smpСкорая медицинская помощьEMERGENCY MEDICAL CARE2072-6716Northwest State Medical University named after II Mechnikov10.24884/2072-6716-2025-26-1-44-48smp-878Research ArticleАНЕСТЕЗИОЛОГИЯ И РЕАНИМАТОЛОГИЯANESTHESIOLOGY AND RESUSCITATIONВлияние внутривенного введения лидокаина на нервно- мышечную проводимостьEffect of intravenous lidocaine introduction on neuromuscular conductionhttps://orcid.org/0000-0002-4768-8856БестаевГ. Г.BestaevG. G.

Бестаев Георгий Гивиевич —  кандидат медицинских наук, доцент кафедры анестезиологии, реанимации и интенсивной терапии 

362001, Владикавказ, ул. Пушкинская, д. 41 

 Vladikavkaz

georbest@mail.ruФГБОУ ВО «Северо- Осетинская государственная медицинская академия» Минздрава РоссииРоссияNorth-Ossetian State Medical AcademyRussian Federation2025040320252614448Copyright © Бестаев Г.Г., 20252025Бестаев Г.Г.Bestaev G.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://smp.spb.ru/jour/article/view/878

Введение. Использование лидокаина в схеме в мультимодальной анестезии с целью снижения доз анестетиков по сравнению с классическим обезболиванием — перспективное направление современной анестезиологии. Широкое применение в анестезиологической практике местных анестетиков позволило выявить их существенное влияние на нейромышечный профиль. Однако имеющиеся исследования по изучению комбинаций этих препаратов с мышечными релаксантами носят весьма разноречивый характер. Цель исследования: изучить влияния предоперационного внутривенного введения лидокаина на нервно-мышечную проводимость. Материалы и методы исследования. С целью оценки влияния лидокаина на нервно-мышечную проводимость обследовано 60 пациентов (ASA I–II), которым была проведена лапароскопическая холецистэктомия по поводу хронического калькулезного холецистита. Были сформированы две группы пациентов: принимавшие лидокаин в дозе 2 мг·кг-1 (30 человек, группа 1) и те, кто использовал 0,9% раствор натрия хлорида (физиологический раствор) (30 человек, группа 2). Нервно-мышечную проводимость оценивали с помощью метода акцелеромиографии (монитор TOF-Watch SX). Результаты. Скорость восстановления нервномышечной проводимости были в пределах 47 и 48 мин в 1-й и 2-й группах аналогично (р=0,92). Заключение. В результате исследования установлено, что лидокаин статистически не оказывал значимого влияния на нервно-мышечную передачу.

The use of lidocaine in a regimen of multimodal anesthesia to reduce doses of anesthetics compared to classical anesthesia is a promising direction in modern anesthesiology. The widespread use of local anesthetics in anesthesiological practice has made it possible to identify their significant effect on the neuromuscular profile. However, the available research on combinations of these drugs with muscle relaxants is very contradictory. Objective. To study the effects of preoperative intravenous lidocaine on neuromuscular conduction. Materials and methods. In order to assess the effect of lidocaine on neuromuscular conduction, 60 patients (ASA I–II) were examined, who underwent laparoscopic cholecystectomy for chronic calculous cholecystitis. Two groups were formed: patients using lidocaine at a dose of 2 mg·kg-1 (30 people, the first group), and patients who used saline (30 people, the second group). Neuromuscular conduction was assessed using the acceleromyography method (monitor TOF-Watch SX). Results. The rate of recovery of neuromuscular conduction was within 47 and 48 minutes in groups 1 and 2, respectively (p=0.92). Conclusion. As a result of the study, it was found that lidocaine did not statistically have a significant effect on neuromuscular transmission.

миорелаксантылидокаиннервно-мышечный блокмониторингфакторыmuscle relaxantslidocaineneuromuscular blockReferencesSoto G., Naranjo González M., Calero F. Intravenous lidocaine infusion // Revista Espanola de Anestesiologia y Reanimacion. 2018. Vol. 65, No. 5. P. 269–274. doi: 10.1016 /j.redar.2018.01.004.Soto G., Naranjo González M., Calero F. Intravenous lidocaine infusion // Revista Espanola de Anestesiologia y Reanimacion. 2018. Vol. 65, No. 5. P. 269–274. doi: 10.1016 /j.redar.2018.01.004.Sloan T., Mongan P., Lyda C., Koht A. Lidocaine infusion adjunct to total intravenous anesthesia reduces the total dose of propofol during intraoperative neurophysiological monitoring // Journal of Clinical Monitoring and Computing. 2014. Vol. 28, No. 2. P. 139–147. doi 10.1007/s10877–013–9506-x.Sloan T., Mongan P., Lyda C., Koht A. Lidocaine infusion adjunct to total intravenous anesthesia reduces the total dose of propofol during intraoperative neurophysiological monitoring // Journal of Clinical Monitoring and Computing. 2014. Vol. 28, No. 2. P. 139–147. doi 10.1007/s10877–013–9506-x.Бестаев Г.Г., Слепушкин В. Д. Миорелаксанты: сегодня, завтра: монография. Владикавказ, 2019. 125 с.Bestaev G. G., Slepushkin V. D. Muscle relaxants: today, tomorrow: monograph. Vladikavkaz, 2019, 125 p. (In Russ.).Бестаев Г. Г. Слепушкин В. Д. К вопросу о факторах, влияющих на нейромышечную блокаду // Вестник интенсивной терапии им. А. И. Солтанова. 2018. № 2. С. 36–39.Bestaev G. G. Slepushkin V. D. On the issue of factors influencing neuromuscular blockade. Bulletin of Intensive Therapy named after A. I. Soltanova, 2018, No. 2, pp. 36–39 (In Russ.).Бестаев Г. Г. Слепушкин В. Д. Факторы, влияющие на продолжительность действия недеполяризующего миорелаксанта эсмерона: анализ серии наблюдений // Вестник ДГМА. 2020. № 3 (36). С. 14–17.Bestaev G. G., Slepushkin V. D. Factors influencing the duration of action of the non-depolarizing muscle relaxant Esmeron: analysis of a series of observations. Bulletin of the DSMA, 2020, No. 3 (36), pp. 14–17 (In Russ.).Péréon Y., Bernard J. M., Nguyen S., Genet R., Petitfaux F., Guihéneuc P. The effects of desflurane on the nervous system: from spinal cord to muscles // Anesth. Analg. 1999. Vol. 89, No. 2. P. 490–495. doi: 10.1097/00000539.Péréon Y., Bernard J. M., Nguyen S., Genet R., Petitfaux F., Guihéneuc P. The effects of desflurane on the nervous system: from spinal cord to muscles // Anesth. Analg. 1999. Vol.  89, No.  2. P.  490–495. doi: 10.1097/00000539.Hans G.A., Defresne A., Ki B., Bonhomme V., Kaba A., Legrain C., Brichant J. F., Hans P. C. Effect of an intravenous infusion of lidocaine on cisatracurium- induced neuromuscular block duration: a randomized- controlled trial // Acta Anaesthesiol. Scand. 2010. Vol. 54, No. 10. P. 1192–1196. doi: 10.1111/j.1399-6576.2010.02304.Hans G.A., Defresne A., Ki B., Bonhomme V., Kaba A., Legrain C., Brichant J. F., Hans P. C. Effect of an intravenous infusion of lidocaine on cisatracurium- induced neuromuscular block duration: a  randomized- controlled trial // Acta Anaesthesiol. Scand. 2010. Vol.  54, No.  10. P.  1192–1196. doi: 10.1111/j.1399-6576.2010.02304.Weibel S., Jokinen J., Pace N. L., Schnabel A., Hollmann M. W., Hahnenkamp K., Eberhart L. H., Poepping D. M., Afshari A., Kranke P. Efficacy and safety of intravenous lidocaine for postoperative analgesia and recovery after surgery: a systematic review with trial sequential analysis // Br. J. Anaesth. 2016. Vol. 116, No. 6. P. 770–783. doi: 10.1093/bja/aew101.Weibel S., Jokinen J., Pace N. L., Schnabel A., Hollmann M. W., Hahnenkamp K., Eberhart L. H., Poepping D. M., Afshari A., Kranke P. Efficacy and safety of intravenous lidocaine for postoperative analgesia and recovery after surgery: a systematic review with trial sequential analysis // Br. J. Anaesth. 2016. Vol. 116, No. 6. P. 770–783. doi: 10.1093/bja/aew101.Kim M.H., Kim M. S., Lee J. H., Kim S. T., Lee J. R. Intravenously administered Lidocaine and magnesium during thyroid surgery in female patients for better quality of recovery after anesthesia // Anesth. Analg. 2018. Vol. 127, No. 3. P. 635–641. doi: 10.1213/ANE.0000000000002797.Kim M.H., Kim M. S., Lee J. H., Kim S. T., Lee J. R. Intravenously administered Lidocaine and magnesium during thyroid surgery in female patients for better quality of recovery after anesthesia // Anesth. Analg. 2018. Vol. 127, No. 3. P. 635–641. doi: 10.1213/ANE.0000000000002797.Katz R.L., Gissen A. J. Effects of intravenous and intra- arterial procaine and lidocaine on neuromuscular transmission in man // Acta Anaesthesiol. Scand. 1969. Vol. 36, No. 1. P. 103–113. doi: 10.1111/j.1399-6576.1969.tb00482.Katz R.L., Gissen A. J. Effects of intravenous and intra- arterial procaine and lidocaine on neuromuscular transmission in man // Acta Anaesthesiol. Scand. 1969. Vol.  36, No.  1. P.  103–113. doi: 10.1111/j.1399-6576.1969.tb00482.Cardoso L.S., Martins C. R., Tardelli M. A. Effects of intravenous lidocaine on the pharmacodynamics of rocuronium // Rev. Bras. Anestesiol. 2005. Vol. 55, No. 4. P. 371–380. doi: 10.1590/s0034-70942005000400001.Cardoso L.S., Martins C. R., Tardelli M. A. Effects of intravenous lidocaine on the pharmacodynamics of rocuronium // Rev. Bras. Anestesiol. 2005. Vol. 55, No. 4. P. 371–380. doi: 10.1590/s0034-70942005000400001.Czarnetzki C., Lysakowski C., Elia N., Tramer M. R. Intravenous lidocaine has no impact on rocuronium- induced neuromuscular block. Randomised study // Acta Anaesthesiol. Scand. 2012. Vol. 56, No. 4. P. 474–481. doi: 10.1111/j.1399-6576.2011.02625.Czarnetzki C., Lysakowski C., Elia N., Tramer M. R. Intravenous lidocaine has no impact on rocuronium- induced neuromuscular block. Randomised study // Acta Anaesthesiol. Scand. 2012. Vol.  56, No.  4. P.  474–481. doi: 10.1111/j.1399-6576.2011.02625.Vivancos G.G., Klamt J. G., Garcia L. V. Effects of 2 mg.kg of intravenous lidocaine on the latency of two different doses of rocuronium and on the hemodynamic response to orotracheal intubation // Rev. Bras. Anestesiol. 2011. Vol. 61, No. 1. P. 1–12. doi: 10.1016/S0034-7094(11)70001-0.Vivancos G.G., Klamt J. G., Garcia L. V. Effects of 2  mg.kg of intravenous lidocaine on the latency of two different doses of rocuronium and on the hemodynamic response to orotracheal intubation // Rev. Bras. Anestesiol. 2011. Vol. 61, No. 1. P. 1–12. doi: 10.1016/S0034-7094(11)70001-0.Feldman S.A., Crawley B. E. Interaction of diazepam with muscle relaxant drugs // Brit. Med. J. 1970. Vol. 1, No. 2. P. 336–338. doi: 10.1136/bmj.2.5705.Feldman S.A., Crawley B. E. Interaction of diazepam with muscle relaxant drugs // Brit. Med. J. 1970. Vol. 1, No. 2. P. 336–338. doi: 10.1136/bmj.2.5705.Zhou H.H., Jin T. T., Qin B., Turndorf H. Suppression of spinal cord motoneuron excitability correlates with surgical immobility during isoflurane anesthesia // Anesthesiology. 1998. Vol. 88, No. 4. P. 955. doi: 10.1097/00000542-199804000-00015.Zhou H.H., Jin T. T., Qin B., Turndorf H. Suppression of spinal cord motoneuron excitability correlates with surgical immobility during isoflurane anesthesia // Anesthesiology. 1998. Vol.  88, No.  4. P.  955. doi: 10.1097/00000542-199804000-00015.Matsuo S., Rao D. B., Chaudry I., Foldes F. F. Interaction of muscle relaxants and local anesthetics at the neuromuscular junction // Anesth. Analg. 1978. Vol. 57, No. 5. P. 580–587. doi: 10.1213/00000539-197809000-00014.Matsuo S., Rao D. B., Chaudry I., Foldes F. F. Interaction of muscle relaxants and local anesthetics at the neuromuscular junction // Anesth. Analg. 1978. Vol. 57, No. 5. P. 580–587. doi: 10.1213/00000539-197809000-00014.Toft P., Kirkegaard Nielsen H., Severinsen I., Helbo- Hansen H. S. Effect of epidurally administered bupivacaine on atracurium- induced neuromuscular blockade // Acta Anaesthesiol. Scand. 1990. Vol. 34, No. 8. P. 649–652. doi: 10.1111/j.1399-6576.1990.tb03165.Toft P., Kirkegaard Nielsen H., Severinsen I., Helbo- Hansen H. S. Effect of epidurally administered bupivacaine on atracurium- induced neuromuscular blockade // Acta Anaesthesiol. Scand. 1990. Vol. 34, No. 8. P. 649–652. doi: 10.1111/j.1399-6576.1990.tb03165.Bryssine B., Maurin C., Soubiroud J. L., Ksarelof M., Roche O. Abstract PR425: Interaction of Intravenous Lidocaine with Neuromuscular Blocking // Anesthesia & Analgesia. 2016. Vol. 123, No. 3. P. 538. doi: 10.1213/01.ane.0000492812.61695.cb.Bryssine B., Maurin C., Soubiroud J. L., Ksarelof M., Roche O. Abstract PR425: Interaction of Intravenous Lidocaine with Neuromuscular Blocking // Anesthesia & Analgesia. 2016. Vol.  123, No.  3. P.  538. doi: 10.1213/01.ane.0000492812.61695.cb.Paula-Garcia W.N., Oliveira-Paula G. H., de Boer H. D., Garcia L. V. Lidocaine combined with magnesium sulfate preserved hemodynamic stability during general anesthesia without prolonging neuromuscular blockade: a randomized, double- blind, controlled trial // BMC Anesthesiology. 2021. Vol. 21, No. 1. P. 91. doi: 10.1186/s12871-021-01311-y.Paula-Garcia   W.N., Oliveira-Paula G.    H., de Boer H. D., Garcia L. V. Lidocaine combined with magnesium sulfate preserved hemodynamic stability during general anesthesia without prolonging neuromuscular blockade: a randomized, double- blind, controlled trial // BMC Anesthesiology. 2021. Vol. 21, No. 1. P. 91. doi: 10.1186/s12871-021-01311-y.

The authors declare that there are no conflicts of interest present.