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Anesth Analg 2006;103:876-881
© 2006 International Anesthesia Research Society
doi: 10.1213/01.ane.0000237287.53957.18

ANESTHETIC PHARMACOLOGY

Epidural Lidocaine Induces Dose-Dependent Neurologic Injury in Rats

Tomoko Muguruma, MD, Shinichi Sakura, MD, and Yoji Saito, MD

From the Department of Anesthesiology, Shimane University School of Medicine, Izumo City, Japan.

Address correspondence and reprint requests to Dr. Muguruma, Department of Anesthesiology, Shimane University School of Medicine, 89-1 Enya-cho, Izumo City, 693-8501, Japan. Address e-mail to hamutaro{at}med.shimane-u.ac.jp.

Although epidural lidocaine administered as a bolus has been shown to cause little neurotoxicity, local anesthetics are often administered repetitively or continuously into the epidural space, and in high doses may induce neurologic injury. We investigated whether epidural lidocaine is neurotoxic when a large dose is continuously administered in rats, and whether the functional impairment and histologic damage is dose dependent. In Experiment 1, 13 rats received a 120-min epidural infusion (at 5 µL/min) of saline or 2% lidocaine. Four days after infusion, rats given 2% lidocaine developed significantly more prolonged tail-flick latencies and showed more apparent morphologic damage than those given saline. In Experiment 2, 41 rats were randomly divided into 5 groups to receive an epidural infusion of saline for 120 min or 5% lidocaine for 15, 30, 60, or 120 min at a rate of 5 µL/min. Rats given 5% lidocaine for 120 min developed a significant increase in tail-flick latency. Paw pressure thresholds did not change in any group. Nerve injury scores for rats given 5% lidocaine for 30, 60, and 120 min were significantly higher than those for rats given saline. Significant difference in damage in nerve roots was also observed among rats given the anesthetic for different durations of time; nerve injury scores with 120-min infusion were higher than with 15- and 30-min infusions, and injury with 60-min infusion was greater than with 15-min infusion. In conclusion, these results suggest that epidural lidocaine causes dose-dependent neurotoxicity after continuous infusion in rats.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2006 by the International Anesthesia Research Society.