Effect of intravenous lidocaine on experimental spinal cord injury

Abstract

A series of experiments was conducted to study the effect of systemic intravenous administration of lidocaine on neurological recovery after acute experimental spinal cord injury in cats. The spinal cord was injured by the rapid inflation of an epidural balloon at T-6. The physiological integrity of the spinal cord ceased within 2 seconds in all animals, as demonstrated by acute disappearance of the somatosensory evoked response (SER). There was essentially no return of the SER in the five untreated animals when monitored for 4 hours post-injury. All of the pathological specimens from these animals revealed severe central cord hemorrhage. Intravenous lidocaine was begun 15 minutes after the injury in five animals. Three of these animals had significant return of the SER. The pathological specimens from the lidocaine-treated animals revealed either mild or moderate central cord hemorrhage. The results of this experiment suggest that systemic lidocaine administration has a significant beneficial effect in the treatment of acute spinal cord injury.

Anoxie Injury in the Rat Spinal Cord: Pharmacological Evidence for Multiple Steps in Ca2+-Dependent Injury of the Dorsal Columns

“…Although details of the molecular cascade leading to irreversible axonal dysfunction in spinal cord injury and ischemia are still only partially understood, our results may have implications for therapeutic strategies for these disorders. Some in vivo studies of lidocaine in spinal cord injury have been reported as showing a protective effect (Kobrine et al, 1984;Cole et al, 1989), although other studies have not (Haghighi et al, 1987). The earlier negative studies utilized lidocaine at concentrations that were much lower than in the present study.…”

“…The tertiary amine anesthetics procaine and lidocaine reversibly block Na channels (Strichartz, 1976) and have been shown to be protective in the anoxic optic nerve in vitro (Stys et al, 1992c) and in some models of spinal cord injury in vivo (Haghighi et al, 1987;Kobrine et al, 1984). We therefore studied the effects of tertiary anesthetics on CAP recovery from a 60-min period of anoxia in the spinal cord.…”

Local Blockade of Sodium Channels by Tetrodotoxin Ameliorates Tissue Loss and Long-Term Functional Deficits Resulting from Experimental Spinal Cord Injury

“…One reported a beneficial effect (Kobrine et al, 1984) and the second (Haghighi et al, 1987) reported no discernible effect. In these studies in which lidocaine was administered intravenously, plasma concentrations were approximately an order of magnitude lower than concentrations found to be protective in the recent in vitro studies (Stys et al, 1992a;Agrawal and Fehlings, 1996).…”

Medical treatment of acute spinal cord injuries

“…Lidocaine is an antioxidant agent [17]. The pathological specimens from the lidocaine-treated animals revealed either mild or moderate central cord hemorrhage.…”

“…Since Allen (1908), many surgical experiments have been done on SCI and the merits of various treatments in reducing spinal cord damage discussed, such as hypothermia, steroids, hyperosmotic agents, and myelotomy [1,15,17].…”