents Blood Gas Changes During Local-anesthetic-induced Convulsions in Paralyzed Cats
  1. Rudolph H. de Jong, M.D.,
  2. John D. Bonin, M. A. and
  3. Charles A. Gamble, B.S.
  1. From the Anesthesia Research Laboratory, Tufts University School of Medicine, Boston, Massachusetts

Abstract

Lightly anesthetized, ventilated, paralyzed cats had convulsions induced by lidocaine (n = 40) or bupivacaine (n = 45). The mean control arterial Po2 (Fio2 ⋍ 0.3) was 176 torr; the lowest Po2 anytime thereafter was never less than 120 torr. At the onset of convulsions, arterial pH was 0.04 (bupivacaine group) to 0.06 (lidocaine group) units less than control; Pco2 was 1.1 (bupivacaine group) to 2.1 (lidocaine group) torr greater than control; plasma bicarbonate ion concentration decreased 1.1 (bupivacaine group) to 1.4 mmol/L (lidocaine group). To yield long-lasting seizures, local anesthetic infusion was continued until twice the convulsant dose (bupivacaine 10.6 mg/kg, lidocaine 56.0 mg/kg) had been given. Some 15 minutes later, arterial Pco2 and pH had not changed significantly from threshold ictal values. We conclude that adequate alveolar ventilation will maintain acid-base balance and aid survival after massive overdoses of amide local anesthetics.

  • Acid-base equilibrium
  • Acidosis
  • metabolic
  • Bicarbonate ion concentration
  • Carbon dioxide tension
  • Bupivacaine
  • Lidocaine
  • Complications
  • acidemia
  • convulsions

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Footnotes

  • This research was supported by the Saltonstall Endowment and a grant from Breon Laboratories.

    Address reprint requests to Dr. de Jong: Department of Anesthesia, University of Cincinnati Medical Center, 231 Bethesda Avenue (M.L. 531), Cincinnati, OH 45267.