Effect of repetitive lidocaine infusion on peripheral nerve

Neurotoxicity in rat tibial nerve was assessed following injections of lidocaine through implanted catheters. Doses of 1 to 4% lidocaine in volumes sufficient to inhibit motor nerve function, were infused three times a day for 3 days. When 4% lidocaine was infused into a Silastic cuff surrounding the sciatic nerve, all function was lost and there was considerable nerve fiber degeneration. When 4% lidocaine was infused within the muscle pocket surrounding the nerve, but at some distance from the nerve, there was no measurable permanent loss of motor function, but occasional nerve fiber degeneration. In contrast, 1% lidocaine appeared to cause no neurotoxicity, even when infused within a surrounding cuff. In addition, 1% lidocaine injection did not cause damage to the underlying muscle. Therefore, intermittent nerve block with low concentrations of lidocaine appears to be nontoxic to nerve and muscle when administered during 3 days. However, long-term studies are needed before clinical usage can be considered, because there is the potential for nerve and muscle damage.