Comparison of therapeutic effects of intralipid and medialipid in verapamil toxicity model

Lipid emulsion which improves bupivacainetoxicity is also hopeful for the treatment of otherlipophilic drug toxicities. Our purpose is to drawattention to efficiency of 20% intralipid and 20% medialipid when cardiac toxicity developsduring verapamil infusionwithout applying standard treatment medicine.EighteenadultSpraque-Dawley rats were divided into 3 groups in this experimental study as control, intralipid, medialipid(Group K, I, M). Each groupcontained 6 rats. Under ketamine anesthesia tail vein was cannulated. Mechanical ventilation was applied through surgical tracheostomy. Abdominal aorta was cannulatedfor invasiveblood pressuremonitorization.Arterial blood gas was analysed before treatment drugs wereinfused. Baseline heart rate (HRb) and mean arterial pressure (MAPb) were recorded. Verapamil was infused 2.5 mg/kg/min inall groups until MAPbdecreases 50%. At this time verapamil infusion was stopped, HR0and MAP0wererecorded then 12.4 mL 0.9% NaCl, 20% intralipidor 20% medialipid were infused in five minutes to Group K, Group I and Group M, respectively.HR, MAPand asystoletimes wererecorded during60 minutes.Statistical evaluationwas performed byKruskal Wallis and linear mixed model. Statistical significancelevelwasp<0,05.In all groups no HR differences were determined between groups; but MAPvalues werechanged. Intralipid groupwas found more effective than the 61other groups, even though MAP in medialipid group was higher than the controlin some evaluation times.No rats reached to the basal MAP values.As a result of this experiment medialipid 20% as well as intralipid 20%was significantly effective compared to control group, nevertheless both lipids were not enough for rescue treatment. We considered that lipid treatment may be a supportive besides the standard treatment protocol.Key words:verapamil, toxicity, 20% intralipid, 20% medialipid