Buffenoir Kévin, Decq Philippe, Pérot Chantal
CNRS UMR 7338 Biomécanique et Bioingénierie, Université de Technologie de Compiègne, BP 20529, 60205 Compiègne, France.
ScientificWorldJournal. 2013 Aug 7;2013:912716. doi: 10.1155/2013/912716. eCollection 2013.
In spastic subjects, lidocaine is often used to induce a block predictive of the result provided by subsequent surgery. Lidocaine has been demonstrated to inhibit the Hoffmann (H) reflex to a greater extent than the direct motor (M) response induced by electrical stimulation, but the timecourse of these responses has not been investigated.
An animal (rat) model of the effects of lidocaine on M and H responses was therefore developed to assess this time course. M and H responses were recorded in 18 adult rats before and after application of lidocaine to the sciatic nerve.
Two to five minutes after lidocaine injection, M responses were markedly reduced (mean reduction of 44%) and H reflexes were completely abolished. Changes were observed more rapidly for the H reflex. The effects of lidocaine then persisted for 100 minutes. The effect of lidocaine was therefore more prolonged on the H reflex than on the M response.
This study confirms that lidocaine blocks not only alpha motoneurons but also Ia afferent fibres responsible for the H reflex. The authors describe, for the first time, the detailed time course of the effect of lidocaine on direct or reflex activation of motoneurons in the rat.
在痉挛患者中,利多卡因常被用于诱导一种阻滞,以预测后续手术的效果。已证实利多卡因对霍夫曼(H)反射的抑制作用比对电刺激诱发的直接运动(M)反应的抑制作用更大,但尚未对这些反应的时间进程进行研究。
因此,建立了一个利多卡因对M和H反应影响的动物(大鼠)模型来评估这个时间进程。在对坐骨神经应用利多卡因之前和之后,记录了18只成年大鼠的M和H反应。
利多卡因注射后2至5分钟,M反应明显降低(平均降低44%),H反射完全消失。H反射的变化观察得更快。然后,利多卡因的作用持续了100分钟。因此,利多卡因对H反射的作用比对M反应的作用持续时间更长。
本研究证实,利多卡因不仅阻断α运动神经元,还阻断负责H反射的Ia传入纤维。作者首次描述了利多卡因对大鼠运动神经元直接或反射性激活作用的详细时间进程。