The Addition of 7.5% Glucose Does Not Alter the Neurotoxicity of 5% Lidocaine Administered Intrathecally in the Rat
The Addition of 7.5% Glucose Does Not Alter the Neurotoxicity of 5% Lidocaine Administered Intrathecally in the Rat
复制标题
%20添加%20的%207.5%%20葡萄糖%20做%20不%20改变%20的%20神经毒性%20的%205%%20利多卡因%20给予%20鞘内%20在%20的%20大鼠中
作者：
S. Sakura;V. Chan;R. Ciriales;K. Drasner
背景：最近关于脊髓麻醉后主要和次要神经系统后遗症的报道引起了人们对一些目前使用的鞘内药物安全性的关注。葡萄糖在脊髓麻醉相关的神经毒性损伤中的作用（如果有的话）尚不清楚。目前的实验试图确定7.5%葡萄糖的存在是否改变鞘内注射5%利多卡因的神经毒性。方法两个实验。首先，将48只大鼠植入鞘内导管，并随机分为8个相等的组。每只动物接受5%利多卡因的单次鞘内输注（P1-P4组）或含7.5%葡萄糖的5%利多卡因（G1-G4组），以1微升/分钟的速率持续0.5、1、2或4 h。使用甩尾试验评估感觉功能;缺陷被定义为在输注后持续4天在尾部的近端、中间或远端部分完全缺乏对热刺激的反应。在第二个实验中，将60只大鼠随机分为两组，分别接受1 h鞘内输注5%利多卡因或5%利多卡因+7.5%葡萄糖。输注后4天，评价动物甩尾反射潜伏期的增加。结果在第一个实验中，两种利多卡因溶液产生相似的剂量依赖性感觉功能丧失。在第二个实验中，两种溶液诱导了甩尾潜伏期的相似变化。结论7.5%葡萄糖的存在并不影响鞘内注射5%利多卡因诱发感觉障碍的可能性。这些发现进一步支持了脊髓麻醉后的近期损伤是由局麻药的直接神经毒性作用引起的这一假设。
Background Recent reports of major and minor neurologic sequelae after spinal anesthesia have generated concern regarding the safety of some currently used intrathecal agents. The role of glucose, if any, in neurotoxic injury associated with spinal anesthesia is not known. The current experiments sought to determine whether the presence of 7.5% glucose alters the neurotoxicity of intrathecally administered 5% lidocaine. Methods Two experiments were performed. First, 48 rats were implanted with an intrathecal catheter and randomly divided into eight equal groups. Each animal received a single intrathecal infusion of 5% lidocaine (groups P1‐P4) or 5% lidocaine with 7.5% glucose (G1‐G4) for 0.5, 1, 2, or 4 h at a rate of 1 micro liter/min. Sensory function was assessed using the tail‐flick test; a deficit was defined as a complete lack of response to the heat stimulus at the proximal, mid or distal portion of the tail persisting 4 days after the infusion. In the second experiment, 60 rats were randomly divided into two groups to receive a 1‐h intrathecal infusion of 5% lidocaine or 5% lidocaine with 7.5% glucose. Animals were evaluated for increase in the latency of the tail‐flick reflex 4 days after infusion. Results In the first experiment, the two lidocaine solutions produced similar dose‐dependent loss of sensory function. In the second experiment, the two solutions induced similar alterations in tail‐flick latency. Conclusions The presence of 7.5% glucose does not affect the potential of intrathecally administered 5% lidocaine to induce sensory impairment. These findings provide further support for the hypothesis that recent injuries after spinal anesthesia resulted from a direct neurotoxic effect of the local anesthetic.