Local anesthetic neurotoxicity : Mechanisms and prevention
| Project/Area Number |
09671563
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Anesthesiology/Resuscitation studies
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| Research Institution | Shimane Medical University |
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Principal Investigator |
KIRIHARA Yumiko (1999) Shimane Medical University, Anesthesiology, Technical Official, 医学部, 教務職員 (90234400)
角 真理子 (1997-1998) 島根医科大学, 医学部, 助手 (70252939)
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| Co-Investigator(Kenkyū-buntansha) |
HASHIMOTO Keishi Shimane Medical University, Intensive care unit, Assistant Professor, 医学部, 講師 (60252920)
SAKURA Shinichi Shimane Medical University, Anesthesiology, Associate Professor, 医学部, 助教授 (80170637)
桐原 由美子 島根医科大学, 医学部, 教務職員 (90234400)
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| Project Period (FY) |
1997 – 1999
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| Project Status |
Completed (Fiscal Year 1999)
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| Budget Amount *help |
¥3,100,000 (Direct Cost: ¥3,100,000)
Fiscal Year 1999: ¥600,000 (Direct Cost: ¥600,000)
Fiscal Year 1998: ¥700,000 (Direct Cost: ¥700,000)
Fiscal Year 1997: ¥1,800,000 (Direct Cost: ¥1,800,000)
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| Keywords | spinal anesthesia / local anesthetic / neurotoxicity / lidocaine / tetracaine / epinephrine / phenylephrine / epidural anesthesia / 神経障害 / 血管収縮薬 |
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| Research Abstract |
The main results of studies performed during the term concering this project were as follows : The first study sought to determine whether the presence of phenylephrine or the concentration of glucose in the anesthetic solution affects the incidence of transient neurologic symptoms following spinal anesthesia with 0.5% tetracaine. The results of the study demonstrate that transient neurologic symptoms may occur after spinal anesthesia with tetracaine and that adding phenylephrine to the anesthetic solution increases the incidence of these symptoms. The results also support prior data indicating that the concentration of glucose in the anesthetic solution does not affect the occurrence of this complication.
The second study sought to determine whether epinephrine potentiates functional impairment or morphologic damage induced by intrathecal administration of tetracaine. The results suggest that the neurotoxic potential of intrathecally administered tetracaine is increased by the addition
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of epinephrine, but that epinephrine alone is not neurotoxic when administered at clinically relevant concentrations. Although the mechanisms of epinephrine-enhanced toxicity remain to be determined, these findings suggest that it is not due to spinal cord ischemia. The results are similar to those previously observed with lidocaine and, thus, epinephrine's enhancement of toxicity is not restricted to a single anesthetic. Clinical recommendations for maximum safe intrathecal does of local anesthetic should consider whether the anesthetic solution contains epinephrine.
In the third study, we have demonstrated that the addition of epinephrine intensified sensory block during lumbar epidural anesthesia with lidocaine. Despite no differences in the extent of sensory block to cold, pinprick and touch between the two solutions, lidocaine with epinephrine produced a more intense sensory block than lidocaine alone, with all CPT values at T9 and L2 increasing significantly after the former solution but none after the latter one. These results provide further evidence that co-administration of a vasoconstrictor improves the quality of epidural anesthesia. Less
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Report
(4 results)
Research Products
(6 results)
