• 성인간호학회지
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• 제20권3호
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• pp.386-394
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• 2008

Purpose: The purpose of this study was to examine the effect of topical lidocaine cream on pain and anxiety during the AV fistula puncture among hemodialysis patients. Methods: The study employed one group repeated measurement design. The data were collected from 50 hemodialysis patients who received AV fistula puncture. The topical lidocaine cream was applied 30 minutes before the puncture. The data were measured total 3 times (T1=without lidocaine, T2=2% lidocaine, T3=5% lidocaine). Pain was measured by VAS and a behavioral checklist. Anxiety was measured by Korean manual of SCL-90-R. Results: Patients with 5% lidocaine cream reported significantly lower of VAS pain score than those with 2% lidocaine and without lidocaine. Patients with 2% lidocaine cream reported significantly lower of behavioral pain scores than those without lidocaine, but less effective than 5% lidocaine cream. Patients with 2% lidocaine cream reported significantly lower of anxiety scores than those without lidocaine, but less effective than 5% lidocaine cream. Conclusion: Topical application of lidocaine cream for 30 minutes before AV fistula puncture significantly decreased pain and anxiety among hemodialysis patients. Specifically 5% lidocaine was more effective than 2% lidocaine for both pain and anxiety.

• 공업화학
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• 제9권7호
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• pp.1090-1097
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• 1998

국부 마취제로 이용되는 lidocaine 화합물들이 마취 효과를 나타내는 과정을 알아보기 위하여 세포벽을 구성하는 지질 이중막의 모사 시스템으로 공기/물 계면에 형성된 지질 단분자 막을 이용하여 lidocaine 화합물들이 지질 단분자 막의 팽창에 미치는 영향을 연구하였다. Lidocaine이 신경 세포와 접하게 되면 세포벽을 구성하는 지질 이중막을 팽창시켜 이중막에 함침된 단백질을 압축하여 이를 통한 이온 통과가 차단되어 신경 전달이 마비된다는 가설과, 단백질 이온 통로에 존재하는 lidocaine receptor에 직접 흡착되어 이온 통로를 막는다는 가설이 구체적 실험 없이 제안되었다. 본 연구에서는 두 가설 타당성을 증명하고자 리피드 단분자 막팽창에 lidocaine이 미치는 영향을 조사하였다. 실험 결과 유용성인 lidocaine은 phosphatidyl choline, sphingomyelin, DS-PL95E, lipoid의 단분자 막을 수축시켰으며 phosphatidyl ethanolamine은 특정 조성 범위에서만 단분자 막을 팽창시켰다. 반면 수용성인 lidocaine-HCl 염은 실험에 사용된 모든 지질의 단분자 막을 팽창시켰다.

• Clinics in Shoulder and Elbow
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• 제24권4호
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• pp.224-230
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• 2021

Background: Local anesthetics often are used in rotator cuff tears as therapeutic tools, although some cases have reported that they have detrimental effects. Neurotropin (NTP) is used widely in Japan as a treatment for various chronic pain conditions and is shown to have protective effects on cartilage and nerve cells. In this study, we investigated the protective effect of NTP against lidocaine-induced cytotoxicity. Methods: Tenocytes from rotator cuff tendons were incubated with lidocaine, NTP, lidocaine with NTP, and a control medium. Cell viability was evaluated using the WST-8 assay. Cell apoptosis was detected via annexin V staining using flow cytometry. The expression of BCL-2 and cytochrome c, which are involved in the intrinsic mitochondrial pathway of apoptosis, was evaluated via Western blotting and immunohistochemical staining. Results: In the cell viability assay, lidocaine decreased cell viability in a dose-dependent manner, and NTP did not affect cell viability. Moreover, NTP significantly inhibited the cytotoxic effect of lidocaine. The flow cytometry analysis showed that lidocaine significantly induced apoptosis in tenocytes, and NTP considerably inhibited this lidocaine-induced apoptosis. Western blotting experiments showed that lidocaine decreased the protein expression of BCL-2, and that NTP conserved the expression of BCL-2, even when used with lidocaine. Immunohistochemical staining for cytochrome c showed that 0.1% lidocaine increased cytochrome c-positive cells, and NTP suppressed lidocaine-induced cytochrome c expression. Conclusions: NTP suppresses lidocaine-induced apoptosis of tenocytes by inhibiting the mitochondrial apoptotic pathway. Intra-articular/bursal injection of NTP with lidocaine could protect tenocytes in rotator cuff tendons against lidocaine-induced apoptosis.

• The Korean Journal of Pain
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• 제14권1호
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• pp.26-31
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• 2001

Background: Sympathetic blocks with local anesthetics are used to differentiate sympathetically- maintained pain (SMP) from sympathetically-independent pain (SIP). However, systemic lidocaine is also used in the management of neuropathic pain. Therefore, there may be possibility of a false positive response in relieving their pain by systemic absorption of lidocaine following a diagnostic sympathetic block in patients with SIP. In this study, we measured the plasma lidocaine concentrations after a stellate ganglion block (SGB) using three volumes of 1% lidocaine. Methods: This prospective, crossover study was performed in 3 patients who experience sudden hearing loss and in 4 volunteers. Each person received SGB three times using three different volumes (6 ml, 12 ml and 16 ml) of 1% lidocaine at one week intervals. SGB was performed using a 23 G butterfly needle via a paratracheal approach by two persons. Two ml of venous blood was obtained from a prepared contra-lateral sided venous route at 1, 3, 5, 7, 10, 20 and 60 min after SGB. Plasma lidocaine level was analyzed by immunoassay. Results: Mean plasma lidocaine concentrations correlated well with the volumes of 1% lidocaine used in SGB; larger volumes showed higher concentrations (P < 0.01). Mean peak plasma concentrations were $1.08{\pm}0.18$ in 6 ml, $1.90{\pm}0.47$ in the 12 ml and $2.74{\pm}0.67{\mu}g/ml$ in the 16 ml groups (P < 0.01). The mean time to reach peak plasma concentration was not significantly different between the three groups. Conclusions: The peak plasma lidocaine concentrations in SGB using large volume were found to be similar to that of IV lidocaine infusion in the management of neuropathic pain. These data suggest that diagnostic sympathetic block may result in many false positive responses for SMP. Part of its effect may be related to systemic local anesthetic absorption and not to a sympathetic block. Therefore, physicians may be required to use optimal volumes and minimal concentration of local anesthetic in diagnostic sympathetic block procedures and also make a careful assessment of the performance of a permanent sympathetic block.

• 대한약리학회지
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• 제24권1호
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• pp.17-29
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• 1988

Lidocaine 투여에 의한 전신경련의 작용기전을 추구하고자 흰쥐의 전체뇌를 또는 선조체, 해마, 및 중뇌를 부위별로 적출하여 synaptosomes를 마련하고 $20{\mu}M$ veratrine또는 $5{\mu}M\;K^+$ 첨가에 의한 신경 전달물질 (Aspartic acid, Glutamic acid, GABA, Norepinephrine)의 유리촉진작용에 미치는 lidocaine, propranolol, norepinephrine 또는 serotonin의 억제효과를 관찰하였고 $[^3H]M$와 $[^3H]-glutamic$ acid의 synaptosomes로의 섭취에 미치는 lidocaine의 영향도 관찰하였다. 아울러 crude synaptic membrane을 이용하여 $[^3H]-GABA$와 $[^3H]-glutamic$ acid의 수용체 결합에 미치는 lidocaine의 작용도 실험하여 다음과 같은 결과를 얻었다. 1. Lidocaine과 propranolol은 veratrine에 의한 aspartate, glutamate, GABA 및 norepinephrine의 유리를 억제하였고, 그중 GABA 유리에 대한 억제작용이 가장 현저하였다. 2. Norepinephrine과 serotonin은 $100{\mu}M$의 농도에서 veratrine에 의한 aspartate, glutamate 및 GABA의 유리촉진 작용을 억제하였다. 3. Lidocaine은 veratrine에 의한 아미노산 유리촉진 효과에 대해서 보다 과 $K^+$ 에 의한 유리촉진 효과를 더욱 약하게 억제하였고 특히 GABA 유리에 대한 억제작용이 가장 약했다. 4. GABA와 glutamic acid의 수용체 결합과 synaptosomes로의 섭취는 1 mM 이하의 lidocaine농도에서 크게 면화가 없었다. 이상의 결과로 보아 신경전도물질의 veratrine에 의한 유리가 과 $K^+$에 의한 유리보다 더욱 생리적이라는 점을 고려한다면, lidocaine 경련은 lidocaine이 흥분성 전도물질인 aspartate나glutamate보다 억제성 전도물질인 GABA의 유리를 더욱 현저하게 억제함으로서 나타남을 시사한다.

• Journal of Yeungnam Medical Science
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• 제11권1호
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• pp.30-34
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• 1994

염산 lidocaine의 피하 주입시 발생되는 고통을 감소시키기 위하여 8.4% sodium bicarbonate로 중화시켜 사용해 보았다. 지원자를 대상으로한 실험군의 100%에서 예상된 효과를 얻을 수 있었다.

• 대한약리학회지
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• 제26권2호
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• pp.121-126
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• 1990

Lidocaine의 심근 수축력 억제작용의 기전을 규명하기 위한 일환으로 정상 Krebs-Ringer bicarbonate glucose용액에서 각종 대사기질이 lidocaine 억제심방과 정상심방의 수축력에 미치는 영향, 그리고 glucose 제거용액에서 lidocaine의 심방 수축력에 대한 영향을 검토하여 다음과 같은 결과를 얻었다. 1. Pyruvate(5mM), acetate(5mM), fructose(30mM)는 lidocaine에 의해 감소된 심방 수축력을 현저히 증가시켰으나, 정상심장에는 별 영향이 없었다. 2. Glucose(20mM)는 lidocaine억제심방의 수축력을 증가시키지 못하였으나 정상심방의 수축력을 현저히 증가시켰다. 3. Glucose 제거용액에서 lidocaine은 정상용액에서보다 심방 수축력을 현저히 더 감소시켰다. 이상의 결과로 보아 lidocaine은 적출심장에서 외인성 glucose를 제거시, 심장 glycogen의 이용을 glucose phosphate isomerase 단계 혹은 glycogen이 glucose-6-phosphates로 전환되는 단계를 억제한다는 것을 시사하고 있다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권3호
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• pp.276-282
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• 2005

Inferior alveolar nerve block using lidocaine is the most frequent local anesthetic method in the dental treatment, but clinically it is not always successful. The 2% lidocaine cartridge has been used commonly in dental anesthesia. It contains vasoconstrictor and antioxidant, which presents low pH which provides chemical stability and longer shelf life. But alkalinized local anesthetics has less tissue trauma, easier dissociation of the non-ionized base which penetrates nerve sheath, rapid onset and more intensity. In this study, in inferior alveolar nerve block, alkalinized lidocaine using sodium bicarbonate (experimental group) is compared with plain lidocaine (control group) about injection pain, anesthetic onset, duration and postinjection discomfort. In inferior alveolar nerve block, alkalinized lidocaine using sodium bicarbonate showed lower injection pain. There was significant difference statistically from plain lidocaine(p=0.019). Comparing with plain lidocaine, alkalinized lidocaine produced more rapid onset (lip & pulp anesthetic onset), there was no significant difference(p>0.05). but there was boundary significance (0.050.05). These results suggest that addition of sodium bicarbonate to 2% lidocaine(1:100,000 epinephrine) for inferior alveolar nerve block is more effective for reduction of injection pain and onset time.

• Journal of Pharmaceutical Investigation
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• 제37권3호
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• pp.149-158
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• 2007

To investigate the permeability of lidocaine, percutaneous absorption studies were performed using excised hairless mouse skin and the penetration of lidocaine via the skin was determined. To increase the skin permeation of lidocine, the effects of $Labrasol^{(R)}$, $Labrafil^{(R)}$, $Labrafac^{(R)}$ and $Transcutol^{(R)}$ were investigated. The skin permeation of lidocaine was increased when $Labrasol^{(R)}$ and $Transcutol^{(R)}$ were used as permeation enhancer. To evaluate the influence of ultrasound, various factors such as application modes (continuous mode and pulsed mode), frequency (1.0 and 3.0 MHz) and intensity (1.0, 1.5 and 2.0 w/$cm^2$) were investigated with lidocaine hydrogel. The pronounced effect of ultrasound on the skin permeation of lidocaine was observed at all ultrasound energy levels. The influence of frequency having an effect on skin permeation rate was higher in the case of using 1 MHz, 2.0 w/$cm^2$ and continuous treatment. As the intensity of ultrasound increased, the permeation of lidocaine was accelerated. The in vivo anesthetic effects were evaluated by two aspects as mechanical threshold and electrical threshold. Six healthy volunteers consented to the randomized, double-blind, and cross-over designed study in each group. In each subject, 3 groups were adapted such as K group (ultrasound with gel base only), L group (lidocaine gel) and B group (ultrasound with lidocaine gel). In conclusion, lidocaine was potent anesthetic which could be block pain threshold effectively. And ultrasound could accelerate the skin penetration of lidocaine. The phonophoretic delivery system could be a good candidate for lidocaine as a local anaesthetic to improve the skin permeation and in vivo anaesthetic effect.

• 대한두개안면성형외과학회지
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• 제20권4호
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• pp.239-245
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• 2019

Background: Lidocaine spray is a local anesthetic that improves random-pattern skin flap survival. The fractional ablative carbon dioxide laser (FxCL) produces vertical microchannels that delivers topically applied drugs to the skin. In this study, we hypothesized that FxCL therapy would enhance the lidocaine effect to improve random-pattern skin flap survival in rats. Methods: McFarlane random-pattern skin flaps were elevated in 48 rats, which were divided into four groups according to treatment: FxCL+lidocaine, FxCL, lidocaine, and nontreatment (control). On postoperative day 7, necrotic flap areas, the number of capillary vessels, and neutrophil count were evaluated. Anti-rat vascular endothelial growth factor (VEGF) and CD31 antibody activity were also evaluated by immunohistochemical staining. Results: Flap survival rate was $53.41%{\pm}5.43%$, $58.16%{\pm}4.80%$, $57.08%{\pm}5.91%$, and $69.08%{\pm}3.20%$ in the control, lidocaine, FxCL, and FxCL+lidocaine groups, respectively. Mean neutrophil count in the intermediate zone excluding the necrotic tissue was $41.70{\pm}8.40$, $35.43{\pm}6.41$, $37.23{\pm}7.15$, and $27.20{\pm}4.24cells/field$ in the control, lidocaine, FxCL, and FxCL+lidocaine groups, respectively. Anti-rat VEGF and CD31 antibody activity were the highest in the FxCL+lidocaine group. Conclusion: FxCL with lidocaine had a positive effect on random-pattern skin flap survival in rats. Thus, FxCL with lidocaine spray should be considered as a new treatment option to improve flap viability.