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백서 좌골신경에서 아드레날린이 국소마취제에 의한 복합활동전압의 억제에 미치는 영향
한성민,유재영,최윤,이동명,임승운,양현철,양홍석,임중우 대한마취과학회 1999 Korean Journal of Anesthesiology Vol.37 No.4
Background : Adrenaline has often been used to prolong the local anesthetic effect during surgical procedures. As a possible explanation for this, a local vasoconstriction caused by adrenaline has been proposed. However, in a recent study, clonidine, an α2 adrenergic receptor agonist, was reported to block the conduction of mammalian nerves in vitro. Thus, there is a possibility that adrenaline may block nerve conduction by acting on the adrenergic receptor. The present study is performed to see : (1) If adrenaline directly affects nerve conduction ; (2) If adrenaline affects conduction blockade caused by local anesthetic. Methods : Recordings of compound action potentials (CAPs) of A- and C-components were obtained from isolated sciatic nerves of adult male Sprague-Dawley rats. Dose-response curves of lidocaine and adrenaline regarding depression of CAPs were determined. Effects of adrenaline on the lidocaine-induced nerve block was assessed by comparing the effect of lidocaine (3.5× 10 5) with a licaine-epinephrine mixture (Lido-Epi, 3.5 ×10 5 lidocaine with 1:100,000 epinephrine). Results : Adrenaline, near the clinical concentrations, had no effect on the size of either A- or C-component of CAPs. The ED50 of lidocaine was 3.5× 10 5. Lidocaine depressed A-CAP 45.9± 7.0 when compared with baseline value, and the Lido-Epi solution depressed A-CAP to 41.7± 5.0 (P > 0.05). Lidocaine depressed C-CAP 59.8 ± 3.4 when compared with the baseline value, and the Lido-Epi solution depressed C-CAP to 60.5 8.1 (P > 0.05). Consequently, adrenaline did not augment lidocaine induced nerve blockade. Conclusion : This study confirmed that adrenaline applied to the peripheral nerve has no effect either on nerve conduction itself or on conduction block produced by lidocaine. (Korean J Anesthesiol 1999; 37: 675∼684)