Hemodynamic effects of lipid emulsion after local anesthetic intoxication may be due to a direct effect of fatty acids on myocardial voltage-dependent calcium channels

The authorsconsidered two hypotheses regarding the mechanism ofaction of lipid emulsions. The first hypothesis was phar-macological, wherein a circulating lipid sink extractslipophilic local anesthetic from either plasma or tissues.The second hypothesis was metabolic, invoking reversionof the local anesthetic inhibition of the myocardial fattyacid oxidation. We suggest that a third mechanism could beinvolved, i.e., a direct stimulation of the voltage-gatedcalcium channels (Ca