Serum lidocaine concentration after epidural administration in dogs

Vnuk, Dražen; Lemo, Nikša; Radišić, Berislav; Nesek-Adam, Vesna; Musulin, Andrija; Kos, Josip

doi:10.17221/5569-vetmed

Cited by 6 publications

(10 citation statements)

References 14 publications

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“…Hence, such cardiac depression, at least in terms of the early phase, is unlikely to have been caused solely by the CEA of lidocaine. Plasma or serum lidocaine concentrations in humans and dogs reach a maximum at 10-15 min after a single epidural administration [17,19]. We did not measure plasma concentrations within 30 min of starting CEA and thus could not determine the maximum plasma concentration.…”

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confidence: 97%

“…Loading injections in the MD group involved doses of 4 mg/kg; such doses are widely considered to maintain clinical analgesic effects for approximately 2 hr in dogs under epidural analgesia [9]. Vnuk et al [19] reported that a single epidural injection of 4 mg/kg lidocaine rarely influenced HR and blood pressure in dogs anesthetized with isoflurane. Because our regimen included CEA after a loading injection, our parameters and theirs cannot be directly compared; however, HR and blood pressure in the MD and HD groups decreased rapidly immediately after the loading injection (Fig.…”

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Plasma Concentration and Cardiovascular Effects of Lidocaine during Continuous Epidural Administration in Dogs Anesthetized with Isoflurane

Sakonju

Maeda

Karasawa³

et al. 2011

The Journal of Veterinary Medical Science

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ABSTRACT. The cardiovascular effects of continuous epidural administration (CEA) of lidocaine were investigated in anesthetized dogs. Loading epidural injections of 2, 4, or 6 mg/kg of lidocaine were followed by CEA with 1, 2, or 3 mg/kg/hr lidocaine, respectively, for 2 hr under 2.0% isoflurane anesthesia. Heart rate, direct blood pressure, cardiac index, and stroke volume decreased dose-dependently during CEA, whereas systemic vascular resistance did not significantly differ with dose, and no characteristic changes were observed in any groups. Plasma lidocaine concentration reached a steady state during CEA and increased in a dose-dependent manner. Circulatory suppression caused by lidocaine CEA was not attributable to peripheral vasodilation, but rather to the direct cardiac action of systemic lidocaine absorption from the peridural space.KEY WORDS: canine, continuous epidural administration, lidocaine.J. Vet. Med. Sci. 73(3): 393-398, 2011 Perioperative pain is often managed using local anesthetics, the main side effects of which depend on blood concentrations and occur through cardiovascular and central nervous system toxicities [14]. Blood concentrations of local anesthetics in vivo are influenced by absorption and elimination rates, as well as by dose [18]. Therefore, the absorption characteristics of drugs at administration sites should be considered when investigating the safety of local anesthetics.Local epidural anesthesia induces peripheral vasodilation due to sympathetic block of the spinal cord segments, and it reduces cardiac output and blood pressure due to a decrease in cardiac perfusion [2,13]. Local anesthetics are absorbed after epidural administration via the venous plexus or lymphatic system into the systemic circulation, and they reduce conduction velocity and contractile force via direct cardiac toxicity [8,13]. Therefore, cardiovascular safety after epidural administration of local anesthetics should be investigated from the viewpoint of changes in peripheral circulation in addition to direct cardiac toxicity, depending on blood levels.Veterinarians frequently induce epidural analgesia using lidocaine [9]. However, repeated or continuous administration is required to sustain analgesia, because lidocaine is short acting. A safe dosage regimen for continuous epidural administration (CEA) of lidocaine in humans has been established [5,17]. However, little is understood about the safety of continuous epidural lidocaine administration in dogs.The present study investigated the cardiovascular effects of various lidocaine dosages in dogs anesthetized with isoflurane. Plasma concentrations during lidocaine CEA were simultaneously measured in order to estimate its impact on the central nervous system. The Institutional Animal Care and Use Committee of Kitasato University approved all protocols in the present study, which were repeated in 7 clinically healthy beagles (4 males and 3 females; body weight, 9.0-12.0 kg) at intervals of at least 7 days. All animals were deprived of food and water fo...

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Plasma Concentration and Cardiovascular Effects of Lidocaine during Continuous Epidural Administration in Dogs Anesthetized with Isoflurane

Sakonju

Maeda

Karasawa³

et al. 2011

The Journal of Veterinary Medical Science

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“…A study conducted by Sakonju (15) investigated the effects of continuous epidural administration of lidocaine (3 mg/kg) in dogs anesthetized with isofl urane and they found that HR and MAP signifi cantly decreased immediately after epidural administration of lidocaine. Vnuk et al (16) showed that epidural administration of lidocaine (4 mg/kg) in dogs under isofl urane anesthesia had no signifi cant changes on HR and MAP. In the present study, we observed declines in cardiovascular parameters following the administration of epidural anesthesia.…”

Section: Fig 1 Cortisol Levels In Fentanyl and Lidocaine Groupsmentioning

confidence: 99%

Comparison of the effects of lidocaine and fentanyl in epidural anesthesia in dogs

Saritas¹,

Sarıtaş²,

Pamuk³

et al. 2014

BLL

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Abstract:The study included 12 clinically healthy, adult male dogs of various breeds, admitted to our clinic for castration. After general anesthesia with sevofl urane, we administered epidural fentanyl (1 mcg/kg) to fentanyl group, while lidocaine group was given Lidocaine (3 mg/kg) through epidural administration. When hemodynamic parameters were stabilized, fi rst measurements were recorded at minutes 0, 15, 30, 60 in both groups, which included Heart Rate (HR), body temperature, systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), sodium (Na + ), potassium (K + ), glucose (GLC), and hemoglobin (HB) measurements. In addition, serum samples were obtained from arterial blood at the same measurement times, and pH, pO 2 , pCO 2 , HCO 3 , %O 2 Saturation, BE levels were measured. For hematological analysis, WBC, RBC, HCT, THR counts were performed. For serum biochemical analysis, venous blood samples were collected at minutes 0 and 60 and CK, TP, UREA, ALT, AST, ALB, GGT, CRE, CK-MB parameters were assessed using auto-analyzer. Moreover, cortisol levels were measured in the samples collected at minutes 0, 30, and 60. Mean arterial blood pressure values measured at minutes 15, 30 and 60 were found signifi cantly lower in the fentanyl group (p<0.01). In conclusion, we suggest that epidural anesthesia with lidocaine and fentanyl can provide an effective and safe option in high-risk groups (Tab. 5, Fig. 1, Ref. 24). Text in PDF www.elis.sk.

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“…On the other hand, absorption of local anaesthetics from the site of infiltration into the systemic circulation could lead to toxic effects, mainly concerning the central nervous system (CNS) (excitation, convulsions, CNS depression and respiratory arrest) and the cardiovascular system (hypotension, arrhythmia, myocardial depression and cardiac arrest) (Liu et al ., ). The degree of toxicity is a function of the peak plasma concentration reached which, in turn, depends on the dose administered, the route of administration, the rate of systemic absorption and the metabolism and elimination of the drug (Vnuk et al ., ).…”

Section: Introductionmentioning

confidence: 97%

“…However, Vnuk et al . () pointed out that signs of neurotoxicity of lidocaine might be masked in dogs undergoing general anaesthesia.…”

Section: Introductionmentioning

confidence: 99%

Intra‐articular administration of lidocaine in anaesthetized dogs: pharmacokinetic profile and safety on cardiovascular and nervous systems

Salvo

Bufalari

Monte

et al. 2014

Vet Pharm & Therapeutics

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The intra-articular administration of lidocaine is a frequent practice in human orthopaedic surgical procedures, but an eventual absorption of the drug into the bloodstream can lead to toxicity, mainly concerning the central nervous system and the cardiovascular systems. The purpose of this study was to determine the pharmacokinetic profile and the safety, in terms of cardiovascular and CNS toxicity, of lidocaine after intra-articular administration to anesthetized dogs undergoing arthroscopy. Lidocaine 2% was administered to eight dogs before surgery in differing amounts, depending on the volume of the joints involved, and blood samples were taken at predetermined time points. The maximum serum concentration of lidocaine ranged from 0.50 to 3.01 μg/mL (mean ± SD: 2.18 ± 0.91 μg/mL), and the time to reach it was 28.75 ± 15.74 min. No signs of cardiac toxicity were detected during the entire procedure, and possible signs of CNS toxicity were masked by the anaesthesia. However, concentrations reported in literature as responsible for neurotoxicity in dog were achieved in three of eight investigated subjects. Pending further studies, veterinarians should consider the possibility of side effects occurring following the intra-articular administration of local anaesthetics.

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Serum lidocaine concentration after epidural administration in dogs

Cited by 6 publications

References 14 publications

Plasma Concentration and Cardiovascular Effects of Lidocaine during Continuous Epidural Administration in Dogs Anesthetized with Isoflurane

Plasma Concentration and Cardiovascular Effects of Lidocaine during Continuous Epidural Administration in Dogs Anesthetized with Isoflurane

Comparison of the effects of lidocaine and fentanyl in epidural anesthesia in dogs

Intra‐articular administration of lidocaine in anaesthetized dogs: pharmacokinetic profile and safety on cardiovascular and nervous systems

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