Purine metabolite washout and platelet aggregation at reflow after tourniquet ischemia: effect of intravenous regional lidocaine

Tourniquet ischemia will influence the biochemical milieu of tissue cells and affect the metabolism of purines in skeletal muscle distal to the occlusion. At reperfusion, generation of oxygen radicals by the hypoxanthine‐xanthine oxidase system may ensue, influencing white blood cell and thrombocyte aggregation, causing damage to the endothelial cell barrier and inducing non‐reflow type phenomena. Amide‐type local anaesthetics are known to affect local vasotone, leukocyte adherence and platelet function but the influence of lidocaine on purine metabolite washout and platelet aggregation following tourniquet ischemia for lower limb surgery is not known in detail. Therefore, the effects of regional intravenous lidocaine during tourniquet ischemia for knee surgery on purine catabolite washout and platelet function following reflow were assessed.

[1]  K. Winther,et al.  Attenuated platelet aggregation in the presence of high concentrations of lactate. , 1991, Thrombosis research.

[2]  I. Cederholm,et al.  Effect of intradermal injection of saline or a local anaesthetic agent on skin blood flow – a methodological study in man , 1991, Acta anaesthesiologica Scandinavica.

[3]  Kirk Nelson,et al.  Pulmonary effects of ischemic limb reperfusion: Evidence for a role for oxygen‐derived radicals , 1991, Critical care medicine.

[4]  R. Hobson,et al.  Iloprost infusion decreases skeletal muscle ischemia-reperfusion injury. , 1990, Journal of vascular surgery.

[5]  R. Hobson,et al.  The role of leukocytes in the pathophysiology of skeletal muscle ischemic injury. , 1989, Journal of vascular surgery.

[6]  R. Valeri,et al.  Reperfusion pulmonary edema. , 1989, JAMA.

[7]  P. Andiné,et al.  Extracellular increase of hypoxanthine and xanthine in the cortex and basal ganglia of fetal lambs during hypoxia-ischemia , 1989, Brain Research.

[8]  D. Granger,et al.  Role of xanthine oxidase and granulocytes in ischemia-reperfusion injury. , 1988, The American journal of physiology.

[9]  R. Korthuis,et al.  Leukocyte depletion attenuates vascular injury in postischemic skeletal muscle. , 1988, The American journal of physiology.

[10]  M. Heideman,et al.  The ischaemic leg as a source of complement activation , 1987, The British journal of surgery.

[11]  K. Takeshige,et al.  Cinchocaine and amethocaine inhibit activation and activity of superoxide production in human neutrophils. , 1986, British journal of anaesthesia.

[12]  C. Forbes,et al.  A haemorheological study of lignocaine. , 1986, British journal of anaesthesia.

[13]  J. Modig,et al.  Potential Anti‐Thrombotic Effects of Local Anaesthetics due to their Inhibition of Platelet Aggregation , 1985, Acta anaesthesiologica Scandinavica.

[14]  J. McCord,et al.  Oxygen-derived free radicals in postischemic tissue injury. , 1985, The New England journal of medicine.

[15]  J. Hurley,et al.  The effect of prostacyclin on the adhesion of leucocytes to injured vascular endothelium , 1984, The Journal of pathology.

[16]  G. Stewart.  Antithrombotic Activity of Local Anesthetics in Several Canine Models , 1982, Regional Anesthesia & Pain Medicine.

[17]  H. Hagberg,et al.  Cellular Effects of Complete Tourniquet Ischemia , 1982 .

[18]  N. Krinsky,et al.  Superoxide, Xanthine Oxidase and Platelet Reactions: Further Studies on Mechanisms by which Oxidants Influence Platelets , 1981, Thrombosis and Haemostasis.

[19]  A. Scheinin,et al.  Antithrombotic Effects of Lidocaine and Related Compounds on Laser‐Induced Microvascular Injury , 1981, Acta anaesthesiologica Scandinavica.

[20]  L. Casey,et al.  Lidocaine increases prostacyclin in the rat. , 1980, Prostaglandins.

[21]  E. Enger,et al.  Cellulr restitution after 3 h of complete tourniquet ischemia. , 1978, European surgical research. Europaische chirurgische Forschung. Recherches chirurgicales europeennes.

[22]  F Reynolds,et al.  The effect of concentration on vasoactivity of bupivacaine and lignocaine. , 1976, British journal of anaesthesia.

[23]  E. Enger,et al.  Human skeletal Muscle Energy Metabolism During and after Complete Tourniquet Ischemia , 1975, Annals of surgery.

[24]  O. Saugstad.  Hypoxanthine as a Measurement of Hypoxia , 1975, Pediatric Research.

[25]  Blair Mr.  Cardiovascular pharmacology of local anaesthetics. , 1975 .

[26]  M. R. Blair.  Cardiovascular pharmacology of local anaesthetics. , 1975, British journal of anaesthesia.

[27]  D. Giddon,et al.  In vivo quantitation of local anesthetic suppression of leukocyte adherence. , 1972, The American journal of pathology.

[28]  S. Närvänen,et al.  Metabolic changes in the upper limb during tourniquet ischaemia. A clinical study. , 1968, Acta orthopaedica Scandinavica.