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Effect of lidocaine on the meninges in an experimental animal model
C Nguyen1, K C Ho, V M Haughton
1Department of Radiology, Medical College of Wisconsin, Milwaukee.
Abstract:
Arachnoiditis has been reported in patients who had received previous epidural injections of anesthetic agents. The purpose of this study was to determine if epidural injections of lidocaine are sufficient to cause arachnoiditis. Four monkeys that received a single epidural injection of lidocaine hydrochloride 1% were compared to four controls that had epidural injections of 0.9% saline. Four dogs that had multiple epidural injections of lidocaine hydrochloride 1% were compared to four controls that had multiple injections of saline. All animals were killed on the eighty-fourth day of the experiment. The dural sac, containing nerve roots and spinal cord, was removed intact from the lumbar spinal canal, fixed, sectioned, stained, and examined microscopically for evidence of arachnoid inflammation and fibrosis. No significant changes were found in the treated animals. Lidocaine hydrochloride 1% injected singly or repeatedly in the epidural space does not appear to be a cause of significant chronic meningeal reaction.
Insights
Epidural injections of lidocaine do not cause arachnoiditis. This study found no significant chronic meningeal reactions in animals receiving single or multiple epidural lidocaine injections, suggesting it is safe for epidural use.
Area of Science:
- Anesthesiology
- Neurology
- Pathology
Background:
- Arachnoiditis has been linked to previous epidural anesthetic injections.
- The potential for anesthetic agents to induce arachnoiditis requires investigation.
Purpose of the Study:
- To investigate whether epidural injections of lidocaine can cause arachnoiditis.
- To assess the safety of lidocaine hydrochloride 1% in the epidural space.
Main Methods:
- Monkeys received single epidural injections of lidocaine or saline.
- Dogs received multiple epidural injections of lidocaine or saline.
- Microscopic examination of spinal cord and nerve roots for inflammation and fibrosis.
Main Results:
- No significant arachnoid inflammation or fibrosis was observed in animals treated with lidocaine.
- Both single and repeated epidural injections of lidocaine hydrochloride 1% showed no adverse meningeal effects.
Conclusions:
- Epidural lidocaine hydrochloride 1% does not appear to cause significant chronic meningeal reactions.
- Findings suggest lidocaine is not a cause of arachnoiditis when administered epidurally.