Failure of Lidocaine to Trigger Porcine Malignant Hyperthermia

Wingard, Daniel W.; Bobko, Stephen

doi:10.1213/00000539-197903000-00008

Cited by 37 publications

(7 citation statements)

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“…Lidocaine-induced hyperthermia has been reported in a case where it was injected directly into the skeletal muscle and the local anesthetics were myotoxic. 3 Myofibril hypercontraction progresses to lytic degeneration, edema, and necrosis. Because lidocaine and bupivacaine were previously used twice in the present patient without any adverse events, these drugs are unlikely to have triggered the hyperthermia.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Hyperthermia of Unknown Origin Treated With Dantrolene Sodium

Inada¹,

Jinno²,

Kohase³

et al. 2005

Anesthesia Progress

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An 11-year-old girl was scheduled for alveolar cleft bone grafting with an iliac bone under general anesthesia. Anesthesia was performed with 70% nitrous oxide, 30% oxygen, and propofol. On the first and second postoperative day, persistent hyperthermia was observed. Because the administration of diclofenac sodium had not been effective for the hyperthermia, dantrolene sodium was given. Her body temperature gradually dropped and returned to normal level on the fifth postoperative day. The hyperthermia in the present case might have been caused by a rapidly elevated muscle metabolism in response to pain and stress after the propofol anesthesia. The oral administration of dantrolene sodium successfully lowered the patient's high body temperature.

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Section: Discussionmentioning

confidence: 99%

Postoperative Hyperthermia of Unknown Origin Treated With Dantrolene Sodium

Inada¹,

Jinno²,

Kohase³

et al. 2005

Anesthesia Progress

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“…In experiments with MH-susceptible pigs, infusion of amide local anaesthetics (lidocaine and bupivacaine) failed to produce overt MH, although high peak plasma levels exceeding the toxic concentration in humans were reached (8,9). One clinical report even describes the successful treatment of arrhythmias with lidocaine during M H (10).…”

Section: Discussionmentioning

confidence: 99%

3‐in‐1 lumbar plexus block for muscle biopsy in malignant hyperthermia patients. Amide local anaesthetics may be used safely

Gielen

Viering

1986

Acta Anaesthesiol Scand

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A 3-in-1 lumbar plexus block with the aid of a nerve stimulator was performed in 32 patients and a psoas compartment block was performed in five patients for muscle biopsy of the upper leg for diagnosis of malignant hyperthermia (MH) susceptibility. Twenty-two patients were found to be MH susceptible by the in vitro contracture test. Twenty patients received 40 ml prilocaine 1.5% with epinephrine 1:200,000 and two received 40 ml bupivacaine 0.5% with epinephrine 1:200,000 without any untoward reaction. The 3-in-1 block provides a high success rate and excellent analgesia for muscle biopsy of the upper leg. Amide local anaesthetics are safe in MH-susceptible patients.

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“…Amide local anesthetics were previously thought to be harmful, because lidocaine may enhance in vitro contracture by inhibition of calcium sequestration into the sarcoplasmic reticulum. Reexamination has shown that lidocaine does not trigger MH in susceptible swine, even when given in doses above the convulsive threshold [100]. All local anesthetics, including the amides, are currently considered acceptable for anesthetic purposes [101,102].…”

Section: Non-anesthetic Drugs and Circumstancesmentioning

confidence: 99%