• Cheng Zhou, Jing Gan, Jin Liu, Wen-Jun Luo, Wen-Sheng Zhang, and Yun-Fei Chai.
• Department of Pharmacology, West China School of Pharmacy, Sichuan University, Chengdu, Sichuan, People's Republic of China.
• Anesth. Analg. 2011 Aug 1; 113 (2): 245-50.

BackgroundOur previous studies have demonstrated that emulsified isoflurane (EI) produced epidural anesthesia and blockade of nerve conduction. We designed this study to observe whether EI could produce an anesthetic effect in IV regional anesthesia (IVRA) and to investigate the underlying interaction between EI and lidocaine when they were combined in IVRA.MethodsIVRA was evaluated using tail-flick and tail-clamping tests in a rat model. In experiment 1, Sprague-Dawley rats were assigned to 4 groups (n = 10 per group), receiving 0.5 mL of 8%EI, 0.5% lidocaine, 30% Intralipid, or normal saline to observe whether EI could produce an anesthetic effect in IVRA. In experiment 2, for tail IVRA, EC(50) (median effective concentration) of EI alone and EC(50) of lidocaine alone, as well as EC(50) of lidocaine with the addition of Intralipid (0.0% EI) or with the addition of EI at different concentrations (0.4%, 0.8%, and 1.6%) were determined using an up-and-down method. Isobolographic analysis was used to evaluate the interaction between EI and lidocaine.ResultsFor experiment 1, successful IVRA was observed in 8 of 10 rats with 8% EI, 10 of 10 rats with 0.5% lidocaine, and 0 of 10 rats with 30% Intralipid or normal saline. The anesthetic effect was not different in onset time (1.5 ± 0.9 vs 1.0 ± 0.0 minutes, P = 0.104) or recovery time (15 ± 9 vs 18 ± 12 minutes, P = 0.394) between 8% EI and 0.5% lidocaine. For experiment 2, EC(50) of EI was 4.467% ± 0.375% and EC(50) of lidocaine was 0.183% ± 0.072%; EC(50) of lidocaine was 0.173% ± 0.036% with the addition of Intralipid, and 0.064% ± 0.008%, 0.035% ± 0.005%, and 0.028% ± 0.006% with the addition of 0.4%, 0.8%, and 1.6% EI, respectively. With the addition of EI, the requirement for lidocaine was reduced in a synergistic manner.ConclusionsEI produced IVRA, and a synergistic interaction was found between EI and lidocaine for IVRA in a rat tail model.

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