Intrathecal mepivacaine and prilocaine are less neurotoxic than lidocaine in a rat intrathecal model

Regional Anesthesia and Pain Medicine
Tamie TakenamiSumio Hoka

Abstract

Histologic evidence of the comparative neurotoxicity of lidocaine, mepivacaine, and prilocaine is incomplete. We compared the intrathecal neurotoxicity in rats among these 3 drugs based on morphologic and neurofunctional findings. Rats (n=169) randomly received 0.12 microL/g of 0%, 2%, 5%, 7.5%, 10%, or 20% lidocaine, mepivacaine, or prilocaine or 25% glucose dissolved in distilled water via a chronically implanted intrathecal catheter. The effect of the agents on neurofunction was evaluated by movement of the hind limb (behavior test) and by sensory threshold (paw-stimulation test). The L1 spinal cord, the posterior and anterior roots, and the cauda equina were removed en bloc 5 days later and examined by light and electron microscopy. A significant decrease in sensory threshold or irreversible hind-limb limitation was observed only in rats receiving 20% lidocaine. Morphologic abnormalities characterized by axonal degeneration were observed in rats receiving > or =7.5% lidocaine, 20% mepivacaine, and 20% prilocaine, at the posterior white matter and the proximal portion of the posterior root just at the entrance into the spinal cord. The incidence of lesions was significantly higher in rats receiving lidocaine than mepivacaine...Continue Reading

References

Oct 1, 1985·Anesthesiology·L B ReadyS M Sumi
Nov 1, 1974·Anesthesia and Analgesia·H J AdamsG Kilpatrick
Jun 2, 2000·Regional Anesthesia and Pain Medicine·J C Rowlingson
Jun 5, 2001·Anesthesiology·S S Liu, S B McDonald
Jan 19, 2002·Regional Anesthesia and Pain Medicine·Tamie TakenamiSumio Hoka
Nov 2, 2002·Anesthesiology·Tomomune KishimotoKenneth Drasner
Dec 1, 1976·Physiology & Behavior·T L Yaksh, T A Rudy

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Citations

Mar 3, 2012·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Tamie TakenamiHirotsugu Okamoto
Feb 6, 2009·British Journal of Anaesthesia·G S NairF Chung
Jul 10, 2009·Regional Anesthesia and Pain Medicine·Tamie TakenamiSumio Hoka
Aug 23, 2011·Regional Anesthesia and Pain Medicine·Chen-Hwan CherngChun-Chang Yeh
Dec 29, 2012·Regional Anesthesia and Pain Medicine·Toshiaki KomatsuKazuo Yago
Dec 11, 2014·Regional Anesthesia and Pain Medicine·Tamie TakenamiTadashi Kawakami
Jul 23, 2014·Current Opinion in Anaesthesiology·Karl HamplHinnerk Wulf
Jul 6, 2020·Neuroscience Letters·Ying-Jen ChangYu-Wen Chen

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