2008, Number 6
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ABSTRACTObjective: The aim of this study was to evaluate the effect of intraduodenal lidocaine infusion in early stages on experimental acute pancreatitis induced by pancreatic bile duct ligation.
Methods: We studied Wistar rats induced by pancreatic-bile duct ligation. In group I, pancreatic bile duct was ligated, intraduodenal physiological solution was infused over 2 h and serum amylase concentration was determined. Group II was sham operated. Group III was sham operated with lidocaine infusion. Group IV rats were operated on as mentioned. Intraduodenal infusion of 2% lidocaine was given at a dose of 5.8 mg/kg/body weight every 10 min over a 240-min period. Group V was operated on and infused with lidocaine, but the third determination of serum amylase was made 1 h after suspending the lidocaine infusion. All rats were sacrificed and histopathological study of the pancreas was performed.
Results: Experimental hemorrhagic pancreatitis can be induced by pancreatic bile duct ligation, which was corroborated by increasing serum amylase levels and histopathological lesions. Lidocaine infusion can significantly decrease amylase activity (p ‹0.0001) and pancreatic lesions (p ‹0.0001). Interruption of lidocaine infusion produced a significant increase in plasma amylase levels (p ‹0.001) and only improved inflammatory pancreatic lesions (p ‹0.01).
Conclusions: Ligature of the common pancreatic bile duct is an experimental model of acute pancreatitis in rats, confirmed by histological and biochemical methods. Treatment with intraduodenal lidocaine infusion improves reversibly the biochemical and histopathological course of experimental acute pancreatitis.
Baron TH, Morgan DE. Acute necrotizing pancreatitis. N Engl J Med 1999;340:1412-1417.
Nagar AB, Gorelick FS. Acute pancreatitis. Curr Opin Gastroenterol 2004;20:439-443.
Halangk W, Lerch MM. Early events in acute pancreatitis. Clin Lab Med 2005;25:1-15.
Cosen-Binker LI, Binker MG, Negri G, Tiscornia O. Acute pancreatitis: possible initial triggering mechanism and prophylaxis. Pancreatology 2003;3:445-456.
Williams JA. Intracellular signaling mechanisms activated by cholecystokinin-regulating synthesis and secretion of digestive enzymes in pancreatic acinar cells. Annu Rev Physiol 2001;63:77-97.
Uhl W, Buchler MW, Malfertheiner P, Beger HG, Adler G, Gaus W. A randomised, double blind, multicentre trial of octreotide in moderate to severe acute pancreatitis. Gut 1999;45:97-104.
Schroder T, Kinnunen PK, Lempinen M. Xylocaine treatment in experimental pancreatitis in pigs. Scand J Gastroenterol 1978;13:863-865.
Bertsch T, Fischer EG. Phospholipase A2 and acute pancreatitis in rats. Gut 1999;44:290.
Kunze H, Nahas N, Traynor JR, Wurl M. Effects of local anaesthetics on phospholipases. Biochim Biophys Acta 1976;441:93-102.
Kinasiewicz A, Juszczak M, Mazurek AP, Rowinski W, Pachecka J, Fiedor P. Lidocaine as a protective agent during pancreas cold ischemia. Acta Pol Pharm 2000;57:455-458.
Boyes RN, Adams HJ, Duce BR. Oral absorption and disposition kinetics of lidocaine hydrochloride in dogs. J Pharmacol Exp Ther 1970;174:1-8.
Samuel I, Toriumi Y, Yokoo H, Wilcockson DP, Trout JJ, Joehl RJ. Ligationinduced acute pancreatitis in rats and opossums: a comparative morphologic study of the early phase. J Surg Res 1994;57:299-311.
Lerch MM, Saluja AK, Dawra R, Ramarao P, Saluja M, Steer ML. Acute necrotizing pancreatitis in the opossum: earliest morphological changes involve acinar cells. Gastroenterology 1992;103:205-213.
Schmidt J, Rattner DW, Lewandrowski K, Compton CC, Mandavilli U, Knoefel WT, et al. A better model of acute pancreatitis for evaluating therapy. Ann Surg 1992;215:44-56.
Merriam LT, Wilcockson D, Samuel I, Joehl RJ. Ligation-induced acute pancreatitis increases pancreatic circulating trypsinogen activation peptides. J Surg Res 1996;60:417-421.
Álvarez-Castello R. Evolución de la pancreatitis aguda experimental en ratas Wistar sometidas a vagotomía. Cir Cir 2002;70:267-274.
Walker NI. Ultrastructure of the rat pancreas after experimental duct ligation. Am J Pathol 1987;126:439-451.
Bilchk AJ, Leach SD, Zucker KA, Modin MI. Experimental models of acute pancreatitis. J Surg Res 1990;48:639-647.
Ohshio G, Saluja A, Steer L. Effects of short-term pancreatic duct obstruction in rats. Gastroenterology 1991;100:196-202.
Ley de protección a los animales del Distrito Federal. Diario Oficial de la Federación, 7 de enero de 1981.
Portiansky EL, González PH. Protective effect of lidocaine in the experimental foot-and-mouth disease pancreatitis. Experientia 1995;51:1060-1062.
MacGregor RR, Thorner RE, Wright DM. Lidocaine inhibits granulocyte adherence and prevents granulocyte delivery to inflammatory sites. Blood 1980;56:203-209.
Bjorck S, Dahlstrom A, Ahlman H. Topical treatment of ulcerative proctitis with lidocaine. Scand J Gastroenterol 1989;24:1061-1072.
McCafferty DM, Sharkey KA, Wallace JL. Beneficial effects of local or systemic lidocaine in experimental colitis. Am J Physiol 1994;266:G560-G567.
Cassuto J, Sewert A, Modal M, Lundgren O. The involvement of intramural nerves in cholera toxin induced intestinal secretion. Acta Physiol Scand 1983;117:195-202.
DiMagno MJ, DiMagno EP. New advances in acute pancreatitis. Curr Opin Gastroenterol 2007;23:494-501.
Adler G, Hahn C Kern HF, Rao KN. Cerulean-induced pancreatitis in rats Increased lysosoml enzyme activity and autophagocytosis. Digestion 1985;32:10-13.
Yamaguchi H, Kimura T Mimura K, Nawata H. Activation of proteases in cerulein-induced pancreatitis. Pancreas 1989;4:565-571.
Chen MH, Jofe SN, Magee DF, Murphy RF, Naruse S. Cyclic changes of plasma pancreatic polypeptide and pancreatic secretion in fasting dogs. J Physiol 1983;341:453-461.
Laurer S, Freise H, Fischer LG, Singbartl, Aken HV, Lerch MM, et al. The role of thoracic epidural analgesia in receptor-dependent and receptorindependent pulmonary vasoconstriction in experimental pancreatitis. Anesth Analg 2007;105:453-459.