Determination of the toxic dose of lidocaine in dogs and its corresponding serum concentration

Lemo, Nikša; Vnuk, Dražen; Radišić, Berislav; Skender, Ljiljana; Karačić, Višnja; Brčić, Irena

doi:10.1136/vr.160.11.374

Cited by 30 publications

(19 citation statements)

References 13 publications

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“…A bolus infusion of 4 mg/kg followed by a continuous infusion rate of 0.3 mg/kg/min of lidocaine induced muscular tremors after 24 ± 13 minutes. At this point, the plasma lidocaine concentration was 2.7 ± 1.1 mcg/ml [40]. In our study, there were no apparent signs of toxicity, even in the animal with the highest lidocaine concentration, which was still below the previously reported toxic concentration after IV lidocaine infusion [40].…”

Section: Resultssupporting

confidence: 40%

“…At this point, the plasma lidocaine concentration was 2.7 ± 1.1 mcg/ml [40]. In our study, there were no apparent signs of toxicity, even in the animal with the highest lidocaine concentration, which was still below the previously reported toxic concentration after IV lidocaine infusion [40]. The inclusion of the vasoconstrictor and the low lidocaine concentration in the tumescent solution (0.275%) probably contributed to the apparent lack of toxicity.…”

Section: Resultsmentioning

confidence: 99%

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Perioperative evaluation of tumescent anaesthesia technique in bitches submitted to unilateral mastectomy

et al. 2013

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BackgroundTumescent anaesthesia (TA) is a widely used technique in oncologic surgeries necessitating large resection margins. This technique produces transoperative and postoperative analgesia, reduces surgical bleeding, and facilitates tissue divulsion. This prospective, randomised, blind study evaluated the use of TA in bitches submitted to mastectomy and compared the effect of TA with an intravenous fentanyl bolus. A 2.5-mcg/kg intravenous fentanyl bolus (n = 10) was compared with TA using 0.275% lidocaine (n = 10) in bitches submitted to unilateral mastectomy. Sedation was performed by intramuscular (IM) injection of 0.05 mg/kg of acepromazine combined with 2 mg/kg of meperidine. Anaesthesia was induced with 5 mg/kg of intravenous propofol and maintained with isoflurane/O2. Heart and respiratory rates; systolic, mean, and diastolic arterial blood pressures; central venous pressure; SpO2; ETCO2; inspired and expired isoflurane concentrations; and temperature were measured transoperatively. Visual analogue scales for sedation and pain and the Glasgow composite and Melbourne pain scales were used for postoperative assessment. The surgeon investigated the quality of the surgical approach, considering bleeding and resection ability, and the incidence of postoperative wound complications.ResultsThe heart rate was lower and the end-tidal isoflurane concentration was higher in dogs treated with fentanyl than in dogs treated with TA. A fentanyl bolus was administered to 8 of 10 dogs treated with fentanyl and to none treated with TA. Intraoperative bleeding and the mammary gland excision time were lower in dogs treated with TA. The maximal mean and individual plasma lidocaine concentrations were 1426 ± 502 ng/ml and 2443 ng/ml at 90 minutes after infiltration, respectively. The Glasgow Composite Pain Scale scores were higher in dogs treated with fentanyl than in dogs treated with TA until 2 hours after extubation.ConclusionsCompared with intravenous fentanyl, TA in bitches: may be easily performed in non-inflamed, ulcerated, adhered mammary tumours; has an isoflurane-sparing effect; improves transoperative and immediate postoperative analgesia; is apparently safe for use in clinical conditions as evidenced by the fact that it did not produce any adverse signs or lidocaine plasma concentrations compatible with toxicity; does not modify the recovery time; and facilitates the surgical procedure without interfering with wound healing.

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Section: Resultssupporting

confidence: 40%

Section: Resultsmentioning

confidence: 99%

Perioperative evaluation of tumescent anaesthesia technique in bitches submitted to unilateral mastectomy

et al. 2013

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“…The dose of 2% lidocaine used was approximately 2 mg (0.1 ml) blebs at each needle insertion, without exceeding 2 mg/kg total dose [7]. Each recording was performed in the same manner, in a low lit, quiet room, with the patient gently restrained in sternal recumbency.…”

Section: Methodsmentioning

confidence: 99%

Electroencephalographic Recordings in the Canine: Effects of Low Dose Medetomidine or Dexmedetomidine Followed by Atipamezole

Tepper¹,

Shores²

2014

OJVM

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Objectives: 1) To describe electroencephalogram (EEG) appearance in the awake dog and compare these results with EEG recordings after low dose medetomidine (2 µg/kg IV) followed by atipamezole (10 µg/kg, IM); 2) To institute EEG recordings after low dose medetomidine or dexmedetomidine as a standard of practice if focal abnormalities and amplitudes were not significantly altered by pharmaceuticals in Phase 1 of this study. Methods: Electroencephalograms were performed on eight clinical canine patients with suspected intracranial disease involving the prosencephalon. A five lead montage was used to record the EEGs. Each dog had an awake, baseline recording followed by an EEG performed after administration of low dose medetomidine (2 µg/kg IV) then atipamezole (10 µg/kg, IM). In the second phase of this study, the same dose of medetomidine or dexmedetomidine at 1 µg/kg IV and atipamezole (10 µg/kg, IM) were used in the evaluation of 20 clinical patients with suspected neurologic disease. Results: In Phase 1, awake recordings were laced with movement artifacts. After medetomidine and atipamezole, EEG waveforms were slower. Following atipamezole, however, the frequencies were observed to increase with time. Statistical evaluation revealed significantly more artifacts in baseline recordings.No statistically significant change was observed in focal abnormalities or amplitude. In Phase 2, the α2-adrenoreceptor agonists followed by atipamezole without the use of lidocaine produced clinically reliable results. Clinical Significance: Quality and diagnostic electroencephalogram (EEG) recordings are frequently inconvenient to obtain in the awake dog. Movement results in artifacts and dislodged leads. Administration of low dose medetomidine or dexmedetomidine followed by atipamezole reliably reduced the impact of movement artifacts and produced clinically valid EEG recordings in dogs.

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“…Although a scavenger might eat central nervous tissue, and thus be exposed to lidocaine, doing so would require opening the cranium or vertebral column, which would be unlikely to occur without considerable effort. The total toxic dosage of lidocaine has been reported to be 11.1 mg/kg IV for dogs, but a wide range of values (4.6–19.4 mg/kg) has been given depending on rate and method of administration . Although cats and goats reportedly are more sensitive, the range of total toxic dose for lidocaine is similar for other species …”

Section: Discussionmentioning

confidence: 99%

Drug Residues after Intravenous Anesthesia and Intrathecal Lidocaine Hydrochloride Euthanasia in Horses

Aleman

Davis

Knych

et al. 2016

Veterinary Internal Medicne

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BackgroundIntrathecal lidocaine hydrochloride under general anesthesia has been used as an alternative method of euthanasia in equids. Carnivore, scavenger, and even human consumption of horse meat from carcasses have been anecdotally reported in rural areas after this method of euthanasia. The presence of drug residues in horse meat has not been investigated.Hypothesis/ObjectivesTo investigate if drug residues are found in horse tissues and determine their concentrations.AnimalsOf 11 horses requiring euthanasia for medical reasons.MethodsProspective descriptive study. Horses were anesthetized with total IV dose of xylazine (mean, 2.5 mg/kg), midazolam (0.1 mg/kg), and ketamine hydrochloride (mean, 5.8 mg/kg). An atlanto‐occipital cisterna centesis for the collection of cerebrospinal fluid (CSF) and administration of lidocaine hydrochloride (4 mg/kg) was performed. Blood samples for both serum and plasma, skeletal muscle (triceps brachii, gluteus medius), and CSF were collected for the determination of drug residues. Frozen skeletal muscle available from 5 additional horses that received standard dosages of drugs for short‐term anesthesia (xylazine 1.1 mg/kg, midazolam 0.1 mg/kg, and ketamine 2.2 mg/kg) also were analyzed.ResultsDrug residues were found in the tissues of all horses, but at extremely low concentrations.Conclusions and Clinical ImportanceEuthanasia by administration of lidocaine intrathecally to horses under IV anesthesia poses a low risk of toxicity to carnivores and scavengers that might consume muscle tissue from a carcass in which this protocol has been used.

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Determination of the toxic dose of lidocaine in dogs and its corresponding serum concentration

Cited by 30 publications

References 13 publications

Perioperative evaluation of tumescent anaesthesia technique in bitches submitted to unilateral mastectomy

Perioperative evaluation of tumescent anaesthesia technique in bitches submitted to unilateral mastectomy

Electroencephalographic Recordings in the Canine: Effects of Low Dose Medetomidine or Dexmedetomidine Followed by Atipamezole

Drug Residues after Intravenous Anesthesia and Intrathecal Lidocaine Hydrochloride Euthanasia in Horses

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