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Effects of lidocaine and steroids on breast milk‐induced lung injury in rabbits 1
Author(s) -
HOWLETT THOMAS,
LERMAN JERROLD
Publication year - 2006
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/j.1460-9592.2006.01858.x
Subject(s) - lidocaine , medicine , anesthesia , saline , methylprednisolone , isoflurane , lung
Summary Background : Local anesthetics inhibit mediator and free radical release from polymorphonuclear granulocytes and migration to their site of action. In a recent study, lidocaine significantly improved the alveolar–arterial oxygen difference gradients (A‐aDO 2 ) after tracheal instillation of acid in rabbits. The purpose of the current study was to evaluate the effects of lidocaine and pulse‐dose steroids on human breast milk (HBM)‐induced lung injury in rabbits. Methods : After Animal Care Committee approval, six adult rabbits were assigned to each of three treatments: control, lidocaine, and steroids. After induction of anesthesia and controlled ventilation, acidified HBM at pH 1.8 and volume 1.2 ml·kg −1 was instilled into the trachea. Rabbits in the lidocaine group received lidocaine 2 mg·kg −1 i.v. before tracheal instillation and then 2 mg·kg −1 ·h −1 i.v. continuously. Rabbits in the steroid group received 30 mg·kg −1 methylprednisolone before tracheal instillation. A‐aDO 2 , static compliance and blood for white cell count, and cytokine interleukin‐8 (IL‐8) concentration were obtained at baseline and at 1 and 4 h postinstillation. After 4 h, the rabbits were killed. The left upper lobe was isolated and excised to determine the wet/dry ratio. The right lung was lavaged with 30 ml normal saline to determine the white cell count and the concentrations of albumin and IL‐8. Data were analyzed using one‐ or two‐way anova with repeated measures and an Student‐Newman‐Keuls (SNK) posthoc test ( P < 0.05). Results : All rabbits completed the protocol. A‐aDO 2 and CO 2 tensions increased significantly at 1 and 4 h compared with baseline, although there were no differences among the treatments ( P < 0.05). Compliance in the control group decreased compared with lidocaine and steroids. Conclusion : We conclude that preemptive lidocaine and steroids attenuate in part HBM‐induced lung injury in rabbits.