The Main Effect Of Lidocaine
What is lidocaine?
It is a local anesthetic sodium channel blocker that has membrane-stabilizing effects and is used against ventricular arrhythmias; It also has the regulatory function of the immune system, plays an anti-inflammatory role in multiple links of inflammatory response, its significant inhibition of inflammatory response, acute lung injury, anti-cancer drug sensitization effect, antibacterial, often used in clinical brain protection and reduce postoperative cognitive dysfunction (POCD) and other aspects.
Antiarrhythmic effects of lidocaine:
Ridoca selectively acts on Purkinje fibroblasts and ventricular myocytes because of IB antiarrhythmic drugs, which slows down the 4-phase depolarizing rate, reduces the automaticity of Purkinje fibers, promotes K+ efflosion, shorens the duration of action potential and prolongs the effective refractory period. It is often used for the prevention and treatment of ventricular arrhythmia. Lidocaine can slow down cardiac conduction, inhibit cardiac contractility and reduce cardiac output. Lidocaine has been used in clinical antiarrhythmic treatment for a long time and has more experience. In the face of ventricular arrhythmia, clinicians often use lidocaine to control it, which has high effectiveness and safety
Lidocaine prevents an excessive inflammatory response:
Many studies have shown that lidocaine has a good preventive and therapeutic effect on inflammation induced by trauma or endotoxin. Lidocaine is a membrane stabilizer that inhibits the adhesion and aggregation of neutrophil granulocytes (PMN), reduces the release of oxygen free radicals and proteolytic enzymes, stabilizes cell membranes, regulates cytokines, and inhibits excessive inflammatory responses. The inflammatory mediators LB4 and Interleukin 1α (IL-1α) are both strong PMN chemoattractant, inducing PMN to bind, pellete, exudate, and produce superoxide, and cooperate with prostaglandin E2 to increase vascular permeability. In vitro, monocytes were incubated with different concentrations (2-20mol/L) of lidocaine, which significantly inhibited the release of LB4 and IL-1α. The micromolar concentration level of lidocaine could inhibit the release of histamine from leukocytes, mast cells and basophils, indicating that lidocaine could inhibit the release of some key inflammatory mediators. It acts as an anti-inflammatory, so most serum-free freezes contain it to reduce cell penetration and promote cell dormancy as soon as possible.
In clinical application, a number of studies have found that intraoperative intravenous infusion of lidocaine can regulate patients' immune function and accelerate patients' postoperative recovery. There are complications such as phlebitis in the process of PCIA, and adding lidocaine to the intravenous analgesia pump can effectively prevent phlebitis. Perioperative intravenous injection of low-dose lidocaine can reduce the inflammation caused by surgery and reduce the amide local anesthetics commonly used in surgery. Studies have shown that it has anti-inflammatory effects, and perioperative intravenous infusion of lidocaine can reduce postoperative pain, reduce the use of opioid analgesics, reduce inflammation, accelerate the recovery of gastrointestinal function and shorten the length of hospital stay of patients.
Antibacterial action of lidocaine
It has been reported that lidocaine can inhibit the adhesion and chemotactic process of granulocytes, and can inhibit intracellular bacteria. Studies have shown that local anesthetics inhibit the cell growth of E. coli and cause the outflow of cell contents and interfere with its respiration. In summary, the use of lidocaine for epidural anesthesia or long-term postoperative analgesia can prevent the growth of microorganisms in the epidural space and catheter, which is safe and feasible. The mechanism of antibacterial activity of local anesthetics such as lidocaine is still unclear. It is possible that the interaction between local anesthetics and macromolecular substances on the surface of bacterial cells or cell membranes interferes with the cell membranes of eukaryotes and prokaryotes, changes the function of cell membranes, and leads to the death or growth inhibition of bacteria.
Some studies have shown that the antibacterial effect of lidocaine (0.5%-1.0%) and bupivacaine (0.125%-0.25%) is obvious at common clinical doses, and the antibacterial effect tends to increase with the increase of concentration. Moreover, 1% lidocaine can be considered to have a stronger bacteriostatic effect than 0.125% bupivacaine.
Brain protective effects of lidocaine
Lidocaine is easy to cross the blood-brain barrier and has membrane stabilization. While lidocaine can directly shrink the brain and systemic large blood vessels, it may reduce intracellular Na+ and Ca2+ concentrations by blocking Na+, K+ and Ca2+ channels, reduce ATP consumption, play a protective role in hypoxic nerve cells, reduce K+ outflow, inhibit the release of excitatory amino acids and oxygen free radicals to reduce brain tissue damage and improve cerebral blood flow. Play a brain protective role. Studies have shown that lidocaine can not only directly shrink the brain and the large blood vessels in the whole body, but also expand the cerebral microvessels at the trauma site, which can reduce cerebral oxygen metabolism, reduce anaerobic colysis, maintain the stability of blood sugar, and not prolong the postoperative recovery time.
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