The effect of lidocaine on in vitro neutrophil and endothelial adhesion molecule expression induced by plasma obtained during tourniquet-induced ischaemia and reperfusion.
BACKGROUND
Changes in neutrophil and endothelial adhesion molecule expression occur during perioperative ischaemia and reperfusion (I/R) injury. We investigated the effects of lidocaine on neutrophil-independent changes in neutrophil and endothelial adhesion molecule expression associated with tourniquet-induced I/R.


METHODS
Plasma was obtained from venous blood samples (tourniquet arm) taken before (baseline), during, 15 min, 2 and 24 h following tourniquet release in seven patients undergoing elective upper limb surgery with tourniquet application. Isolated neutrophils from healthy volunteers (n = 7) were pretreated in the presence or absence of lidocaine (0.005, 0.05 and 0.5 mg mL(-1) for 1 h, and then incubated with I/R plasma for 2 h. Human umbilical vein endothelial cells (HUVECs) were pretreated in the presence or absence of lidocaine (0.005, 0.05 and 0.5 mg mL(-1)) for 1 h, and then incubated with the plasma for 4 h. Adhesion molecule expression was estimated using flow cytometry. Data were analysed using ANOVA and post hoc Student-Newman-Keuls tests.


RESULTS
I/R plasma (withdrawn 15 min following tourniquet release) increased isolated neutrophil CD11b (P = 0.03), CD18 (P = 0.01) and endothelial intercellular adhesion molecule-1 (ICAM-1) (P = 0.008) expression compared to baseline. CD11b, CD18 and ICAM-1 expression on lidocaine (0.005 mg mL(-1)) treated neutrophils was similar to control. CD11b (P < 0.001), CD18 (P = 0.03) and ICAM-1 (P = 0.002) expression on lidocaine (0.05 mg mL(-1)) treated neutrophils and HUVECs was less than that on controls.


CONCLUSIONS
Increased in vitro neutrophil and endothelial cell adhesion molecule expression on exposure to plasma obtained during the early reperfusion phase is diminished by lidocaine at greater than clinically relevant plasma concentrations.
Lan
W
W
Academic Department of Surgery, Cork University Hospital and University College Cork, Ireland. dweilan@hotmail.com
Harmon
D
D
Wang
J H
JH
Ghori
K
K
Shorten
G
G
Redmond
P
P
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D000779:Anesthetics, Local / Q000097:blood / Q000494:pharmacology; D015815:Cell Adhesion Molecules / Q000097:blood / Q000187:drug effects*; D042783:Endothelial Cells / Q000187:drug effects*; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D007511:Ischemia / Q000503:physiopathology*; D008012:Lidocaine / Q000097:blood / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000187:drug effects*; D012016:Reference Values; D015424:Reperfusion / Q000379:methods*; D015427:Reperfusion Injury / Q000097:blood / Q000209:etiology; D013997:Time Factors; D014111:Tourniquets / Q000009:adverse effects; D014471:Umbilical Veins
D000779:Anesthetics, Local; D015815:Cell Adhesion Molecules; D008012:Lidocaine