Skip to main content
SpringerLink
Log in

Effect of lidocaine onin Vivo hepatic function

  • Original Articles
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Lidocaine is administered to assess donor or recipient liver function during hepatic transplantation. This study was performed to determine whether lidocaine administered at a constant concentration affected hepatic function or had demonstrable effects on hepatocellular ultrastructure. Fourteen pigs were randomly allocated to receive either a two-stage infusion of lidocaine hydrochloride or of saline. Transhepatic blood samples were taken and ultrasonic portal venous and hepatic arterial blood flow readings made on animals anesthetized with isoflurane in nitrous oxide. Liver biopsies were taken for histological analysis and determination of adenine nucleotide status prior to and after 2 hr of the two-stage infusion. A mean systemic constant plasma lidocaine concentration of 5.9 μg/ml was achieved during the second hour of infusion. There were no differences between the two groups in a large number of indices of hepatic function and plasma composition prior to and during the second hour of the respective infusions. Hepatic blood flow was also similar at these times. On histological examination there were no electron microscopic changes that could be specifically attributed to the administration of lidocaine. However, there were progressive changes with time. This study suggests that in anesthetized pigs a constant lidocaine concentration of about 6 μg/ml has no detrimental effect on hepatic function. Progressive hepatic ultrastructural changes occurred that could not be attributed to the administration of lidocaine. These may be the result of anesthetic administered or the surgery performed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Oellerich M, Ringe B, Gubernatis G, Pichlmayr R, Burdelski M, Lamesch P, Bunzendahl H, Herrmann H: Lidocaine metabolite formation as a measure of pre-transplant liver function. Lancet 1:640–642, 1989

    Google Scholar 

  2. Burdelski M, Oellerich M, Lamesch P, Raude E, Ringe B, Neuhaus P, Bortfeld S, Kammerling C: Evaluation of quantitative liver function tests in liver donors. Transplant Proc 19:3838–3839, 1987

    Google Scholar 

  3. Oellerich M, Burdelski M, Ringe B, Wittekind CH, Lamesch P, Lautz HU, Gubernatis G, Beyrau R: Functional state of donor liver and early outcome of transplantation. Transplant Proc 23:1575–1578, 1991

    Google Scholar 

  4. Branch R: Drugs as indicators of hepatic function. Hepatology 2:97–105, 1982

    Google Scholar 

  5. Barstow L, Small RE: Liver function assessment by drug metabolism. Pharmacotherapy 10:280–288, 1990

    Google Scholar 

  6. Rutten AJ, Nancarrow C, Mather LE, Isley AH, Runciman WB, Upton RN: Hemodynamic and central nervous system effects of intravenous bolus doses of lidocaine, bupivacaine, and ropivacaine in sheep. Anesth Analg 69:291–299, 1989

    Google Scholar 

  7. Liu PL, Feldman HS, Giasi R, Patterson K, Covino BG: Comparative CNS toxicity of lidocaine, etidocaine, bupivacaine, and tetracaine in awake dogs following rapid intravenous administration. Anesth Analg 62:375–379, 1983

    Google Scholar 

  8. Reiz S, Nath S: Cardiotoxicity of local anesthetic agents. Br J Anesth 58:736–746, 1986

    Google Scholar 

  9. Tarba C, Cracium C: A comparative study of the effects of procaine, lidocaine, tetracaine and dibucaine on the functions and ultrastructure of isolated rat liver mitochondria. Biochim Biophy Acta 1019:19–28, 1990

    Google Scholar 

  10. Collinsworth KA, Kalman SL, Harrison DC: The clinical pharmacology of lidocaine as an antiarrythmic drug. Circulation 50:1217–1230, 1974

    Google Scholar 

  11. Benowitz N, Forsyth RP, Melmon KL, Rowland M: Lidocaine disposition kinetics in monkey and man: I Prediction by a perfusion model. Clin Pharmacol Ther 16:87–98, 1974

    Google Scholar 

  12. Terblanche J, Hickman R, Dent DM, Spilg H, Harrison GG, Saunders SJ: The use of domestic pigs in medical research in South Africa. I Liver and anesthetic research. J S Afr Vet Med Assoc 41:93–103, 1970

    Google Scholar 

  13. Hickman R, Saunders SJ, Simson E, Terblanche J: Perfusion of the isolated pig liver. Functional assessment under control normothermic conditions. Br J Surg 58:33–38, 1971

    Google Scholar 

  14. Jaworek D, Gruber W, Bergmeyer HU: Adenosine-5-diphosphate and adenosine-5-monophosphate.In Methods in Enzymatic Analysis, 2nd ed. HU Bergmeyer (ed). New York, Academic Press, 1974, pp 2127–2131

    Google Scholar 

  15. Lamprecht W, Trautschold I: Adenosine-5-triphosphate determination with hexokinase and glucose-6-phosphate dehydrogenase.In Methods in Enzymatic Analysis, 2nd ed. HU Bergmeyer (ed), New York, Academic Press, 1974, pp 2101–2109

    Google Scholar 

  16. Atkinson DE: The energy charge of the adenylate pool as a regulatory parameter. Interaction with feedback modifiers. Biochemistry 7:4030–4034, 1968

    Google Scholar 

  17. Luzzi FA, Wenger TL, Klinger JK, Barchowsky A, Straus HC: Simultaneous determination of lidocaine and its metabolites in plasma and myocardium. J Chromatogr 311:291–299, 1984

    Google Scholar 

  18. Crowder MJ, Hand DJ: Analysis of Repeated Measures. New York, Chapman and Hall, 1990

    Google Scholar 

  19. Nauta ILD, Ruland CM, Hertzberger DH, Rensing JBM: Heart failure and hepatitis in a patient taking tocainide. Int J Cardiol 5:89–90, 1984

    Google Scholar 

  20. Boelsterli UA, Lanzotti A, Goldlin C, Oertle M: Identification of cytochrome P-450IIB1 as a cocaine-bioactivating isoform in rat hepatic microsomes and in cultured rat hepatocytes. Drug Metab Dispos 20:96–101, 1992

    Google Scholar 

  21. Salzer LB, Weinreib AB, Marina RJ, Lima JJ: A comparison of methods of lidocaine administration in patients. Clin Pharmacol Ther 29:617–624, 1981

    Google Scholar 

  22. Foldes FF, Molloy R, McNall PG, Koukal LR: Comparison of toxicity of intravenously given local anesthetic agents in man. JAMA 172:1493–1498, 1960

    Google Scholar 

  23. Dabadie P, Bendriss P, Erny P, Mazat JP: Uncoupling effects of local anesthetics on rat liver mitochondria. FEBS Lett 226:77–82, 1987

    Google Scholar 

  24. Mets B, Janicki PK, Hickman R, Chalton DO: The effect of lidocaine on hepatic blood flow and endogenous catecholamines in the anesthetized pig. Pharmacol Commun 1:155–162, 1992

    Google Scholar 

  25. Cotran RS, Kumar V, Robbins SL: Robbins Pathological Basis of Disease, 4th ed. London, WB Saunders, 1989

    Google Scholar 

  26. Brown BR: Anesthesia in Hepatic and Biliary Tract Disease. Philadelphia, FA Davis, 1988

    Google Scholar 

  27. Gelman S: General anesthesia and hepatic circulation. Can J Physiol Pharmacol 65:1762–1769, 1987

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Departments of Clinical Pharmacology and Anesthesia, University of Cape Town Medical School and Groote Schuur Hospital, Observatory, Cape, South Africa

    Berend Mets MB ChB, FRC Anaes, FFA(SA), PhD, Rosemary Hickman MD, ChM, Ulane Neveling MB ChB MMed (Anat Path), Malcolm Emms Dip Med Tech & Derek O. Chalton MSc, PhD

  2. MRC Liver Research Center, University of Cape Town Medical School and Groote Schuur Hospital, Observatory, Cape, South Africa

    Berend Mets MB ChB, FRC Anaes, FFA(SA), PhD, Rosemary Hickman MD, ChM, Ulane Neveling MB ChB MMed (Anat Path), Malcolm Emms Dip Med Tech & Derek O. Chalton MSc, PhD

  3. Department of Pathology, Red Cross War Memorial Children's Hospital, Rondebosch, Cape, South Africa

    Berend Mets MB ChB, FRC Anaes, FFA(SA), PhD, Rosemary Hickman MD, ChM, Ulane Neveling MB ChB MMed (Anat Path), Malcolm Emms Dip Med Tech & Derek O. Chalton MSc, PhD

  4. Medical Research Council Unit for Biostatistics, Tygerberg, Cape, South Africa

    Berend Mets MB ChB, FRC Anaes, FFA(SA), PhD, Rosemary Hickman MD, ChM, Ulane Neveling MB ChB MMed (Anat Path), Malcolm Emms Dip Med Tech & Derek O. Chalton MSc, PhD

Authors
  1. Berend Mets MB ChB, FRC Anaes, FFA(SA), PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rosemary Hickman MD, ChM
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ulane Neveling MB ChB MMed (Anat Path)
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Malcolm Emms Dip Med Tech
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Derek O. Chalton MSc, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Support was gratefully received from the Medical Research Council of South Africa and from the Mauerberger Foundation.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mets, B., Hickman, R., Neveling, U. et al. Effect of lidocaine onin Vivo hepatic function. Digest Dis Sci 38, 2163–2169 (1993). https://doi.org/10.1007/BF01299890

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01299890

Key Words

Search

Navigation