Intrathecal mepivacaine and prilocaine are less neurotoxic than lidocaine in a rat intrathecal model

Abstract

It is suggested that intrathecal mepivacaine and prilocaine are less neurotoxic than highly concentrated lidocaine in a rat intrathecal model.

Glutamate Release and Neurologic Impairment After Intrathecal Administration of Lidocaine and Bupivacaine in the Rat

“…28,29 These findings are comparable with the clinical pictures of transient neurologic symptoms in which only sensory symptoms have appeared.…”

Effects of Sodium Bisulfite With or Without Procaine Derivatives on Axons of Cultured Mouse Dorsal Root Ganglion Neurons

“…8,11 The results also showed that the area most sensitive to the neurotoxic effects of the aforementioned agents was identical; axons on the posterior root just at entry into the spinal cord (entry zone). [8][9][10][11] Although NaHSO 3 has been used as an antioxidant additive most frequently with chloroprocaine, we have not yet investigated the neurotoxicity of chloroprocaine on posterior root axons. For this reason, we used mainly procaine and additionally chloroprocaine in this study.…”

“…[14][15][16] These reports correspond to our previous results, indicating that intrathecal anesthetics affected posterior column and produced gait disturbance with intact motor system in rats. [8][9][10][11] If intrathecal anesthetics affected dorsal column by blocking Aβ fiber, our cultured model examined the effect of local anesthetics on the axon projecting from large type DRG neurons and might reflect the effects of local anesthetics in the clinical setting. Moreover, NaHSO 3 enhanced chloroprocaine effects on the axon in our experiment.…”

“…relatively high because the dose for intrathecal injection commonly used in most of rat experimental studies is usually about 30 μL, and not 120 μL. [8][9][10][11]26,27 It is not clear why the high dose of chloroprocaine or NaHSO 3 used in the previously mentioned studies induced only mild nerve injury rather than severe injury, unlike the results described by Ready et al 4 and Wang et al 5 If NaHSO 3 provides protection against neurotoxicity of local anesthetics, it should be recommended as an additive agent to local anesthetics. However, our results showed that the use of NaHSO 3 combined with procaine or chloroprocaine produced more profound inhibition of axonal transport than after the use of NaHSO 3 or procaine or chloroprocaine alone.…”

Epinephrine Administered With Lidocaine Solution Does Not Worsen Intrathecal Lidocaine Neurotoxicity in Rats

“…After fixation, the lumbar spinal cord with the anterior and posterior roots (PRs) and the cauda equina were removed en bloc and dissected into 4 samples: transverse section with both roots of L3, posterior or anterior roots just proximal to the dorsal ganglion, and cauda equina nerves for light and electron microscopic examinations, as described in our previous study. 12 All specimens were embedded in epoxy resin. The semithin sections (0.5Y1.0 Km thick) were stained with polychrome dyes.…”