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Local anesthetics in cerebral ischemia
1Department of Anaesthesia, University Hospital, and the Robarts Research Institute, London, Ontario, Canada.
Journal of Neurosurgical Anesthesiology
|December 1, 1989
Summary
Local anesthetics like lidocaine may protect the brain during ischemia by reducing energy use. However, their effectiveness varies, especially in global ischemia, suggesting a neurovascular rather than a membrane-stabilizing role.
Area of Science:
- Neuroscience
- Pharmacology
- Ischemic Stroke Research
Background:
- Local anesthetics are hypothesized to benefit ischemia by lowering cerebral energy demands.
- They may also prevent neuronal membrane depolarization during ischemic events.
Purpose of the Study:
- To evaluate the prophylactic effects of lidocaine in models of cerebral ischemia.
- To investigate the mechanism of action, distinguishing between membrane stabilization and neurovascular effects.
Main Methods:
- Review of in vitro studies on local anesthetics.
- Analysis of in vivo studies using focal and global ischemia models.
Main Results:
- In vitro and focal ischemia models show benefits from prophylactic lidocaine.
- Conflicting results were observed in global ischemia models.
Conclusions:
- Lidocaine's protective effects in ischemia may be linked to neurovascular actions.
- The mechanism might not solely be membrane stabilization, particularly in global ischemia scenarios.