McFarlane C, Warner D S, Dexter F, Todd M M
Department of Anesthesiology, University of Iowa College of Medicine, Iowa City 52242.
Anesth Analg. 1994 Oct;79(4):701-5. doi: 10.1213/00000539-199410000-00014.
We tested the hypothesis that glutamate receptor antagonists increase the dose of lidocaine required to induce seizure activity. Sprague-Dawley rats were anesthetized with halothane in 40% O2/balance N2 and mechanically ventilated. After surgical preparation, halothane was discontinued. Normocapnia, normoxia, and normothermia were maintained. The electroencephalogram (EEG) and arterial blood pressure were monitored continuously. Rats were then randomized to one of six groups (control, one of three intravenous [i.v.] bolus doses of the competitive glutamate N-methyl-D-aspartate [NMDA] receptor antagonist CGS 19755, or one of two i.v. bolus and continuous infusion regimens of the competitive glutamate alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid [AMPA] receptor antagonist 2,3-dihydroxy-6-nitro-7-sulfamoyl-benzo-(F)quinoxalline [NBQX]). Thirty minutes after onset of CGS 19755 or NBQX administration (end-tidal halothane < 0.2%), rats received a continuous i.v. infusion of 1.5% lidocaine until EEG seizures occurred. The duration of the infusion (min) and total lidocaine dose (mg/kg) administered were recorded. CGS 19755 increased the lidocaine seizure threshold in a log-linear dose-dependent fashion (P < 10(-6)). The largest dose of CGS 19755 (112.5 mg/kg) increased the time to initial EEG seizure activity more than twofold (e.g., control = 12.6 +/- 2.6 min; CGS 19755 = 28.6 +/- 6.9 min). The effect of AMPA receptor antagonism was less obvious because treatment resulted in an EEG morphology dissimilar to that observed in the CGS 19755 or control groups. Our findings indicate that competitive NMDA receptor antagonists (e.g., CGS 19755) increase the dose of lidocaine required for seizures.(ABSTRACT TRUNCATED AT 250 WORDS)
我们检验了谷氨酸受体拮抗剂会增加诱发癫痫活动所需利多卡因剂量这一假设。将Sprague-Dawley大鼠用含40%氧气/其余为氮气的氟烷麻醉,并进行机械通气。手术准备完成后,停止使用氟烷。维持正常碳酸血症、正常氧合及正常体温。持续监测脑电图(EEG)和动脉血压。然后将大鼠随机分为六组之一(对照组、三种静脉推注剂量的竞争性谷氨酸N-甲基-D-天冬氨酸(NMDA)受体拮抗剂CGS 19755中的一组,或两种静脉推注及持续输注方案的竞争性谷氨酸α-氨基-3-羟基-5-甲基-4-异恶唑丙酸(AMPA)受体拮抗剂2,3-二羟基-6-硝基-7-氨磺酰基苯并(F)喹喔啉(NBQX)中的一组)。给予CGS 19755或NBQX 30分钟后(呼气末氟烷<0.2%),大鼠接受1.5%利多卡因的持续静脉输注,直至出现EEG癫痫发作。记录输注持续时间(分钟)和给予的利多卡因总剂量(毫克/千克)。CGS 19755以对数线性剂量依赖性方式提高利多卡因癫痫阈值(P<10⁻⁶)。CGS 19755的最大剂量(112.5毫克/千克)使首次出现EEG癫痫活动的时间增加了两倍多(例如,对照组=12.6±2.6分钟;CGS 19755=28.6±6.9分钟)。AMPA受体拮抗作用的效果不太明显,因为治疗导致的EEG形态与CGS 19755组或对照组中观察到的不同。我们的研究结果表明,竞争性NMDA受体拮抗剂(如CGS 19755)会增加癫痫发作所需的利多卡因剂量。(摘要截短于250字)