Figure 2.

Local anesthetics act on Na⁺, K⁺, Ca²⁺ channels, interfere with signal transduction in cells and transmembrane cells, and inhibit the metabolic processes of PKB, AMPK, and other molecules related to cell survival and apoptosis. Local anesthetics increase the release of cytochrome c from mitochondria to cytoplasm, increased apoptosis, and impaired mitochondrial function. Lipid emulsion inhibited the opening of MPTP to restore mitochondrial function. Lipid emulsion can activate Ca²⁺ channels, increase the intracellular calcium level, and activate upstream kinase PI3K, and PKB-mediated downstream kinase GSK-3β Phosphorylation leads to the inhibition of MPTP opening, thereby reversing cardiomyocyte apoptosis induced by local anesthetics. Lipid emulsion inhibits the activation of eNOS, reduces the production and release of NO, and reverses the severe vasodilation caused by LAST.