Anaes SAQs · Local anaesthetic systemic toxicity
Bupivacaine cardiotoxicity
Final SAQ — strong protein-binding; slow dissociation (poor recovery ratio); low CV/CNS ratio; prolonged refractory arrest; ropivacaine as the safer s-enantiomer alternative.
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Target exams
ANZCAFRCAABAEDAIC
Prompt
Discuss why bupivacaine is the most cardiotoxic local anaesthetic and the implications for anaesthetic practice.
Question
Discuss why bupivacaine is the most cardiotoxic local anaesthetic and the implications for anaesthetic practice.
References3ShowHide
- [1]Pham DT, et al. New long-acting local anesthetics: safety. Curr Opin Anaesthesiol, 2026.PMID 42228505
- [4]Motayagheni N, et al. Lipid emulsion: more than reversing bupivacaine cardiotoxicity. J Pharm Pharm Sci, 2017.PMID 29145932
- [42228506]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.