The influence of lidocaine and racemic bupivacaine on neuromuscular blockade produced by rocuronium. A study in rat phrenic nerve-diaphragm preparation

Acta Cir Bras. 2009 May-Jun;24(3):211-5. doi: 10.1590/s0102-86502009000300009.

Abstract

Purpose: To evaluate in vitro lidocaine and racemic bupivacaine effects in neuromuscular transmission and in neuromuscular blockade produced by rocuronium.

Methods: Rats were distributed in 5 groups (n = 5) in agreement with the studied drugs: lidocaine, racemic bupivacaine, rocuronium, separately (Groups I, II, III); rocuronium in preparations exposed to local anesthetics (Groups IV, V). The concentrations used were: 20 microg/mL, 5 microg/mL and 4 microg/mL, for lidocaine, bupivacaine and rocuronium, respectively. It was evaluated: 1) amplitude of diaphragm muscle response to indirect stimulation, before and 60 minutes after separately addition of lidocaine, racemic bupivacaine and rocuronium and the association of local anesthetics - rocuronium; 2) membrane potentials (MP) and miniature end-plate potentials (MEPP).

Results: Lidocaine and bupivacaine separately didn't alter the amplitude of muscle response and MP. In preparations previously exposed to lidocaine and racemic bupivacaine, the rocuronium blockade was significantly larger (90.10 +/- 9.15% and 100%, respectively), in relation to the produced by rocuronium separately (73.12 +/- 9.89%). Lidocaine caused an increase in the frequency of MEPP, being followed by blockade; racemic bupivacaine produced decrease being followed by blockade.

Conclusions: Local anesthetics potentiated the blockade caused by rocuronium. The alterations of MEPP identify presynaptic action.

MeSH terms

  • Androstanols / pharmacology*
  • Anesthetics, Local / pharmacology*
  • Animals
  • Bupivacaine / pharmacology
  • Diaphragm / innervation
  • Drug Evaluation, Preclinical
  • Electric Stimulation
  • Lidocaine / pharmacology
  • Male
  • Motor Endplate / drug effects
  • Neuromuscular Blockade / methods*
  • Neuromuscular Junction / drug effects*
  • Neuromuscular Nondepolarizing Agents / pharmacology*
  • Phrenic Nerve / drug effects*
  • Rats
  • Rats, Wistar
  • Rocuronium
  • Statistics, Nonparametric

Substances

  • Androstanols
  • Anesthetics, Local
  • Neuromuscular Nondepolarizing Agents
  • Lidocaine
  • Rocuronium
  • Bupivacaine