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Anaesthesia Miscellaneous (Local and Regional Anesthesia) 669801ae

Which one of the following local anesthetics is highly cardio-toxic:

A
Lignocaine
B
Procaine
C
Mepivacaine
D
Bupivacaine
High-Yield Explanation
Ans. is 'd' i.e., Bupivacaine Local anaesthetics are cardiac depressants but no significant effects are observed at conventional doses.At higher doses or on inadvertent i.v. injection they have quinidine like effect on heart i.e. they -Decrease automaticity Decrease excitability Decrease contractility Decrease conductivity Increase effective refractory periodAt a very high plasma concentration, some local anaesthetics can markedly alter electrophysiological properties of heart and they can themselves induce cardiac arrhythmias.Bupivacaine is the most cardiotoxic local anaesthetic and it can produce arrhythmias and severe cardiotoxic reactions which areA. V. heart blockDysrhythmias such as ventricular fibrillationCirculatory collapse (This occurs due to smooth muscle dilatation)

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