ANESTHETIC LIDOCAINE INHIBITS CHOLINERGIC CONTRACTION OF THE MOUSE SMALL INTESTINE AND CAUSES DISORDERS OF THE HUMAN GASTROINTESTINAL TRACT

O.S. Savuliak, I.A. Sukha, D.О. Dziuba, M.I. Melnyk, D. Dryn
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Abstract

Lidocaine is one of the components of multimodal low-opioid anesthesia, which is commonly used in surgical procedures, especially in cardiac surgery. Lidocaine has been used in medicine for a long time as a local anesthetic, but after the invention of the method of its intravenous administration, questions arose about its possible side effects on the visceral system, in particular on the motility of the gastrointestinal tract. Therefore, the aim of our work was to investigate the main aspects of the use of lidocaine-based opioid-free anesthesia and its side effects and also to study the effect of lidocaine on the contractile activity of small intestine smooth muscle, namely the mouse ileum. We recorded the contractile activity of smooth muscles of the ileum of mice using the tensiometry method and found that lidocaine at the clinically relevant concentration range, i.e. 1.5, 3, and 5 μg/ml, inhibited carbachol-induced contractions by 16, 27 and 37%, respectively (n = 7). To determine the side effects of opioid-free anesthesia, we studied 60 patients with coronary artery disease undergoing coronary artery stenting with the administration of anesthesia based on lidocaine solution at different concentrations (1 and 2 mg/kg). The side effects included nausea and vomiting, which may indicate а disturbance of gastrointestinal motility, as well as numbness of the limbs, cheeks, tongue, etc. These results contribute to a better understanding of the spectrum of action of lidocaine, a popular anesthetic in surgery, on the visceral system and become an important basis for the future development of new schemes for the use of local anesthetics in clinical practice, particularly in surgical procedures.
麻醉剂利多卡因能抑制小鼠小肠的胆碱能收缩,并导致人类胃肠道功能紊乱
利多卡因是多模式低阿片麻醉的成分之一,常用于外科手术,尤其是心脏手术。利多卡因作为局麻药在医学中应用已久,但在发明了静脉注射方法后,人们对其可能对内脏系统,特别是胃肠道蠕动产生的副作用产生了疑问。因此,我们工作的目的是研究基于利多卡因的无阿片麻醉的主要方面及其副作用,同时研究利多卡因对小肠平滑肌(即小鼠回肠)收缩活动的影响。我们用张力测定法记录了小鼠回肠平滑肌的收缩活动,发现利多卡因在临床相关浓度范围内,即1.5、3和5微克/毫升,对卡巴胆碱引起的收缩的抑制率分别为16%、27%和37%(n = 7)。为了确定无阿片类药物麻醉的副作用,我们对 60 名接受冠状动脉支架手术的冠心病患者进行了研究,使用不同浓度(1 毫克/千克和 2 毫克/千克)的利多卡因溶液进行麻醉。副作用包括恶心和呕吐,这可能表明胃肠道运动紊乱,以及四肢、脸颊、舌头等部位麻木。这些结果有助于更好地了解利多卡因这种外科常用麻醉剂对内脏系统的作用谱,为今后在临床实践中,特别是在外科手术中使用局麻药制定新方案奠定了重要基础。
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