Lidocaine Concentrations in Plasma and Cerebrospinal Fluid After Systemic Bolus Administration in Humans

Tsai, Pei-Shan; Buerkle, Hartmut; Lee, T. C.; Yang, Lin; Lee, J. H.

doi:10.1097/00000539-199809000-00020

Cited by 23 publications

(14 citation statements)

References 28 publications

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“…The concentration of lidocaine in human plasma reaches 2.2 g/ml after epidural administration (8). After 2 mg/ml intravenous administration, the peak plasma concentration of lidocaine reached 1.5-1.9 g/ml (6 -8 M) within 15 min (45). Similar plasma concentrations were obtained after topical application of lidocaine (1 mg/cm 2 ) in partial thickness burns (7).…”

Section: Discussionsupporting

confidence: 66%

Lidocaine depresses splenocyte immune functions following trauma-hemorrhage in mice

Kawasaki¹,

Choudhry²,

Schwacha³

et al. 2006

American Journal of Physiology-Cell Physiology

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Traumatic and/or surgical injury as well as hemorrhage induces profound suppression of cellular immunity. Although local anesthetics have been shown to impair immune responses, it remains unclear whether lidocaine affects lymphocyte functions following trauma-hemorrhage (T-H). We hypothesized that lidocaine will potentiate the suppression of lymphocyte functions after T-H. To test this, we randomly assigned male C3H/HeN (6–8 wk) mice to sham operation or T-H. T-H was induced by midline laparotomy and ∼90 min of hemorrhagic shock (blood pressure 35 mmHg), followed by fluid resuscitation (4× shed blood volume in the form of Ringer lactate). Two hours later, the mice were killed and splenocytes and bone marrow cells were isolated. The effects of lidocaine on concanavalin A-stimulated splenocyte proliferation and cytokine production in both sham-operated and T-H mice were assessed. The effects of lidocaine on LPS-stimulated bone marrow cell proliferation and cytokine production were also assessed. The results indicate that T-H suppresses cell proliferation, Th1 cytokine production, and MAPK activation in splenocytes. In contrast, cell proliferation, cytokine production, and MAPK activation in bone marrow cells were significantly higher 2 h after T-H compared with shams. Lidocaine depressed immune responses in splenocytes; however, it had no effect in bone marrow cells in either sham or T-H mice. The enhanced immunosuppressive effects of lidocaine could contribute to the host's enhanced susceptibility to infection following T-H.

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Section: Discussionsupporting

confidence: 66%

Lidocaine depresses splenocyte immune functions following trauma-hemorrhage in mice

Kawasaki¹,

Choudhry²,

Schwacha³

et al. 2006

American Journal of Physiology-Cell Physiology

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“…15 Our analysis, correspondingly, was a two-step procedure. First, we evaluated noninferiority on both outcomes in both 31 [25,55] 36 [23,60] All statistics reported as "mean ± SD," "median [first quartile, third quartile]", or "N (%)", as appropriate. …”

Section: Effect Of Lidocaine On Postoperative Painmentioning

confidence: 99%

“…The prolonged analgesic effect of lidocaine, which extends well beyond the infusion time, could potentially also be explained by sustained concentrations of lidocaine in the cerebrospinal fluid. 25 In addition, lidocaine metabolites have analgesic effects by inhibiting the glycine transporter 1.…”

Section: Pain Medicinementioning

confidence: 99%

Effect of Perioperative Intravenous Lidocaine Administration on Pain, Opioid Consumption, and Quality of Life after Complex Spine Surgery

et al. 2013

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Background: The authors tested the primary hypothesis that perioperative IV lidocaine administration during spine surgery (and in the postanesthesia care unit for no more than 8 h) decreases pain and/or opioid requirements in the initial 48 postoperative hours. Secondary outcomes included major complications, postoperative nausea and vomiting, duration of hospitalization, and quality of life. Methods: One hundred sixteen adults having complex spine surgery were randomly assigned to perioperative IV lidocaine (2 mg·kg −1 ·h −1 ) or placebo during surgery and in the post anesthesia care unit. Pain was evaluated with a verbal response scale. Quality of life at 1 and 3 months was assessed using the Acute Short-form (SF) 12 health survey. The authors initially evaluated multivariable bidirectional noninferiority on both outcomes; superiority on either outcome was then evaluated only if noninferiority was established. MORE than half-million spine surgeries are performed each year in the United States. Extensive spine surgery is painful, and postoperative pain is often difficult to control. Opioids-the most common analgesic approachin turn, often provoke postoperative nausea and vomiting. Patients with extensive lumbar spine surgery are prone to life-threatening complications, with incidences varying from 2.3% among patients having decompression alone to 5.6% among those having complex fusions.1 However, the overall complication incidence, including minor and major complications, is up to 16.4% (17.8% in thoracolumbar vs. 8.9% in cervical procedures).2 Therefore, functional recovery is often prolonged.2 A likely common mechanism for many adverse outcomes is the systemic inflammatory response to surgical tissue injury.Systemic lidocaine is antiinflammatory, 3 analgesic,

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“…Only preservative free formulations should be given intravenously. Bolus administration of 2 mg/kg and a continuous infusion of 2-5 mg/kg/h have shown to reach plasma levels of 1-4 μg/ml [121]. After a bolus injection or continuous administration for up to 12 h, the half-life of lidocaine is about 100 minutes and shows linear pharmacokinetics [122].…”

Section: Myoclonic Jerks Dysphoria/hallucinationsmentioning

confidence: 99%

A Review of Intravenous Lidocaine Infusion Therapy for Paediatric Acute and Chronic Pain Management

Lauder¹

2017

Pain Relief - From Analgesics to Alternative Therapies

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Pediatric acute and chronic pain experiences involve the interaction of physiological, psychological, behavioural, developmental, pharmacological and situational factors. In the acute perioperative pain setting preventative multimodal analgesia is required to provide comfort and minimise the potential for "wind-up" and central sensitisation. When pain is recurrent, ongoing or chronic some children embark on a downward spiral of decreased physical, psychological and social functioning. The multidisciplinary team management approach is a well-established standard of care for children with complex chronic pain. Intravenous lidocaine has peripheral and central mediated analgesic, anti-inflammatory and anti-hyperalgesic properties. Intravenous lidocaine infusion therapy (IVLT) has been shown to be effective in the management of acute and chronic pain in adults. This chapter will present the rational for IVLT in pediatric pain management with emphasis on preventative multimodal therapy in acute pain and the multidisciplinary treatment approach in chronic pain. Large multi-centre randomised controlled trials are required to provide the evidence-base to confirm that IVLT is indeed an effective and safe treatment option in acute preventative multimodal analgesia and as an adjunct in the multidisciplinary care of chronic pain in the pediatric population. Keywords

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Lidocaine Concentrations in Plasma and Cerebrospinal Fluid After Systemic Bolus Administration in Humans

Abstract: Cerebrospinal fluid concentrations of lidocaine after its systemic bolus delivery in humans indicate that the spinal cord may be the major site of antinociceptive action by this route of drug administration.

Cited by 23 publications

References 28 publications

Lidocaine depresses splenocyte immune functions following trauma-hemorrhage in mice

Lidocaine depresses splenocyte immune functions following trauma-hemorrhage in mice

Effect of Perioperative Intravenous Lidocaine Administration on Pain, Opioid Consumption, and Quality of Life after Complex Spine Surgery

A Review of Intravenous Lidocaine Infusion Therapy for Paediatric Acute and Chronic Pain Management

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