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REGIONAL ANESTHESIA AND PAIN MANAGEMENT

The Anticonvulsant Effects of Volatile Anesthetics on Lidocaine-Induced Seizures in Cats

Department of Anesthesiology, Kansai Medical University Hospital, Moriguchi, Osaka, Japan

Address correspondence and reprint requests to Koh Shingu, MD, Department of Anesthesiology, Kansai Medical University Hospital, Fumizono-cho 10–15, Moriguchi, Osaka 570-8507, Japan. Address e-mail to shingu{at}takii.kmu.ac.jp

Large concentrations of sevoflurane and isoflurane, but not halothane, induce spikes in the electroencephalogram. To elucidate whether these proconvulsant effects affect lidocaine-induced seizures, we compared the effects of sevoflurane, isoflurane, and halothane in cats. Fifty animals were allocated to 1 of 10 groups: 70% nitrous oxide (N₂O), 0.6 minimum alveolar anesthetic concentration (MAC) + 70% N₂O, 1.5 MAC + 70% N₂O, and 1.5 MAC of each volatile agent in oxygen. Lidocaine 4 mg · kg^-1 · min^-1 was infused IV under mechanical ventilation with muscle relaxation. Electroencephalogram in the cortex, amygdala, and hippocampus and multiunit activities in the midbrain reticular formation (R-MUA) were recorded. Lidocaine induced spikes first from the amygdala or hippocampus in the 70% N₂O and halothane groups and from the cortex in the sevoflurane and isoflurane groups. Lidocaine induced seizures in all cats in the 70% N₂O and 0.6 MAC + N₂O groups. Seizure occurrence was reduced in the 1.5 MAC + N₂O group (P < 0.05 versus 70% N₂O). The onset of seizure was delayed in the 0.6 MAC + N₂O and 1.5 MAC groups for sevoflurane and isoflurane, but not for halothane, compared with the 70% N₂O group (P < 0.05). Lidocaine increased R-MUA with seizure by 130% ± 56% in the 70% N₂O group. The increase of R-MUA with seizure was more suppressed in the volatile anesthetic groups than in the 70% N₂O group (P < 0.05). In the present study, sevoflurane and isoflurane attenuated seizure when the blood lidocaine concentration was accidentally increased.

Implications: Increasingly, epidural blockade is combined with general anesthesia to achieve stress-free anesthesia and continuous pain relief in the postoperative period. In the present study, sevoflurane and isoflurane attenuated seizure when the blood lidocaine concentration was accidentally increased.

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