Summary
The pharmacokinetics of lignocaine has been compared after epidural anaesthesia in diabetics and nondiabetic patients. Epidural lignocaine 8 mg · kg−1 was given to 8 well controlled Type II diabetic and 8 nondiabetic patients and the plasma drug concentration in serial blood samples were measured by HPLC.
The plasma level of lignocaine was lower in diabetics compared to non-diabetics. The peak level was attained at 20 min in both groups. The clearance of the drug was significantly higher, (39,9 vs 16,7 ml · min− · kg−) associated with a decreased elimination half-life and mean residence time.
The study suggests that the rate of absorption of lignocaine is not altered after epidural administration and that its hepatic metabolism is increased in diabetics compared to non-diabetics.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Atkinson M, Hosking DJ (1983) Gastrointestinal complications of diabetes mellitus. Clin Gastroenterol 12: 632–650
Pirttiaho HI, Salmela PI, Sotaniemi EA, Pelkonen RO, Pitkanen U, Luoma PV (1984) Drug metabolism in diabetic subjects with fatty livers. Br J Clin Pharmacol 18: 895–899
Adithan C, Srinivas B, Indhiresan J, Shashindran CH, Bapna JS, Thakur LC, Swaminathan RP (1991) Influence of type I and type II diabetes mellitus on phenytoin steady state levels. Int J Clin Pharmacol Ther Toxicol 129: 310–313
Flood JG, Bowers GN, McComb RB (1980) Simultaneous liquid chromatographic determination of three antiarrythmic drugs: disopyramide, lidocaine and quinidine. Clin Chem 26: 197–200
Gibaldi M (1984) Biopharmaceuticals and clinical pharmaco-kinetics, 3rd edn. Lea & Febiger, Philadelphia
Thomson PD, Melmon KL, Richardson JA, Cohn K, Steinbrunn W Cudihie R, Rowland M (1973) Lidocaine pharmacokinetics in advanced heart failure, liver disease and renal failure in humans. Ann Intern Med 78: 499–508
Blaschke TF (1977) Protein binding and kinetics of drugs in liver disease. Clin Pharmacokinet 2: 32–44
Adithan C, Danda D, Shashindran CH, Bapna JS, Swaminathan RP, Chandrasekar S (1989) Differential effect of type I and type II diabetes mellitus on antipyrine elimination. Methods Find Exp Clin Pharmacol 11: 755–758
Adithan C, Sriram G, Swaminathan RP, Krishnan M, Bapna JS, Chandrasekar S (1989) Effect of type II diabetes mellitus on theophylline elimination. Int J Clin Pharmacol Ther Toxicol 27: 258–260
Parving H-H, Viberti GC, Keen H, Christiansen JS, Lassen NA (1983) The haemodynamic origin of diabetic micro angiopathy. Metabolism 32: 943–949
Viberti GC (1983) Increased capillar permeability in diabetes mellitus and its relationship to microvascular angiopathy. Am J Med 75 [Suppl 5B]: 81–84
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Peeyush, M., Ravishankar, M., Adithan, C. et al. Altered pharmacokinetics of lignocaine after epidural injection in Type II diabetics. Eur J Clin Pharmacol 43, 269–271 (1992). https://doi.org/10.1007/BF02333021
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02333021