Intrathecal Lidocaine Prevents Cardiovascular Collapse and Neurogenic Pulmonary Edema in a Rat Model of Acute Intracranial Hypertension

Hall, Sean; Wang, Louie; Milne, Brian; Ford, Sally E.; Hong, Murray

doi:10.1097/00000539-200204000-00032

Cited by 25 publications

(13 citation statements)

References 10 publications

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“…The hemodynamic response to brain-stem injury and the NPO can be prevented by ␣-adrenergic blockade, spinal cord transection, splanchnectomy, and spinal anesthesia, but not by adrenalectomy or ␤-blockade (62)(63)(64)(65)(66). These observations indicate that norepinephrine released by the nerve endings of the sympathetic nervous system is the mediator and not adrenal epinephrine.…”

Section: Avlonitis Et Almentioning

confidence: 85%

Pulmonary Transplantation: the role of brain death in donor lung injury

et al. 2003

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The paucity of suitable lung donors and the high early mortality as the result of primary graft failure remain major challenges in pulmonary transplantation. There is evidence that the lung is injured in the donor by the process of brain death and often is made unusable or fails posttransplantation after amplification of the injury by the process of ischemia-reperfusion. An understanding of the mechanism of donor lung injury could lead to the development of new treatment strategies for the donor to reduce lung injury, increase the number of donors with acceptable lungs, and improve the results of transplantation. The pathophysiology of brain death is complex and involves sympathetic, hemodynamic, and inflammatory mechanisms that can injure the lung. The literature is reviewed, and these mechanisms are discussed together with their possible interrelations.

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Section: Avlonitis Et Almentioning

confidence: 85%

Pulmonary Transplantation: the role of brain death in donor lung injury

et al. 2003

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“…A randomized, controlled clinical trial has demonstrated that the addition of thoracic epidural to conventional general anesthesia in patients undergoing off‐pump coronary artery bypass graft surgery, accounts for a significant reduction in the incidence of postoperative arrhythmias and improvement in overall quality of recovery [15]. LID prevents cardiovascular collapse in a rat model of acute intracranial hypertension [16]. It was reported that thoracic epidural anesthesia could reduce myocardial infarcted size after coronary artery occlusion in dogs [17].…”

Section: Discussionmentioning

confidence: 99%

Remote intrathecal morphine preconditioning is ineffective in the presence of neuraxial blockade with lidocaine

Wong

Zhang

et al. 2013

The Kaohsiung J of Med Scie

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Remote intrathecal morphine preconditioning (RMPC) induces cardioprotection via a neural pathway. Intrathecal lidocaine (LID) blocks spinal cord nerve transmission. This study examine whether LID prevents the effects of RMPC. Anesthetized, open chest, male Sprague-Dawley rats were assigned to one of seven treatment groups 3 days after intrathecal catheter placement. Rats from both RMPC and LID groups, respectively, received intrathecal morphine (3 μg/kg) and lidocaine (1%, 10 μL); morphine was administered by three cycles of 5-minute infusions interspersed with 5-minute infusion-free periods. The LID + RMPC group received the combination of LID and RMPC. Intrathecal naloxone methiodide (NM) (20 μg/kg) was administered either 15 minutes before RMPC, or 5 minutes before LID + RMPC. Ischemia and reperfusion injury were then induced by 30 minutes of left coronary artery occlusion, followed by 120 minutes of reperfusion. Infarct size, as a percentage of the area at risk (AAR), was determined by 2,3,5-triphenyltetrazolium staining. The RMPC and LID groups markedly reduced the infarct size (IS) compared with controls. LID prevented the effect of RMPC. NM had no effect on control and LID + RMPC treatments. However, NM pretreatment reversed cardioprotection of RMPC treatment. Intrathecal morphine preconditioning is ineffective in the presence of neuraxial blockade with lidocaine.

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“…Sympathetic hyperactivity during sudden intracranial hypertension leads to cardiovascular instability, myocardial dysfunction and neurogenic pulmonary edema. One study o b s e rved that intrathecal lidocaine prevents cardiovascular collapse and neurogenic pulmonary edema in a rat model of acute intracranial hypertension 22 .…”

Section: Discussionmentioning

confidence: 99%

Hemodynamic parameters and neurogenic pulmonary edema following spinal cord injury: an experimental model

Filho¹,

Morandin²,

Almeida³

et al. 2005

Arq. Neuro-Psiquiatr.

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-Neurogenic pulmonary edema is a serious and always life-threatening complication following several lesions of the central nervous system. We re p o rt an experiment with 58 Wi s t a r-Hanover adult male rats. Two gro u p s w e re formed: control (n=4) and experimental (n=54). The experimental group sustained acute midthoracic spinal c o rdinjury by Fogart y 's balloon-compression technique containing 20µL of saline for 5, 15, 30 or 60 seconds. The rats w e reanesthetized by intraperitoneal (i.p.) sodium pentobarbital (s.p.) 60 mg/Kg. The quantitative neurological outcome was presented at 4, 24 and 48 hours from compression to characterize the injury graduation in diff e rent gro u p s . Poor outcome occurred with 60 seconds of compression. Six animals died suddenly with pulmonary edema. Using the pro c e d u re to investigate the pulmonary edema during 60 seconds of compression, followed by decompre s s i o n and time-course of 60 seconds, 20 rats were randomly asigned to one of the following groups: control (1, n=4, anesthetized by i.p. s.p., 60 mg/Kg but without compression) and experimental (2, n=7, anesthetized by i.p. xylazine 10 mg/Kg and ketamine 75 mg/Kg) and (3, n=9, anesthetized by i.p. s.p., 60 mg/Kg). The pulmonary index (100 x wet lung weight / body weight) was 0.395 ± 0.018 in control group, rose to 0.499 ± 0.060 in group 2, and was 0.639 ± 0.14 in group 3. Histologic examination of the spinal cord showed parenchymal ru p t u res and acute hemorrh a g e . Comparison of the pulmonary index with morphometric evaluation of edema fluid-filled alveoli by light micro s c o p y showed that relevant intra-alveolar edema occurred only for index values above 0.55. The results suggest that the p u l m o n a ryedema induced by spinal compression is of neurogenic nature and that the type of anesthesia used might be important for the genesis of lung edema.KEY WORDS: spinal cord injury, neurogenic pulmonary edema, central nervous system lesions. P a r â m e t ros hemodinâmicos e edema pulmonar neurogênico após traumatismo raquimedular: modelo experimental RESUMO -Edema pulmonar neurogênico é complicação séria e aumenta o risco de vida em pacientes com várias lesões do sistema nervoso central. Apresentamos uma experiência com 58 ratos Wistar machos e adultos. Foram formados dois grupos: controle (n=4) e experimental (n=54). O grupo experimental sofreu trauma raquimedular torá-cico médio com o cateter-balão de Fogarty contendo 20µL de salina por 5, 15, 30 ou 60 segundos de compressão. Os ratos foram anestesiados com pentobarbital sódico (p.s.), 60 mg/Kg intraperitoneal (i.p.). Foi investigada a re l a ç ã o e n t re a lesão medular e o tempo de compressão. A evolução neurológica foi quantificada e apresentada com 4, 24 e 48 horas da compressão para caracterizar a graduação da lesão nos diferentes grupos. A pior evolução ocorre u com 60 segundos de compressão. Seis animais morreram subitamente com edema pulmonar. Vinte ratos foram randomicamente distribuídos em um dos seguintes grupos: controle (1, n=4, an...

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Intrathecal Lidocaine Prevents Cardiovascular Collapse and Neurogenic Pulmonary Edema in a Rat Model of Acute Intracranial Hypertension

Abstract: In a rat model of intracranial balloon inflation, intrathecal lidocaine prevented cardiovascular collapse and neurogenic pulmonary edema. Descending neural pathways are involved in the development of cardiopulmonary complications associated with acute intracranial hypertension.

Cited by 25 publications

References 10 publications

Pulmonary Transplantation: the role of brain death in donor lung injury

Pulmonary Transplantation: the role of brain death in donor lung injury

Remote intrathecal morphine preconditioning is ineffective in the presence of neuraxial blockade with lidocaine

Hemodynamic parameters and neurogenic pulmonary edema following spinal cord injury: an experimental model

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