Document Detail

Tissue distribution of lidocaine in critical care patients after intubation.
MedLine Citation:
PMID:  14609655     Owner:  NLM     Status:  MEDLINE    
We investigated tissue distribution of lidocaine in 33 patients after endotracheal intubation with Xylocaine jelly that contains 2% lidocaine hydrochloride. Blood levels of monoethylglycinexylidide (MEGX), an active metabolite of lidocaine, were also determined. Five patients (Group A) were alive on arrival and six patients (Group B) resumed heartbeats after cardiopulmonary resuscitation (CPR). The survival times for Groups A and B ranged from 3 to 72 h. The remaining 22 patients (Group C) did not survive cardiopulmonary arrest on arrival (CPAOA). Systemic distribution of lidocaine was measured in nine patients from Group C. The liver-to-kidney lidocaine ratios and cerebrum-to-cerebrospinal fluid lidocaine ratios were: Group A, 0.1-0.7 and 1.4-3.6, respectively; Group B, 0.2-0.8 and 1.2-2.3, respectively; Group C, 0.1-17 and 0.2-1.0, respectively. MEGX was detected in all blood samples from Group A and only two samples from Group B. No MEGX was detected in samples from Group C. Our results indicate that the absorption of tracheal lidocaine during natural circulation results in a cerebrum-to-cerebrospinal fluid lidocaine ratio of 1.2 or more, whereas absorption during artificial circulation by cardiac massage gives a ratio of 1.0 or less. The cerebrum-to-cerebrospinal fluid lidocaine ratio may be a more useful index to estimate circulatory dynamics of patients during CPR than the liver-to-kidney lidocaine ratio. MEGX was not a useful parameter for monitoring circulatory changes during cardiac massage.
Fumio Moriya; Yoshiaki Hashimoto
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Forensic science international     Volume:  137     ISSN:  0379-0738     ISO Abbreviation:  Forensic Sci. Int.     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2003-11-11     Completed Date:  2004-01-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7902034     Medline TA:  Forensic Sci Int     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  183-7     Citation Subset:  IM    
Department of Legal Medicine, Kochi Medical School, Kohasu, Oko-cho, Nankoku City, Kochi 783-8505, Japan.
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MeSH Terms
Aged, 80 and over
Anesthetics, Local / pharmacokinetics*
Cardiopulmonary Resuscitation
Child, Preschool
Critical Care*
Intubation, Intratracheal*
Lidocaine / analogs & derivatives*,  blood,  pharmacokinetics*
Middle Aged
Tissue Distribution
Reg. No./Substance:
0/Anesthetics, Local; 137-58-6/Lidocaine; 7728-40-7/monoethylglycinexylidide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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