Lidocaine, MK-801, and MAC
Lidocaine, MK-801, and MAC
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DOI：
10.1213/01.ane.0000260318.60504.a9
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发表时间：
2007-05-01
影响因子：
5.7
通讯作者：
Sonner, James M.
中科院分区：
文献类型：
--
作者：
Zhang, Yi;Laster, Michael J.;Sonner, James M.
背景技术背景：既往研究发现，局部麻醉剂/钠通道阻滞剂利多卡因降低MAC的最大量约等于地佐环平（MK-801）（一种N-甲基-D-天冬氨酸（NNMA）受体拮抗剂）产生的降低量。吸入麻醉剂对钠通道的阻断被认为是通过NMDA受体传递受损的可能原因。我们假设利多卡因和MK-801对MAC的净效应是相同的，尽管是在不同的点影响NMDA神经传递。方法：我们测量了不同利多卡因输注对大鼠环丙烷、氟烷、异氟烷和邻二氟苯MAC的影响。我们还测量了利多卡因-MK-801同时输注对异氟烷和邻二氟苯MAC的影响。(a)我们发现利多卡因输注的效果没有限制，在某些情况下，发现利多卡因单独产生不动性;（B）利多卡因输注不会降低邻二氟苯的MAC，这与其他吸入麻醉剂的MAC不同;（c）添加MK-801对异氟烷与邻二氟苯的利多卡因输注产生的MAC降低的影响相同。利多卡因主要不是通过减少神经末梢释放谷氨酸来降低MAC。
BACKGROUND: Previous studies have found that the local anesthetic/sodium channel blocker lidocaine decreased MAC by maximum amounts approximately equal to the decreases produced by dizocilpine (MK-801), a N-methyl-D-aspartate (NNMA) receptor antagonist. Blockade of sodium channels by inhaled anesthetics has been suggested as a possible cause for impairment of transmission through NMDA receptors. We postulated that the net effect of lidocaine and MK-801 on MAC would be the same, albeit by affecting NMDA neurotransmission at different points.,METHODS: We measured the effect of various lidocaine infusions on the MAC of cyclopropane, halothane, isoflurane, and o-difluorobenzene in rats. We also measured the effect of concurrent lidocaine-MK-801 infusion on the MAC of isoflurane and o-difluorobenzene.RESULTS: Our data contradicted our predictions. (a) We found no limit to the effect of lidocaine infusion, in some cases finding that lidocaine, alone, produced immobility; (b) lidocaine infusion did not decrease the MAC of o-difluorobenzene differently from the MAC of other inhaled anesthetics; and (c) the addition of MK-801 equally affected the decrease in MAC produced by lidocaine infusion for isoflurane versus o-difluorobenzene.CONCLUSION: Lidocaine does not primarily decrease MAC by decreasing the release of glutamate from nerve terminals.