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A double-blind randomized study on the toxicity of lidocaine and ropivacaine on sciatic nerve and biceps muscle of rats

https://doi.org/10.21292/2078-5658-2019-16-4-12-18

Abstract

The purpose of the study was to examine the damaging activity of Lidocaine and Ropivacaine on the sciatic nerve and biceps muscle of rats. A double blind randomized study was conducted. The control group received injectiona of 0.9% NaCl. The following concentrations of Lidocaine were examined – 0.5, 1, 1.5, and 2. For Ropivacaine, these concentrations were 0.25, 0.5, 0.75, and 1. Under the US control, 0.2 ml were injected along the perineural sciatic nerve and 0.2 ml into the two-headed muscle. The drugs were taken out in 1 hour after their injection. When injecting 0.9% NaCl no cell necrosis or apoptosis in the muscle and nerve were found, only single cells of inflammatory type were found. The administration of all concentrations of local anesthetics caused inflammatory filtration and damage to muscle tissue and nerve stems compared to 0.9% NaCl. Increased expression of damage and inflammatory infiltration depended on the concentration of the local anesthetic. The higher the concentration of Lidocaine or Ropivacaine was, the greater were the damage and inflammatory changes. The study demonstrated neurotoxic and miotoxic activity of all concentrations of Lidocaine and Ropivacaine compared to 0.9% NaCl. The dependence of damage strengthening and the growth of inflammatory filtration in the muscle and peripheral nerve on the increased concentration of the local anesthetic was revealed.

About the Authors

R. E. Lakhin
S.M. Kirov Military Medical Academy, Russian Ministry of Defense
Russian Federation

Roman E. Lakhin - Doctor of Medical Sciences, Professor of Anesthesiology and Intensive Care Department.

4, Klinicheskaya St., St. Petersburg, 194044, Phone/Fax: +7 (812) 329‒71‒21



I. A. Gemua
S.M. Kirov Military Medical Academy, Russian Ministry of Defense
Russian Federation

Inal A. Gemua - Post Graduate Student of Anesthesiology and Intensive Care Department.

4, Klinicheskaya St., St. Petersburg, 194044, Phone/Fax: +7 (812) 329‒71‒21



P. G. Tolkach
S.M. Kirov Military Medical Academy, Russian Ministry of Defense
Russian Federation

Pavel G. Tolkach - Teacher at the Department for Military Toxicology and Medical Protection.

4, Klinicheskaya St., St. Petersburg, 194044, Phone/Fax: +7 (812) 329‒71‒21



References

1. Barsa J., Batra M., Fink B.R. et al. A comparative in vivo study of local neurotoxicity of lidocaine, bupivacaine, 2-chloroprocaine, and a mixture of 2-chloroprocaine and bupivacaine. Anesth. Analg., 1982, vol. 61, no. 12, pp. 961-967.

2. Benoit P.W., Yagiela A., Fort N.F. Pharmacologic correlation between local anesthetic-induced myotoxicity and disturbances of intracellular calcium distribution. Toxicol. Appl. Pharmacol., 1980, vol. 52, no. 2, pp. 187-198.

3. Cereda C.M.S., Tofoli G.R., Maturana L.G. et al. Local neurotoxicity and myotoxicity evaluation of cyclodextrin complexes of bupivacaine and ropivacaine. Anesth. Analg., 2012, vol. 115, no. 5, pp. 1234-1241.

4. El-Boghdadly K., Pawa A., Chin K.J. Local anesthetic systemic toxicity: current perspectives. Local Reg. Anesth., 2018, vol. 11, pp. 35-44.

5. Kanai Y., Katsuki H., Takasaki M. Lidocaine disrupts axonal membrane of rat sciatic nerve in vitro. Pain Pract., 2003, vol. 1, no. 2, pp. 201-201.

6. Kim H.J., Sung S.R., Seo K.S. et al. Bupivacaine-induced apoptosis in the primary cultured cardiomyocytes via p38 MAPKs. Korean J. Anesthesiol., 2016, vol. 50, no. 6, pp. S48.

7. Lirk P., Haller I., Colvin H.P. et al. In vitro, lidocaine-induced axonal injury is prevented by peripheral inhibition of the p38 mitogen-activated protein kinase, but not by inhibiting caspase activity. Anesth. Analg., 2007, vol. 105, no. 6, pp. 1657-1664.

8. Lirk P., Haller I., Peter H. et al. In vitro, inhibition of mitogen-activated protein kinase pathways protects against bupivacaine- and ropivacaine-induced neurotoxicity. Anesthesia & Analgesia, 2008, no. 5 (106), pp. 1456-1464.

9. Lirk P., Picardi S., Hollmann M.W. Local anaesthetics: 10 essentials. Eur. J. Anaesthesiol., 2014, vol. 31, no. 11, pp. 575-585.

10. Nakahira K., Oshita K., Itoh M. et al. Clinical Concentrations of local anesthetics bupivacaine and lidocaine differentially inhibit human Kir2.x inward rectifier k+ channels. Anesth. Analg., 2016, vol. 122, no. 4, pp. 1038-1047.

11. Nau C., Wang G.K. Interactions of local anesthetics with voltage-gated Na+ channels. J. Membr. Biol., 2004, vol. 201, no. 1, pp. 1-8.

12. Neal J.M., Barrington M.J., Brull R. et al. The second ASRA practice advisory on neurologic complications associated with regional anesthesia and pain medicine: Executive Summary 2015. Reg. Anesth. Pain Med., 2015, vol. 40, no. 5, pp. 401-430.

13. Neal J.M., Salinas F.V, Choi D.S. Local anesthetic-induced myotoxicity after continuous adductor canal block. Reg. Anesth. Pain Med., 2016, vol. 41, no. 6, pp. 723-727.

14. Oz Gergin O., Bayram A., Gergin İ.S. et al. Comparison of myotoxic effects of levobupivacaine, bupivacaine and ropivacaine: apoptotic activity and acute effect on pro-inflammatory cytokines. Biotech. Histochem., 2019, vol. 4, pp. 1-9.

15. Putrenko I., Ghavanini A.A., Meyer Schöniger K.S. et al. Сentral nervous system-toxic lidocaine concentrations unmask L-Type Ca2+ current-mediated action potentials in rat thalamocortical neurons. Anesth. Analg., 2016, vol. 122, no. 5, pp. 1360-1369.

16. Sondekoppam R., Tsui B. Factors associated with risk of neurologic complications after peripheral nerve blocks. Anesth. Analg., 2017, vol. 124, no. 2, pp. 645-660.

17. Verlinde M., Hollmann M., Stevens M. et al. Local anesthetic-induced neurotoxicity. Int. J. Mol. Sci., 2016, vol. 17, no. 3, pp. 339,

18. Wang L.Y., Li X., Han Y.Z. Neuroprotection by epigallo catechin gallate against bupivacaine anesthesia induced toxicity involves modulation of PI3/Akt/PTEN signalling in N2a and SH-SY5Y cells. Int. J. Clin. Exp. Med., 2015, vol. 8, no. 9, pp. 15065-15075.

19. Yildiz K., Efesoy S.N., Ozdamar S. et al. Myotoxic effects of levobupivacaine, bupivacaine and ropivacaine in a rat model. Clin. Investig. Med., 2011, vol. 34, no. 5, pp. 273-280.

20. Zink W., Seif C., Braun P.M. et al. The acute myotoxic effects of bupivacaine and ropivacaine after continuous peripheral nerve blockades. Anesth. Analg., 2003, vol. 97, pp. 1173-1179.


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For citations:


Lakhin R.E., Gemua I.A., Tolkach P.G. A double-blind randomized study on the toxicity of lidocaine and ropivacaine on sciatic nerve and biceps muscle of rats. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2019;16(4):12-18. (In Russ.) https://doi.org/10.21292/2078-5658-2019-16-4-12-18



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ISSN 2078-5658 (Print)
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