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KMID : 0378019940370110019
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New Medical Journal
1994 Volume.37 No. 11 p.19 ~ p.27
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The Effects of Intravenous Lidocaine on the Neuromuscular Responses of Mivacurium administered by Priming Technic in Rabbits.
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Abstract
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Non-depolarizing neuromuscular blocking agents which have rapid onset and no side effects are essential for endotracheal intubation. Many authors, therefore, have tried to develop drugs and methods that fasten onset time of muscle relaxation.
Priming technic, a method of administration drugs by divided doses, has been used to fasten the onset of intermediate acting non-depolarizing neuromuscular agents such as vecuronium and atracurium, but the results have not been satisfactory.
Lidocaine is one of local anesthetics having antiarrhythmic action and has been used to prevent dysrhythmias, coughing and increasing of blood pressure during intubation.
It has also been known that lidocaine has potentiating effects of neuromuscular transmission.
Mivacurium is short acting non-depolarizing neuromuscular blocking agent and has good cardiovascular stability and no cumulative action , but it´s onset time of muscle relaxation is not short enough to use safely for intubation.
So we studied the effects of lidocaine on the onset time of muscle relaxation when mivacurium is administered by priming technic. Thirty-two rabbits which were divided into four groups; succinyl choline group (scc group, succinylcholine lmg/kg i. v.), mivacurium group (miva group, mivacurium 0.08 mg/kg i. v. single bolus), priming group (mivacurium 0.008 mg/kg and 0.072 mg/kg i. v. in divided doses 2min apart) , lidocaine group (mivacurium 0.008 mg/kg, lidocaine 2mg/kg, mivacurium 0.072 mg/kg i. v. 1 min apart). Train-of-four(TOF) responses of anterior tibial
muscle stimulated by supramaximal TOF stimuli of 2 Hz, 2 seconds and stimulation duration of 0.2 msec, and 10 sec interval, were recorded by polygraph (Grass model 7P, U.S. A.). Onset time. duration of muscle relaxation and recovery index (RI;time from T4/T1 25 % to T4/T1 75 %) were compared among the groups.
Results were as follows;
1. Onset time of muscle relaxation in lidocaine group (46.3 ± 8) l sec) was significantly short compared with miva group(69.9 ± 18.5 sec) and priming group (57.8 ± 6.6 sec) (P < 0.05), but no difference with scc group.
2. Duration of muscle relaxation in lidocaine group (361 + 95.2 sec) was significantly long compared with scc group (344 ± 124.Osec), miva group (290 ± 97.8sec) and priming group (332 ± 118.5 sec) ( P < 0.05).
3. Recovery Index of lidocaine group(150. 3 ± 22.1 sec) was significantly short compared with scc group(263 ± 135.4 sec) (P<0.05),but no differences among lidocaine group, miva group and priming group. Above results show that intravenous lidocaine i. v. can fasten the onset time of muscle relaxation and prolongate duration of muscle relaxation mivacurium administered by priming technnic
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