Do local anesthetics increase intracelluler calcium concentration?

2018 Fiscal Year Final Research Report

• Project/Area Number: 16K20100
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Anesthesiology
• Research Institution: Hiroshima University
• Principal Investigator: Otsuki Sachiko 広島大学, 病院(医), 助教 (90774018)
• Research Collaborator: Yasuda Toshimichi ; Mukaida Keiko ; Noda Yuko ; Kanzaki Rieko ; Miyoshi Hirotsugu ; Kondo Takashi ; Hamada Hiroshi ; Kawamoto Masashi
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: 悪性高熱症 / 局所麻酔薬 / 筋毒性

Outline of Final Research Achievements

Malignant hyperthermia (MH) is an inherited muscle disorder caused by abnormal elevations of intracellular calcium (Ca2+) in skeletal muscle. There are several reports of myotoxicity caused by local anesthetics, and the increased intracellular Ca2+ is considered to be an important cause. However, there is insufficient evidence regarding myotoxicity in MH-susceptible individuals when large doses of local anesthetics are administered. This study investigated the effect of MH predisposition on myotoxicity using human skeletal muscles. We calculated the 50% effective concentration (EC50) values of three local anesthetics, namely lidocaine, levobupivacaine, and ropivacaine using the ratiometric dye Fura-2 AM.
These EC50 values were similar in individuals with and without MH predisposition. Therefore, we consider that extra caution is not warranted when using local anesthetics in MH-susceptible individuals.

Free Research Field

麻酔

Academic Significance and Societal Importance of the Research Achievements

一般的に局所麻酔薬はMH素因者にも安全に使用できると言われているが、これまで筋毒性についての報告はされてこなかった。今回の研究で、MH素因者にも健常者と同様に局所麻酔薬を使用できると考えられた。使用できる麻酔薬の種類が限定されるMH素因者において、局所麻酔薬を使用できるということは、MH素因者だけでなく医療者においても非常に有用であると考えられた。