Central nervous system effects of bupivacaine.

The central nervous system and concurrent cardiovascular effects of bupivacaine infusion were studied in cats. It was possible to block cortical E.E.G. desynchronization resulting from a sensory stimulus with bupivacaine. The earliest subcortical change that occurred was rhythmic activity in the amygdala and later in the hippocampus. Occasionally, this activity appeared simultaneously in both these sites. Diazepam pretreatment raised the seizure threshold of bupivacaine. Diazepam was also effective in terminating established seizure activity resulting from bupivacaine. All animals pretreated with diazepam (Valium) or diazepam solvent developed cardiac dysrhythmias durind bupivacaine infusion. The possible clinical significance of the interaction of bupivacaine and diazepam solvent is considered.