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Morphologic Assessment of Plasma Membrane Blebbing Provides a Sensitive, Early Indicator of Low Dose Lidocaine Neurotoxicity

Published online by Cambridge University Press:  02 July 2020

M.E. Johnson  and
P. Dadarkar
M.E. Johnson
Affiliation:
Department of Anesthesiology;, Mayo Foundation, Rochester, MN, 55905
P. Dadarkar
Affiliation:
Department of Anesthesiology;, Mayo Foundation, Rochester, MN, 55905
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Abstract

Background: Lidocaine is a local anesthetic that is frequently used for spinal anesthesia. in clinical and animal studies, lidocaine is associated with an increased risk of spinal neurotoxicity following spinal anesthesia. The mechanism of lidocaine neurotoxicity has not been fully elucidated, but it does not involve blockade of sodium channels, the mechanism by which lidocaine causes local anesthesia. Previous in vitro studies assessing cytoplasmic calcium, nerve conduction and action potential generation, and cell death, have demonstrated overt neurotoxicity at higher concentrations of lidocaine (≥ 2% [74 mM] of the hydrochloride formulation), but equivocal results at lower concentrations. Clinically available preparations of lidocaine for spinal anesthesia contain 5% or 2.5% lidocaine hydrochloride. in most cases, lidocaine mixes rapidly with cerebrospinal fluid after injection for spinal anesthesia, so that lower concentrations are more clinically relevant. We have therefore evaluated morphologic assessment of plasma membrane blebbing as a more sensitive assay of neuronal injury by lidocaine.

Type
Pathology
Information
Microscopy and Microanalysis , Volume 7 , Issue S2: Proceedings: Microscopy & Microanalysis 2001, Microscopy Society of America 59th Annual Meeting, Microbeam Analysis Society 35th Annual Meeting, Long Beach, California August 5-9, 2001 , August 2001 , pp. 652 - 653
Copyright
Copyright © Microscopy Society of America 2001

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