Abstract
The purpose of this study was to determine whether lidocaine was displaced from the lung after bolus injection of bupivacaine. Fourteen anaesthetized rabbits were randomly assigned to either a bupivacaine or a control group. Lidocaine was infused at a rate of 10 mg · kg−1 hr−1. After one hour of infusion, a bolus of bupivacaine (1 mg · kg−1) in normal saline (0.2 ml · kg−1) was injected into the central venous circulation in the bupivacaine group. The control group was injected with normal saline. After bolus injection, arterial blood samples were collected serially from an internal carotid artery at 1.2-sec intervals for 24 sec. The baseline concentration of lidocaine was 3.0 ±0.1 μg · ml−1 in the bupivacaine group and 3.2 ±0.1 μg · ml-1 in the control group (NS). Arterial concentrations of lidocaine increased to a maximum of 4.7 ±0.2 μg · ml−1 in the bupivacaine group (P = 0.0001). No increases were seen in the control group. These findings indicate that lidocaine was displaced from the lung into the blood after bolus injection of bupivacaine. The amount of lidocaine displaced during the first passage of bupivacaine through the lung was calculated to be 92.3 ±9.7 μg. It is concluded that lidocaine is displaced from the lung after bolus injection of bupivacaine.
Résumé
Cette étude vise à déterminer si la lidocaïne est déplacée du poumon après un bolus de bupivacaïne. Quatorze lapins anesthésiés sont répartis au hasard entre un groupe bupivacaïne et un groupe contrôle. La lidocaïne est perfusée à la vitesse de 10 mg · kg−1 hr−1. Dans le groupe bupivacaïne, après une heure de perfusion, un bolus de bupivacaïne (1 mg · kg−1) dans du soluté physiologique (0,2 ml · kg−1) est injecté dans la circulation veineuse centrale. Le groupe contrôle ne reçoit que du physiologique. Après l’injection du bolus, on recueille des échantillons de sang artériel en série par la carotide interne à des intervalles de 1,2 sec pendant 24 sec. La concentration initiale de lidocaïne est de 3,0 ±0,1 μg · ml−1 dans le groupe bupivacaïne et de 3,2 ±0,1 μg · ml−1 dans le groupe contrôle (NS). Les concentrations artérielles de lidocaïne augmentent jusqu’à un maximum de 4,7 ±0,2 μg · ml−1 dans le groupe bupivacaïne (P = 0,0001). On ne trouve pas d’augmentation dans le groupe contrôle. Ces résultats indiquent que la lidocaïne est déplacée du poumon vers le sang après un bolus de bupivacaine. La quantité déplacée calculée lors du premier passage est de 92,3 ±9,7 μg. On conclut que la lidocaïne est déplacée du poumon après une injection en bolus de bupivacaïne.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Nunn JE Non-respiratory functions of the lung. In: Nunn JE Applied Respiratory Physiology, 3rd ed., London: Butterworth & Co. Ltd., 1987: 284–93.
Tucker GT, Boas RA. Pharmacokinetic aspects of intravenous regional anesthesia. Anesthesiology 1971; 34: 538–49.
Bertler Å, Lewis DH, Löfström JB, Post C. In vivo lung uptake of lidocaine in pigs. Acta Anaesthesiol Scand 1978; 22: 530–6.
Jorfeldt L, Lewis DH, Löfström JB, Post C. Lung uptake of lidocaine in healthy volunteers. Acta Anaesthesiol Scand 1979; 23: 567–74.
Rothstein P, Cole JS, Pitt BR. Pulmonary extraction of [3H] bupivacaine: modification by dose, propranolol and interaction with [14C] 5-hydroxytryptamine. J Pharmacol Exp Ther 1987; 240: 410–4.
Post C, Andersson RGG, Ryrfeldt Å, Nilsson E. Physicochemical modification of lidocaine uptake in rat lung tissue. Acta Pharmacol Toxicol 1979; 44: 103–9.
Adams RF, Vandemark FL, Schmidt G. The simultaneous determination of lidocaine and procainamide in serum by use of high pressure liquid chromatography. Clin Chim Acta 1976; 69: 515–24.
Ross G. The cardiovascular system. In: Ross G (Ed.). Essentials of Human Physiology, 1st ed., Chicago: Year Book Medical Publishers Inc., 1978: 96–243.
Post C, Lewis DH. Displacement of nortriptyline and uptake of14C-lidocaine in the lung after administration of14C-lidocaine to nortriptyline intoxicated pigs. Acta Pharmacol Toxicol 1979; 45: 218–24.
Jorfeldt L, Lewis DH, Löfström JB, Post C. Lung uptake of lidocaine in man as influenced by anaesthesia, mepivacaine infusion or lung insufficiency. Acta Anaesthesiol Scand 1983; 27: 5–9.
Bend JR, Serabjit-Singh CJ, Philpot RM. The pulmonary uptake, accumulation, and metabolism of xenobiotics. Annu Rev Pharmacol Toxicol 1985; 25: 97–125.
Roerig DL, Kotrly KJ Vucins EJ, Ahlf SB, Dawson CA, Kampine JP. First pass uptake of fentanyl, meperidine, and morphine in the human lung. Anesthesiology 1987; 67: 466–72.
Tucker GT, Mather LE. Properties, absorption, and disposition of local anesthetic agents. In: Cousins MJ, Bridenbaugh PO (Eds.). Neural Blockade in Clinical Anesthesia and Management of Pain, 2nd ed., Philadelphia: J B Lippincott Company, 1988: 47–110.
Roerig DL, Kotrly KJ, Ahlf SB, Dawson CA, Kampine JP. Effect of propranolol on the first pass uptake of fentanyl in the human and rat lung. Anesthesiology 1989; 71: 62–8.
Sjöstrand U, Widman B. Distribution of bupivacaine in the rabbit under normal and acidotic conditions. Acta Anaesthesiol Scand Suppl 1973; 50: 1–24.
Ellis H, Feldman S. Anatomy for Anaesthetists, 4th ed. Oxford: Blackwell Scientific Publications, 1983.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Ohmura, S., Yamamoto, K., Kobayashi, T. et al. Displacement of lidocaine from the lung after bolus injection of bupivacaine. Can J Anaesth 40, 676–680 (1993). https://doi.org/10.1007/BF03009706
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF03009706