Anti‐inflammatory properties of local anesthetics and their present and potential clinical implications

Cassuto, Jean; Sinclair, Robert C.; Bonderovic, M.

doi:10.1111/j.1399-6576.2006.00936.x

Cited by 376 publications

(340 citation statements)

References 210 publications

(250 reference statements)

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Section: Local Anestheticssupporting

confidence: 53%

“…It attenuates the formation of reactive oxygen metabolites [133], and the release of leukotrienes, , and histamine [135]. Similar effects have been demonstrated with bupivacaine and ropivacaine [130,131,136,137].Lidocaine also inhibits interferon-inducible IL-10 secretion in intestinal epithelial cells [138], attenuates IL-1β, IL -6, IL-8 and ICAM-1 on activated human umbilical vein endothelial cells [139], and impairs the secretions of IL-2, TNF-α, . Furthermore, in animals with LPS-induced lung injury, lidocaine attenuates the release of , whereas ropivacaine reduces the expression of ICAM-1 and the leukocyte adhesion [142].…”

mentioning

confidence: 60%

“…Lidocaine can be also given intravenously exerting analgesic effects [128]. Several studies have investigated the effect of local anesthetics on immune system.In vitro, lidocaine inhibits the IL-8 and IL-1β release [129,130] from epithelial cells, the IL-1β secretion from mononuclear cells and neutrophil function [130], the phagocytosis [130,131], and the migration of leukocytes [130,132]. It attenuates the formation of reactive oxygen metabolites [133], and the release of leukotrienes, , and histamine [135].…”

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confidence: 99%

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Anesthesia, cytokines and cancer recurrence

Kitamura¹,

Biaso²,

Ingelmo

et al. 2015

Glob Anesth Perioper Med

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Cytokines are essential mediators for the regulation of both innate and acquired immunity and hematopoiesis. They modulate immune cell signaling, activation, adhesion and functioning. They regulate the individual response to several insults such as infection, inflammation, trauma, and pain. Moreover, the balance between pro-inflammatory and anti-inflammatory cytokines is critical for the evolution of surgical complications and tumor progression.Several drugs, including anesthetic agents, influence cytokines secretion. Opioids, inhalational agents, intravenous and local anesthetics have shown different effects on immune system and cytokine expression. Therefore, anesthesia may play an important role in postoperative recovery and outcome of cancer patients.The aim of the present article is to review the main role of some important cytokines and the effect of anesthesia techniques and drugs on their secretion. Furthermore, current clinical evidence regarding the effects of anesthesia on cancer recurrence will be discussed. Cytokines and immune systemCytokines are proteins expressed in both innate and acquired immune system and are often named according to the secreting cells (i.e., lymphocytes, interleukins, etc.). They are essential mediators of the natural (non-specific, innate) immunity, which is the initial step of the inflammatory response. They also play a pivotal role during the specific immunity, which occurs after exposure to antigens, as they regulate lymphocyte and leukocyte activation, growth and differentiation, and the immune-mediated inflammation [1].The cytokines have different structures, but also common aspects, which are summarized in Table 1.The aim of the present article is to review the main role of some important cytokines and the effect of anesthesia techniques and drugs on their secretion. Cytokines receptorsThe cytokines receptors are formed by one or more transmembrane proteins: the extracellular portion binds the cytokine, whereas the cytoplasmic part starts the signal cascade. Based on the extracellular portion, they are divided in five categories. 1) Type I receptors, which have four α-helical stands and contain four cysteine residues and the amino acid motif tryptophanserine-X-tryptophan-serine (WSXWS).2) Type II receptors, structurally similar to Type I receptors, but without the sequence WSXWS. Cytokines functionProvided that the same cytokine may be produced during both innate and acquired immunity response, cytokines can be classified according to their functions: 1)Cytokines regulating the innate immunity and secreted by stimulated macrophages; 2)Cytokines regulating the acquired immunity and secreted by lymphocytes; 3)Cytokines stimulating the hematopoiesiss and secreted by bone marrow, leucocytes and other cells. Common aspects of CytokineTheir secretion is brief and limited in time Cytokine expressed during the innate immunity response Tumor necrosis factor (TNF-α, TNF-β)The TNF is responsible for the initial phase of acute inflammatory response, especially against ...

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Section: Local Anestheticssupporting

confidence: 53%

mentioning

confidence: 60%

mentioning

confidence: 99%

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Anesthesia, cytokines and cancer recurrence

Kitamura¹,

Biaso²,

Ingelmo

et al. 2015

Glob Anesth Perioper Med

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“…Several publications reported a broad range of anti-inflammatory actions of local anesthetics through their effects on the cells of the immune system as well as platelets, erythrocytes, and the microorganism itself 5 . Indeed, such agents have been utilized in the treatment of several conditions linked to inflammatory processes like interstitial cystitis, ulcerative proctitis, arthritis, herpetic infections and burns 6 .…”

Section: Introductionmentioning

confidence: 99%

Histological features of peritoneal lavage with ropivacaine in rats with fecal peritonitis

et al. 2012

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PURPOSE:To evaluate the histological features in lungs, peritoneum and liver of rats subjected to fecal peritonitis and treated with peritoneal lavage with 0.2% ropivacaine. METHODS: Twenty Wistar rats were subjected to laparotomy 6 h after the fecal peritonitis induction with autogenous stool. Rats were randomly distributed into 4 groups: I -(n=5) Control, no treatment; II -(n=5) Drying of the abdominal cavity; III -(n=5) Abdominal cavity lavage with 3 ml 0.9% saline solution and drying; and IV -(n=5) Abdominal cavity lavage with 3 ml 0.2% ropivacaine and drying. The animals that died underwent necropsy, and the surviving ones were subjected to euthanasia on the 11th day post-surgery. Fragments of liver, lungs and peritoneum were removed for histological evaluation. RESULTS:The animals that received peritoneal lavage (groups III and IV) showed greater survival than the drying and control groups. Lavage with ropivacaine prevented death during the observed period. Peritoneal lavage with ropivacaine maintained the architecture of the lung, peritoneum and liver without any important histological alterations. The histopathological findings analyzed correlated with greater survival of group IV. CONCLUSION: Treatment of fecal peritonitis in rats with peritoneal lavage using 0.2% ropivacaine demonstrated a reduction in histopathological alterations related to inflammatory response and sepsis. Key words: Peritonitis. Peritoneal Lavage. Anesthetics. Sepsis. Rats. RESUMO OBJETIVO:Avaliar os aspectos histopatológicos em pulmões, peritônios e fígados de ratos submetidos à peritonite fecal e tratados com lavagem peritoneal com ropivacaína a 0,2%. MÉTODOS: Utilizou-se 20 ratos Wistar, submetidos à laparotomia 6 horas após a indução de peritonite fecal com fezes autógenas, distribuídos aleatoriamente em quatro grupos: I-(n=5) Controle, nenhum tratamento; II-(n=5) Enxugamento da cavidade abdominal; III-(n=5) Lavagem da cavidade abdominal com 3 ml de solução salina 0,9% e enxugamento ; IV-(n=5) Lavagem da cavidade abdominal com 3 ml de ropivacaína a 0,2% e enxugamento. Os animais que morreram foram necropsiados e os sobreviventes foram eutanasiados no 11º dia do pós-operatório. Retirou-se fragmentos do fígado, pulmões e do peritônio dos animais para estudo histopatológico. RESULTADOS: Os animais que receberam lavagem peritoneal (grupos III e IV) apresentaram maior sobrevida que os grupos enxugamento e controle. A lavagem com ropivacaína impediu o óbito no período avaliado. A lavagem peritoneal com ropivacaína manteve a arquitetura do pulmão, peritônio e fígado sem alterações histológicas importantes. Os achados histopatológicos analisados foram condizentes com o maior tempo de sobrevida no grupo IV. CONCLUSÃO: A lavagem peritoneal com ropivacaína a 0,2% no tratamento da peritonite fecal em ratos demonstrou reduzir as alterações histopatológicas relacionados à resposta inflamatória e sepse. Descritores: Peritonite. Lavagem Peritoneal. Anestésicos. Sepse. Ratos.Brocco MC et al.

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“…Further research has suggested that the mechanism of action may in part be associated with N-methyl-D-aspartate receptor antagonism (10). Other basic science papers suggest the inhibition of G-protein-coupled receptors and the inflammatory response as possible contributors to the analgesia seen with lidocaine infusions (11). Lidocaine infusion may also reduce anesthetic requirements and MAC by 20% to 40% (12,13), with potential economic benefits.…”

Section: Discussionmentioning

confidence: 99%

Lidocaine Infusion as a Rescue Analgesic in the Perioperative Setting

Clarke

McConachie

Banner

2008

Pain Research and Management

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In the present case series, three patients for whom regional anesthesia may have been the optimum technique for controlling postoperative pain are discussed. However, due to prevailing circumstances, regional anesthesia could not be provided. An intravenous infusion of lidocaine at 4 mg/min was administered perioperatively as an alternative 'rescue' analgesic technique. This infusion rate, based on previous extensive pharmacokinetic studies, is widely considered to be safe. Postoperative pain was lower than expected for the type of surgery. Anecdotal experience suggests that hospital length of stay may also be reduced, with both patient and economic benefits.Key Words: Analgesia; Lidocaine; Postoperative pain Perfusion de lidocaïne comme analgésique de dernier ressort dans un contexte périopératoire Avec la présente série de cas, on décrit trois patients pour qui l'anesthésie régionale aurait pu être la technique optimale de soulagement de la douleur post-opératoire. Or, en raison des circonstances, l'anesthésie régionale n'a pas pu leur être offerte. En dernier ressort, une perfusion intraveineuse de lidocaïne leur a été administrée à raison de 4 mg/min comme solution de rechange en période périopératoire. Ce débit de perfusion, établi selon des études pharmacocinétiques antérieures approfondies, est largement considéré sécuritaire. La douleur post-opératoire a été moins intense que prévu compte tenu du type de chirurgie. L'expérience anecdotique donne à penser que le séjour hospitalier peut également être abrégé, ce qui est intéressant pour le patient et économiquement avantageux.

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Anti‐inflammatory properties of local anesthetics and their present and potential clinical implications

Cited by 376 publications

References 210 publications

Anesthesia, cytokines and cancer recurrence

Anesthesia, cytokines and cancer recurrence

Histological features of peritoneal lavage with ropivacaine in rats with fecal peritonitis

Lidocaine Infusion as a Rescue Analgesic in the Perioperative Setting

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