Pateromichelakis S
Department of Oral and Maxillofacial Surgery, King's College School of Medicine and Dentistry, London, Great Britain.
J Oral Maxillofac Surg. 1992 Jul;50(7):724-7. doi: 10.1016/0278-2391(92)90107-b.
The inadvertent intra-arterial administration of local anesthetics is a serious hazard of oral operations. For this reason, the circulatory and respiratory consequences of introducing lidocaine into the maxillofacial (MF) arterial circulation were examined in anesthetized rats. Lidocaine boluses of 0.3 to 6.0 mg/kg increased infusion pressure (IP) by up to 85%, signifying considerable local vasoconstriction; following a 6.0 mg/kg injection, heart rate (HR) remained unaffected, mean blood pressure (BP) increased by 5%, and respiratory rate (RR) decreased by 20%. Infusions of 50 or 150 micrograms/kg/min for 30 minutes had no effect on the preceding parameters, but within 15 minutes of infusing lidocaine at 600 micrograms/kg/min, IP increased by 97% and RR decreased by 31%; BP and HR remained unaffected. It was concluded that the main consequences of administering plain lidocaine at the aforementioned doses into the rat MF arterial bed were considerable local vasoconstriction and a large reduction in respiratory rate. Heart rate remained unaffected by lidocaine; neither it nor blood pressure is a reliable indicator of approaching systemic toxicity.
局部麻醉药意外动脉内给药是口腔手术的严重风险。因此，研究人员在麻醉大鼠中研究了将利多卡因注入颌面部（MF）动脉循环后的循环和呼吸影响。0.3至6.0mg/kg的利多卡因推注可使输注压力（IP）升高高达85%，表明有明显的局部血管收缩；注射6.0mg/kg后，心率（HR）未受影响，平均血压（BP）升高5%，呼吸频率（RR）降低20%。以50或150μg/kg/min的速度输注30分钟对上述参数无影响，但以600μg/kg/min的速度输注利多卡因15分钟内，IP升高97%，RR降低31%；BP和HR未受影响。得出的结论是，将上述剂量的普通利多卡因注入大鼠MF动脉床的主要影响是明显的局部血管收缩和呼吸频率大幅降低。利多卡因对心率无影响；心率和血压都不是即将发生全身毒性的可靠指标。
