Adjuvanzien in der modernen Anästhesie – Lidocain

Zusammenfassung

Neben ihren bekannten antinozizeptiven und antiarrhythmischen Eigenschaften, zeigen Lokalanästhetika sogenannte alternative natriumkanalunabhängige Effekte. Hierbei stehen ihre antiinflammatorischen Eigenschaften im Vordergrund, die zumindest teilweise ihre benefiziellen Effekte nach systemischer Gabe im perioperativen Bereich erklären könnten. So reduziert die kontinuierliche intravenöse Gabe von Lidocain postoperative Schmerzen, beschleunigt die Rückkehr der gastrointestinalen Funktion und verkürzt die Krankenhausverweildauer in abdominalchirurgischen Patienten.

Abstract

Local anesthetics (LA) are well known for their antinociceptive and antiarrhythmic properties, but exert alternative effects, i.e. anti-inflammatory activity, as well. These immunomodulatory properties might contribute to the beneficial effects observed in the clinical setting, when intravenous lidocaine is given perioperatively. Systemic LA were shown to attenuate postoperative pain, accelerate the return of bowel function and shorten length of hospital stay in patients undergoing abdominal surgery.

Schlüsselwörter:

Lidocain - intravenöse Gabe - perioperativ - antiinflammatorische Effekte

Key words:

lidocaine - intravenous administration - perioperative - anti-inflammatory effects

• Literatur

• 1 Butterworth JF, Strichartz GR. Molecular mechanisms of local anesthesia: a review. Anesthesiology 1990; 72: 711-734
• 2 Hollmann MW, Durieux ME. Local anesthetics and the inflammatory response: a new therapeutic indication?. Anesthesiology 2000; 93: 858-875
• 3 Groeben H, Silvanus MT, Beste M et al. Both intravenous and inhaled lidocaine attenuate reflex bronchoconstriction but at different plasma concentrations. Am J RespirCrit Care Med 1999; 159: 530-535
• 4 Wang D, Wu X, Li J, Xiao F, Liu X, Meng M. The effect of lidocaine on early postoperative cognitive dysfunction after coronary artery bypass surgery. AnesthAnalg 2002; 95: 1134-1141
• 5 Koppert W, Weigand M, Neumann F et al. Perioperative intravenous lidocaine has preventive effects on postoperative pain and morphine consumption after major abdominal surgery. AnesthAnalg 2004; 98: 1050-1055
• 6 Herroeder S, Pecher S, Schonherr ME et al. Systemic lidocaine shortens length of hospital stay after colorectal surgery: a double-blinded, randomized, placebo-controlled trial. Ann Surg 2007; 246: 192-200
• 7 Gallos G, Jones DR, Nasr SH et al. Local anesthetics reduce mortality and protect against renal and hepatic dysfunction in murine septic peritonitis. Anesthesiology 2004; 101: 902-911
• 8 Hollmann MW, Wieczorek K, Smart M et al. Epidural anesthesia prevents postoperative hypercoagulation in patients undergoing major orthopedic surgery. RAPM 2001; 26: 215-222
• 9 Cooke ED, Bowcock SA, Lloyd MJ, Pilcher MF. Intravenous lignocaine in prevention of deep venous thrombosis after elective hip surgery. Lancet 1977; 2: 797-799
• 10 Picardi S, Cartillieri S, Hahnenkamp K et al. Local anesthetic induced inhibition of human neutrophil priming: the influence of structure, lipophilicity and charge. RegAnesth Pain Med 2013; 38: 9-15
• 11 Berger C, Rossaint J, Van Aken H et al. Lidocaine reduces neutrophil recruitment by abolishing chemokine-induced arrest and transendothelial migration in septic patients. J Immunol 2014; 192: 367-376
• 12 Kiefer RT, Ploppa A, Krueger WA et al. Local anesthetics impair human granulocyte phagocytosis activity, oxidative burst, and CD11b expression in response to Staphylococcus aureus. Anesthesiology 2003; 98: 842-848
• 13 Hollmann MW, Gross A, Jelacin N et al. Local anesthetic effects on priming and activation of human neutrophils. Anesthesiology 2001; 95: 113-122
• 14 Hollmann MW, Wieczorek KS, Berger A et al. Local anesthetic inhibition of G protein-coupled receptor signaling by interference with Gq protein function. MolPharmacol 2001; 59: 294-301
• 15 Wettschureck N, Offermanns S. Mammalian G proteins and their cell type specific functions. PhysiolRev 2005; 85: 1159-1204
• 16 Werdehausen R, Kremer D, Brandenburger T et al. Lidocaine metabolites inhibit glycine transporter 1: a novel mechanism for the analgesic action of systemic lidocaine?. Anesthesiology 2012; 116: 147-158
• 17 Gronwald C, Vegh V, Hollmann MW et al. The inhibitory potency of local anesthetics on NMDA receptor signalling depends on their structural features. Eur J Pharmacol 2012; 674: 13-19
• 18 Drachman D, Strichartz G. Potassium channel blockers potentiate impulse inhibition by local anesthetics. Anesthesiology 1991; 75: 1051-1061
• 19 Meuth SG, Budde T, Kanyshkova T et al. Contribution of TWIK-related acid-sensitive K+ channel 1 (TASK1) and TASK3 channels to the control of activity modes in thalamocortical neurons. J Neurosci 2003; 23: 6460-6469
• 20 Hollmann MW, Strumper D, Durieux ME. The poor man's epidural: systemic local anesthetics for improving postoperative outcomes. Med Hypotheses 2004; 63: 386-389
• 21 Marret E, Rolin M, Beaussier M, Bonnet F. Meta-analysis of intravenous lidocaine and postoperative recovery after abdominal surgery. Br J Surg 2000; 95: 1331-1338
• 22 Vigneault L, Turgeon AF, Côté D et al. Perioperative intravenous lidocaine infusion for postoperative pain control: a meta-analysis of randomized controlled trials. Can J Anaesth 2011; 58: 22-37
• 23 Sun Y, Li T, Wang N, Yun Y, Gan TJ. Perioperative systemic lidocaine for postoperative analgesia and recovery after abdominal surgery: a meta-analysis of randomized controlled trials. Dis Colon Rectum 2012; 55: 1183-1194
• 24 McCarthy GC, Megalla SA, Habib AS. Impact of intravenous lidocaine infusion on postoperative analgesia and recovery from surgery: a systematic review of randomized controlled trials. Drugs 2010; 70: 1149-1163
• 25 Wuethrich PY, Romero J, Burkhard FC, Curatolo M. No benefit from perioperative intravenous lidocaine in laparoscopic renal surgery: a randomised, placebo-controlled study. Eur J Anaesthesiol 2012; 29: 537-534
• 26 Bryson GL, Charapov I, Krolczyk G et al. Intravenous lidocaine does not reduce length of hospital stay following abdominal hysterectomy. Can J Anaesth 2010; 57: 759-756
• 27 Basbaum AI, Bautista DM, Scherrer G et al. Cellular and molecular mechanisms of pain. Cell 2009; 139: 267-284
• 28 Little JW, Doyle T, Salvemini D. Reactive nitroxidative species and nociceptive processing: determining the roles for nitric oxide, superoxide, and peroxynitrite in pain. Amino Acids 2012; 42: 75-94
• 29 Sugimoto M, Uchida I, Mashimo T. Local anaesthetics have different mechanisms and sites of action at the recombinant N-methyl-D-aspartate (NMDA) receptors. Br J Pharmacol 2003; 138: 876-882
• 30 Werdehausen R, Kremer D, Brandenburger T et al. Lidocaine metabolites inhibit glycine transporter 1: a novel mechanism for the analgesic action of systemic lidocaine?. Anesthesiology 2012; 116: 147-158
• 31 Barreveld A, Witte J, Chahal H et al. Preventive analgesia by local anesthetics: the reduction of postoperative pain by peripheral nerve blocks and intravenous drugs. AnesthAnalg 2013; 116: 1141-1161
• 32 Grigoras A, Lee P, Sattar F et al. Perioperative intravenous lidocaine decreases the incidence of persistent pain after breast surgery. Clin J Pain 2012; 28: 567-572
• 33 Farag E, Ghobrial M, Sessler DI et al. Effect of perioperative intravenous lidocaine administration on pain, opioid consumption, and quality of life after complex spine surgery. Anesthesiology 2013; 119: 932-940
• 34 Bauer AJ, Boeckxstaens GE. Mechanisms of postoperative ileus. NeurogastroenterolMotil 2004; 16 (Suppl. 02) 54-60
• 35 Groudine SB, Fisher HAG, Kaufman RP et al. Intravenous lidocaine speeds the return of bowel function, decreases postoperative pain, and shortens hospital stay in patients undergoing radical retropubic prostatectomy. AnesthAnalg 1998; 86: 235-239
• 36 Cruickshank AM, Fraser WD, Burns HJ et al. Response of serum interleukin-6 in patients undergoing elective surgery of varying severity. ClinSci (Lond) 1990; 79: 161-165
• 37 McKay A, Gottschalk A, Ploppa A et al. Systemic lidocaine decreased the perioperative opioid analgesic requirements but failed to reduce discharge time after ambulatory surgery. AnesthAnalg 2009; 109: 1805-1808
• 38 De Oliveira Jr GS, Fitzgerald P, Streicher LF et al. Systemic lidocaine to improve postoperative quality of recovery after ambulatory laparoscopic surgery. AnesthAnalg 2012; 115: 262-267
• 39 Swenson BR, Gottschalk A, Wells LT et al. Intravenous lidocaine is as effective as epidural bupivacaine in reducing ileus duration, hospital stay, and pain after open colon resection: a randomized clinical trial. RegAnesth Pain Med 2010; 35: 370-376
• 40 Wongyingsinn M, Baldini G, Charlebois P et al. Intravenous lidocaine versus thoracic epidural analgesia: a randomized controlled trial in patients undergoing laparoscopic colorectal surgery using an enhanced recovery program. RegAnesth Pain Med 2011; 36: 241-248
• 41 Staikou C, Avramidou A, Ayiomamitis GD et al. Effects of intravenous versus epidural lidocaine infusion on pain intensity and bowel function after major large bowel surgery: a double-blind randomized controlled trial. J GastrointestSurg 2014; 18: 2155-2156
• 42 Park WY, Thompson JS, Lee KK. Effect of epidural anesthesia and analgesia on perioperative outcome: a randomized, controlled Veterans Affairs cooperative study. Ann Surg 2001; 234: 560-569
• 43 Di Rosa M, Giroud JP, Willoughby DA. Studies on the mediators of the acute inflammatory response induced in rats in different sites by carrageenan and turpentine. J Pathol 1971; 104: 15-29
• 44 Powell DM, Rodehaever GT, Foresman PA et al. Damage to tissue defenses by EMLA cream. J Emerg Med 1991; 9: 205-9
• 45 Snyder GL, Greenberg S. Effect of anaesthetic technique and other perioperative factors on cancer recurrence. Br J Anaesth 2010; 105: 106-115
• 46 Schlagenhauff B, Ellwanger U, Breuninger H et al. Prognostic impact of the type of anaesthesia used during the excision of primary cutaneous melanoma. Melanoma Res 2000; 10: 165-159
• 47 Exadaktylos AK, Buggy DJ, Moriarty DC et al. Can anesthetic technique for primary breast cancer surgery affect recurrence or metastasis?. Anesthesiology 2006; 105: 660-664
• 48 Lirk P, Picardi S, Hollmann MW. Local anaesthetics: 10 essentials. Eur J Anaesthesiol 2014; 31: 575-585
• 49 Piegeler T, Votta-Velis EG, Bakhshi FR et al. Endothelial barrier protection by local: ropivacaine and lidocaine block tumor necrosis factor-alpha-induced endothelial cell Src activation. Anesthesiology 2014; 120: 1414-1428
• 50 Lirk P, Hollmann MW, Fleischer M et al. Lidocaine and ropivacaine, but not bupivacaine, demethylate deoxyribonucleic acid in breast cancer cells in vitro. Br J Anaesth 2014; 113 (Suppl. 01) 32-38