Epinephrine Increases the Neurotoxic Potential of Intrathecally Administered Lidocaine in the Rat

Hashimoto, Keishi; Hampl, Karl F.; Nakamura, Yuji; Bollen, Andrew W.; Feiner, John; Drasner, Kenneth

doi:10.1097/00000542-200105000-00028

Cited by 63 publications

(34 citation statements)

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“…We should keep in mind that when these patients are in the supine position and epinephrine is added to intrathecal local anaesthetics, we have a higher possibility to expose the patients to a high level of spinal blockade. The neurotoxic potential of intrathecal epinephrine (13) has also to be taken into consideration when the spinal anaesthetic plan is made.…”

Section: Discussionmentioning

confidence: 99%

Inclusion of epinephrine to hyperbaric tetracaine and the supine position enhance the cephalad spread of spinal anaesthesia compared with hyperbaric teracaine alone in the lithotomy position

Inoue

Kawaraguchi

Kitaguchi

et al. 2004

Acta Anaesthesiol Scand

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Section: Discussionmentioning

confidence: 99%

Inclusion of epinephrine to hyperbaric tetracaine and the supine position enhance the cephalad spread of spinal anaesthesia compared with hyperbaric teracaine alone in the lithotomy position

Inoue

Kawaraguchi

Kitaguchi

et al. 2004

Acta Anaesthesiol Scand

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“…Previous studies showed that a single intrathecal injection of plain epinephrine (up to 0.5 mg) is not associated with histological injury in rabbits (Oka et al, 2001) or rats (Bahar et al, 1984;Hashimoto et al, 2001). However, epinephrine worsens histological spinal cord injury when added to 5% lidocaine in rats (Hashimoto et al, 2001) or 1-2% tetracaine in rabbits (Oka et al, 2001).…”

Section: Local Toxicity Evaluationmentioning

confidence: 99%

“…However, epinephrine worsens histological spinal cord injury when added to 5% lidocaine in rats (Hashimoto et al, 2001) or 1-2% tetracaine in rabbits (Oka et al, 2001). Thus, it seems that the addition of epinephrine to a potential irritating substance (local anesthetic) worsens the tissue reaction.…”

Section: Local Toxicity Evaluationmentioning

confidence: 99%

Pharmacokinetic and local toxicity studies of liposome-encapsulated and plain mepivacaine solutions in rats

Tófoli¹,

Cereda²,

Araújo³

et al. 2010

Drug Delivery

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“…41 Ischemia is one of the possible causative mechanisms that may result from changes in peripheral blood flow. 42 An immune-mediated mechanism may be possible as suggested by others. 21,43 In the current study, we observed that the local inflammatory process associated with the Rop-PELA might be due to the stimuli by unabsorbed Rop nanoparticles.…”

mentioning

confidence: 93%

Long-term effect of ropivacaine nanoparticles for sciatic nerve block on postoperative pain in rats

Wang

Huang

Yang

et al. 2016

IJN

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Purpose The analgesic effect of ropivacaine (Rop) for nerve block lasts only ~3–6 hours for single use. The aim of this study was to develop long-acting regional anesthetic Rop nanoparticles and investigate the effects of sciatic nerve block on postoperative pain in rats. Materials and methods Rop nanoparticles were developed using polyethylene glycol-co-polylactic acid (PELA). One hundred and twenty adult male Wistar rats were randomly divided into four groups (n=30, each): Con (control group; 0.9% saline, 200 µL), PELA (PELA group; 10 mg), Rop (Rop group; 0.5%, 200 µL), and Rop-PELA (Rop-PELA group; 10%, 10 mg). Another 12 rats were used for the detection of Rop concentration in plasma. The mechanical withdrawal threshold and thermal withdrawal latency were measured at 2 hours, 4 hours, 8 hours, 1 day, 2 days, 3 days, 5 days, and 7 days after incision. The expression of c-FOS was determined by immunohistochemistry at 2 hours, 8 hours, 48 hours, and 7 days. Nerve and organ toxicities were also evaluated at 7 days. Results The duration of Rop absorption in the plasma of the Rop-PELA group was longer (>8 hours) than that of the Rop group (4 hours). Mechanical withdrawal threshold and thermal withdrawal latency in the Rop-PELA group were higher than that in other groups (4 hours–3 days). c-FOS expression in the Rop-PELA group was lower than that in the control group at 2 hours, 8 hours, and 48 hours and lower than that in the Rop group at 8 hours and 48 hours after paw incision. Slight foreign body reactions were observed surrounding the sciatic nerve at 7 days. No obvious pathophysiological change was found in the major organs after Rop-PELA administration at 7 days. Conclusion Rop-PELA provides an effective analgesia for nerve block over 3 days after single administration, and the analgesic mechanism might be mediated by the regulation of spinal c-FOS expression. However, its potential long-term tissue toxicity needs to be further investigated.

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Epinephrine Increases the Neurotoxic Potential of Intrathecally Administered Lidocaine in the Rat

Abstract: The neurotoxicity of intrathecally administered lidocaine is increased by the addition of epinephrine. When making clinical recommendations for maximum safe intrathecal dose of this anesthetic, one may need to consider whether the solution contains epinephrine.

Cited by 63 publications

References 1 publication

Inclusion of epinephrine to hyperbaric tetracaine and the supine position enhance the cephalad spread of spinal anaesthesia compared with hyperbaric teracaine alone in the lithotomy position

Inclusion of epinephrine to hyperbaric tetracaine and the supine position enhance the cephalad spread of spinal anaesthesia compared with hyperbaric teracaine alone in the lithotomy position

Pharmacokinetic and local toxicity studies of liposome-encapsulated and plain mepivacaine solutions in rats

Long-term effect of ropivacaine nanoparticles for sciatic nerve block on postoperative pain in rats

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