Prevention of bronchoconstriction by an orally active local anesthetic.
Prevention of bronchoconstriction by an orally active local anesthetic.
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通过口服局部麻醉剂预防支气管收缩。
DOI：
10.1164/ajrccm/151.4.1239
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发表时间：
1995
期刊：
影响因子：
--
通讯作者：
Hirshman,C
中科院分区：
文献类型：
--
作者：
Brown,RH;Robbins,W;Staats,P;Hirshman,C
刺激气道刺激受体会产生反射性支气管收缩，可以通过使用抗胆碱能药物或气雾剂或静脉注射的局部麻醉剂进行预处理来预防。我们比较了口服局部麻醉剂盐酸美西律和静脉注射利多卡因在阻断组胺诱导的五只巴辛吉灵缇犬支气管收缩方面的治疗剂量，并使用高分辨率计算机断层扫描 (HRCT) 直接测量气道尺寸的变化。在给予安慰剂的狗中，组胺输注使气道面积减少至对照的 61 +/- 2%（平均值 +/- SEM）（p < 0.01）。美西律预处理完全防止了组胺引起的气道收缩，组胺输注期间气道面积为对照值的 94 +/- 4%（与基线相比，p = 0.07）。美西律血清水平具有治疗作用（1.7 +/- 0.3 mg/L）。同样，利多卡因预处理显着减弱了静脉注射组胺引起的气道收缩。在利多卡因预处理的狗中，组胺使气道面积减少至基线的 79 +/- 4% (p < 0.01)。与美西律一样，利多卡因血清水平也具有治疗作用（2.4 +/- 0.3 mg/L）。美西律在预防组胺引起的支气管收缩方面比利多卡因更有效（p = 0.02）。这些数据表明，口服局部麻醉剂可能有助于预防人类刺激物引起的支气管收缩。
Stimulation of airway irritant receptors produces reflex bronchoconstriction that can be prevented by pretreatment with anticholinergic drugs or local anesthetics delivered by aerosol or intravenously. We compared therapeutic doses of an orally administered local anesthetic, mexiletine hydrochloride, and intravenously administered lidocaine at blocking histamine-induced bronchoconstriction in five basenji-greyhound dogs, using high-resolution computed tomography (HRCT) to directly measure changes in airway size. In the dogs given placebo, a histamine infusion decreased airway area to 61 +/- 2% (mean +/- SEM) of control (p < 0.01). Mexiletine pretreatment completely prevented histamine-induced airway constriction, with an airway area that was 94 +/- 4% of the control value during the histamine infusion (p = 0.07 compared with baseline). Mexiletine serum levels were therapeutic (1.7 +/- 0.3 mg/L). Similarly, pretreatment with lidocaine significantly blunted the airway constriction provoked by intravenous histamine. In lidocaine-pretreated dogs, histamine decreased airway area to 79 +/- 4% of baseline (p < 0.01). As in the case of mexiletine, lidocaine serum levels were also therapeutic (2.4 +/- 0.3 mg/L). Mexiletine was more effective than lidocaine at preventing histamine-induced bronchoconstriction (p = 0.02). These data suggest that orally administered local anesthetics may be useful in preventing irritant-induced bronchoconstriction in humans.