THE INFLUENCE OF CO2 AND pH ON LOCAL ANESTHETIC ACTION

Catchlove, Richard F. H.

doi:10.1097/00132586-197304000-00053

Cited by 27 publications

(29 citation statements)

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“…Acetylcholine has likewise been shown to act only on the outside of the endplate membrane (del Castillo & Katz, 1955). In contrast, the local anaesthetics probably act on the inside of the membrane (Narahashi, Yamada & Frazier, 1969;Strobel & Bianchi, 1970;Narahashi & Frazier, 1971;Catchlove, 1972;Strichartz, 1973). Batrachotoxin also appears to act only on the inner surface of the membrane (Narahashi, Albuquerque & Deguchi, 1971), where binding can be prevented by procaine (Albuquerque, Seyama & Narahashi, 1973).…”

Section: Discussionmentioning

confidence: 99%

Failure of Chronic Denervation to Alter the Sensitivity of the Rat Diaphragm to Local Anaesthetics or Quinidine

Harvey

Rang

1974

British J Pharmacology

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1The actions of procaine, nupercaine and quinidine on the membrane resting and action potentials of the normal and chronically denervated rat diaphragm were studied in vitro. 2 The degree of suppression of the rate of rise of the action potential by any of the drugs was the same in denervated as in normal muscle. 3 The degree of suppression of the rate of rise of the action potential by procaine in denervated muscle was about the same in the presence and absence of tetrodotoxin. 4 Three possible interpretations of the lack of effect of denervation on the response to these drugs are discussed:(a) In the sodium channel, the structural alteration that confers resistance to tetrodotoxin is quite limited and does not affect groups which interact with local anaesthetics.(b) Local anaesthetics are non-selective in their binding so that alteration in membrane structure around the channel has little influence on the efficiency of the local anaesthetic.(c) Denervation may affect the outer surface of the membrane, where acetylcholine and tetrodotoxin act, more than the intracellular surface, where local anaesthetics appear to act. 5 The slope of the log concentration-effect line for quinidine was steeper than that for procaine or nupercaine.

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Section: Discussionmentioning

confidence: 99%

Failure of Chronic Denervation to Alter the Sensitivity of the Rat Diaphragm to Local Anaesthetics or Quinidine

Harvey

Rang

1974

British J Pharmacology

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“…5 Carbonation of local anaesthetics does speed the onset of action in the isolated nerve preparation. 6 The action of local anaesthetics in the epidural space is not analogous, though, to an isolated nerve preparation. Bromage postulates that local anaesthetics placed in the epidural space act at several sites after passing through different diffusion pathways.~ Thus the advantage of carbonation of a local anaesthetic may be lost before reaching the principle sites of action when placed in the epidural space.…”

Section: Discussionmentioning

confidence: 99%

A double-blind comparison of carbonated lidocaine and lidocaine hydrochloride in epidural anaesthesia

Morison

1981

Canad. Anaesth. Soc. J.

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Twenty patients having a standard epidural anaesthetic were randomly assigned to receive 20ml of either carbonated lidocaine 1.73 per cent or lidocaine hydrochloride 2.0 per cent, containing epinephrine 1:200,000. An observer unaware of the solution used measured speed of onset, quality of block, and duration of action. No significant difference was demonstrated in the speed of onset or duration of the block. Carbonated lidocaine gave an improved motor block and showed a trend towards giving fewer missed segments than lidocaine hydrochloride.KEY WORDS: ANAESTHETIC TECHNIQUES, Regional, Epidural; ANAESTHETICS, Local, carbonated lidocaine.CARBONATED LIDOCAINE is reported to be an improvement over lidocaine hydrochloride with regard to speed of onset and quality of block when used in epidural anaesthesia.l.2 The objectives of this study were to compare the carbonated and hydrochloride preparations of lidocaine in epidural block with respect to speed of onset and quality of block achieved. Previous studies of carbonated lidocaine have not utilized a doubleblind design and thus were open to observer bias. In this study, both the patient and anaesthetist] observer were blinded as to the solution used. METHODSTwenty patients scheduled for lower abdominal or lower limb surgery, after giving informed consent, received an epidural block administered by one anaesthetist. The patients were randomly assigned to two groups receiving either 20 ml of carbonated lidocaine 1.73 per cent (equivalent to lidocaine hydrochloride 2 per cent) or 20 ml of lidocaine hydrochloride two per cent. Both solutions contained freshly added epinephrine to a concentration of 1:200,000 and were injected over approximately 45 seconds through a Tuohy needle positioned in the second lumbar epidural space as identified by a loss of resistance technique. The patient was immediately turned from a lateral to the supine position and the following measurements were made by an observer unaware of which solution had been used:

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“…Neonates have a much higher cardiac index than adults and that may exacerbate or mitigate the situation. The toxicity of local anaesthetics is related to the concentration of the free drug only (Catchlove 1972). It has been reported that serum protein binding affects the entry of lignocaine and bupivacaine into the central nervous system in experimental animals (Terasaki, Partridge & Denson 1986;Marathe et al 1991).…”

Section: Cns Toxicitymentioning

confidence: 99%

Local anaesthetic agents in infancy

1995

Pediatric Anesthesia

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THE INFLUENCE OF CO2 AND pH ON LOCAL ANESTHETIC ACTION

Cited by 27 publications

References 0 publications

Failure of Chronic Denervation to Alter the Sensitivity of the Rat Diaphragm to Local Anaesthetics or Quinidine

Failure of Chronic Denervation to Alter the Sensitivity of the Rat Diaphragm to Local Anaesthetics or Quinidine

A double-blind comparison of carbonated lidocaine and lidocaine hydrochloride in epidural anaesthesia

Local anaesthetic agents in infancy

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