Differential stereoselective effects of levobupivacaine, bupivacaine and dexbupivacaine on the heart in isolated rat hearts

抄録

Bupivacaine(BUP) has an advantage over other local anesthetics because of its long-acting sensory anesthesia, but because of its high affinity for the myocardial Na⁺ channel it can be cardiotoxic. Levobupivacaine(LBUP) is an S(-)-isomer of the racemate BUP, and dexbupivacaine(DBUP) is an R(+)-isomer. LBUP has less neuronal and cardiac toxicity than BUP and DBUP, but DBUP induces more negative chronotropism and arrhythmogenic effects than either LBUP or BUP.