الفهرس 
Lidocaime
Renal mechanisms for urine volume excretionOnly 14 pages are availabe for public view
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Abstract
The present work studied the effect of lidocaine
(local anaesthetic and antiarrhythmic agent) on the urine
flow rate, sodium and potassium excretion in urine of
sel~cted twenty patients with acute myocardial infarction for
prophylaxes and treatment of ventricular arrhythmias in
coronary care unit of Mansoura General Hospital.
Our selected patients was 17 males and 3’ females,
their age ranged from 40-60 years with the mean of 52 years.
Our selected cases were subjected to through history
and medical exam. they were presented by severe chest pain
(100%) palpitation (65%) and vomiting (60%}.
Routine laboratory investigations as E.C.G., fasting
blood glucose, serum creatinine and serum bilirubin were
performed to every case.
Cases presenting with hypotension, heart failure,
renal failure, diabetes and apparent liver affection or those
receiving diuretics or above age of 60 years were excluded
from our study.
The lidocaine was administered in this work in the
dose of 1-1.5 mgjkgm. body weight as one loading bolus
intravenously injected.
Urine was collected from every patient one hour
before admin. of iidocaine and every half hour for 3 hours
after the admin. for estimation of the urine flow rate,
sodium, potassium and creatinine excretion.
Venous blood samples were taken from every patient
one hour before and two hours after the administration of the
lidocaine to estimate sodium and ~reatinine for calculation
of the fraction excretion of sodium (FE N~) from the
following formula:
U_r__i_n_e___s_o_d_i__u_m_/_p_l_a_s_m_a_____s_o_d__i_u_m__ x 100
Urine creatinine/plasma creatinine
- Our study reveaied that:-
a) Before admin.: it was 1.15 t 0.05 ml/.in.
b) After admin: it was 1.13 t 0.05 mi/min., 1.01 ± 0.07
ml/.in., 0.94 ± 0.06 ml/min., 0.89 ± 0.06 ml/min., 0.9 !
0.07 ml/min. every haif hour respectively.
- We noticed that iidocaine has marked antidiuretic effect
for 2.5 hours after half hour of lidocaine admin. (P.:< 0.05)
and the .axillu. effect appeared in the perIod 90-120 mInutes
after aoa Ln . (P.:< 0.01).
2. in
a) Before administratIon the urInary Na+ cone. was 117.15 t
6.32 Ilmol./L.
b) After adminIstration: it was as follows: 120.8:t. 5.58
IlllollL, 136.1 t 5.81 Illllol/L. 144.85 j: 5.87 ••ol/L, 151
+ 6.09 IlmollL, 139.2 i 6.61 mmollL and 130.7 t. 6.41
Illlol/L.every half hour respectIvely.
It was noticed that lidocaIne has Ilarked natrIuretic
effect after half hour of ad.In. (~,<0.05) and the Ilaximull
effect appeared In the perIod 80-120 Ilinutes (~,< 0.001) .
It was as follows: before adllin. • the FE Na was %
0.0198 t 0.OQ08 and two hours after ad.in. It was % 0.0225 t
0.0007 (P.:<0.01).
It was notIced that lidocaine Increased the fraction
excretIon of sodiull In urIne signifIcantly after two hours
of the drug adllinistration.
•
c( ) ”
Potassium cone. in urine was as follows: before
admin. : 57.’1 t 2.16 mmol/L, and after ad_in.: 59.3 ±. 2.2
mmol/L, 66.6 ! 1.99 maol/L, 71.4 1 1.79 mmol/L, 73.9 i 1.95
mmol/k. 66.9·~ 2.59 maol/L and 62.9 ~ 2.64 mmol/L.every half
hour respectively.
It was noticed that lidocaine increased, potassium
excretion in urine after half hour of admin. (P. ’.<0.01) and
its maximum effect appeared in the period 90-120 minutes (P.
<0.001) after admin.
* We concluded that lidocaine has marked antidiuretic
and natriuretic effects after half hour of admin. (P.: <0.05)
and the maximum effects appear in the period 90-120 min.
after admin. and also increased K+ excretion in urine after
half hour of admin. (P.: <0.01) the maxiaum effect appear
also in the period 90-120 minutes after administration in
vivo study on patients with acute myocardial infarction.