Guangyi Zhao1, Xudong Ding1, Yao Guo1, Weimin Chen2. 1. Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang 110004, China. 2. Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang 110004, China. Electronic address: zhaobaisong819@163.com.
Abstract
AIMS: The study aims to investigate the neurotoxicity induced by combined use of intrathecal lidocaine with bupivacaine and ropivacaine, and to examine the effect of nerve growth factor (NGF) on lidocaine-induced neurotoxicity. MAIN METHODS: All rats received intrathecal infusion of anesthetics and NGF. To study the neurotoxicity of combined use of lidocaine with bupivacaine and ropivacaine, rats received saline, 5% lidocaine, 1.065% bupivacaine, 1.5% ropivacaine, 5% lidocaine+bupivacaine, or 5% lidocaine+1.5% ropivacaine. To study the neurotoxicity of different proportions of lidocaine and bupivacaine, mixtures were made by mixing 10% lidocaine and 2.5% bupivacaine in ratios of 1:3, 1:2, 1:1, 2:1 and 3:1 by volume. To study the effect of NGF on lidocaine-induced neurotoxicity, rats received saline or 10 μg NGF for 1, 2, 5 and 8 days. KEY FINDINGS: The neurotoxicity of lidocaine was significantly increased when combined with ropivacaine. A mixture of lidocaine and bupivacaine in a ratio of ≤1:1 did not significantly increase lidocaine-induced neurotoxicity. NGF significantly reduced lidocaine-induced neurobehavioral and morphological damage in the spinal cord. This was accompanied by downregulation of caspase 3 expression. SIGNIFICANCE: Ropivacaine is not safe when intrathecally administered with lidocaine at the concentrations used in this study. Bupivacaine may be safely used with lidocaine at a ratio of 1:1. NGF can reduce lidocaine-induced neurotoxicity, possibly via inhibition of caspase 3-mediated apoptosis.
AIMS: The study aims to investigate the neurotoxicity induced by combined use of intrathecal lidocaine with bupivacaine and ropivacaine, and to examine the effect of nerve growth factor (NGF) on lidocaine-induced neurotoxicity. MAIN METHODS: All rats received intrathecal infusion of anesthetics and NGF. To study the neurotoxicity of combined use of lidocaine with bupivacaine and ropivacaine, rats received saline, 5% lidocaine, 1.065% bupivacaine, 1.5% ropivacaine, 5% lidocaine+bupivacaine, or 5% lidocaine+1.5% ropivacaine. To study the neurotoxicity of different proportions of lidocaine and bupivacaine, mixtures were made by mixing 10% lidocaine and 2.5% bupivacaine in ratios of 1:3, 1:2, 1:1, 2:1 and 3:1 by volume. To study the effect of NGF on lidocaine-induced neurotoxicity, rats received saline or 10 μg NGF for 1, 2, 5 and 8 days. KEY FINDINGS: The neurotoxicity of lidocaine was significantly increased when combined with ropivacaine. A mixture of lidocaine and bupivacaine in a ratio of ≤1:1 did not significantly increase lidocaine-induced neurotoxicity. NGF significantly reduced lidocaine-induced neurobehavioral and morphological damage in the spinal cord. This was accompanied by downregulation of caspase 3 expression. SIGNIFICANCE: Ropivacaine is not safe when intrathecally administered with lidocaine at the concentrations used in this study. Bupivacaine may be safely used with lidocaine at a ratio of 1:1. NGF can reduce lidocaine-induced neurotoxicity, possibly via inhibition of caspase 3-mediated apoptosis.
Authors: María S Sisti; Carolina N Zanuzzi; Fabián Nishida; Rodolfo J C Cantet; Enrique L Portiansky Journal: Neurochem Res Date: 2018-09-08 Impact factor: 3.996
Authors: Mark Verlinde; Markus W Hollmann; Markus F Stevens; Henning Hermanns; Robert Werdehausen; Philipp Lirk Journal: Int J Mol Sci Date: 2016-03-04 Impact factor: 5.923