THE EFFETS OF LIDOCAINE ON ENDOTOXIN-INDUCED MULTIPLE ORGAN FAILURE.

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We conducted the current study to assss the effects of lidocaine on endotoxin-induced multiple organ failure (MOF). Seventeen male Japanese white rabbits were divided into two groups : Group S (control, n=8) received iv endotoxin (E.Coli) and saline and Group L (n=9) did endotoxin and lidocaine infusion. Arterial blood samples for measurement of PaO2, GOT,GPT,BUN,and creatinine were drawn 0 hr, 6 hr, 12 hr, and 24 hr after endotoxin. Lung mechanics were measured by the passive expiratory flow-volume technique before endotoxin and 24 hr after endotoxin. The animals were killed 24 hr after endotoxin. Then, the lung, kidney, and liver were removed to determine wet to dry weight ratios (W/D) and myeloperoxidase activities. Cytokine and albumin concentrations in bronchoalveolar lavage (BAL) fluid were measured. The lung, kidney, and liver were also fixed by 4% glutaraldehyde solution. The specimens were stained with hematoxylin and eosin and examined under a light microscope. Endotoxin decreased PaO_2 and lung compliance. Lindocaine successfully attenuated deterioration of oxygenation and compliance. Endotoxin also increased the W/D weight ratio of the three organs, and albumin and interleukin (IL) -6, IL-8 in BAL fluid. Lidocaine attenuated the increases. The myeloperoxidase activities of the lung, kidney, and liver were greater in rabbits which did not receive lidocaine. Endotoxin caused extensive morphologic organ damages, which were lessened by lidocaine treatment. These results indicate that lidocaine pre-treatment attenuates endotoxin-induced MOF in rabbits. Because lidocaine markedly reduced the myeloperoxidase of the organs prepared from rabbits with endotoxin, the drug may attenuate the MOF in part by inhibiting activation of neutrophils.