Efeitos secundários potencialmente desejáveis dos anestésicos locais

Autores

  • Estela Maris Freitas Muri Universidade Federal Fluminense. Faculdade de Farmácia
  • Maria Matilde de Mello Sposito Universidade de São Paulo. Faculdade de Medicina
  • Leonardo Metsavaht Instituto Brasil de Tecnologias da Saúde

DOI:

https://doi.org/10.11606/issn.2317-0190.v17i1a103307

Palavras-chave:

Anestésicos Locais/farmacologia, Canais de Sódio, Literatura de Revisão como Assunto

Resumo

Apesar do uso dos anestésicos locais (ALs) ter a finalidade principal de produzir bloqueios nervosos pela inibição dos canais de Na+, a literatura tem mostrado que esses agentes podem ter ações farmacológicas adicionais, afetando também, os canais de potássio e de cálcio e agindo em mecanismos intracelulares. Os ALs podem, além de causar anestesia, agir diretamente sobre outros receptores e suas vias de sinalização que estão envolvidos nos processos de inflamação, ativação plaquetária, nocicepção, dor periférica e arritmias, dentre outras, buscando cada vez mais, uma melhor eficácia e segurança clínica, além de novas e potencialmente úteis propriedades para os ALs. Assim, o objetivo deste estudo foi pesquisar em literatura científica e descrever uma revisão da farmacologia e dos efeitos adicionais potencialmente desejáveis dos principais anestésicos locais usados na clínica médica.

Downloads

Os dados de download ainda não estão disponíveis.

Referências

Catterall WA, Mackie K. Local anesthetics. In: Hardmons J. Goodman and Gillman's the pharmacologic basis of therapeutics. 11th ed. Columbus, OH: Mc-Graw Hill; 2006.

Pecher S, Böttiger BW, Graf B, Hollmann MW. Alternative effects of local anesthetic agents. Anaesthesist. 2004;53(4):316-25.

Jewell C, Ackermann C, Payne NA, Fate G, Voorman R, Williams FM. Specificity of procaine and ester hydrolysis by human, minipig, and rat skin and liver. Drug Metab Dispos. 2007;35(11):2015-22.

Rang HP, Dale MM, Ritter JM, Flower RJ. Farmacologia. 6th. Rio de Janeiro: Elsevier; 2007.

Rosenberg PH, Veering BT, Urmey WF. Maximum recommended doses of local anesthetics: a multifactorial concept. Reg Anesth Pain Med. 2004;29:564-75.

Paiva LCA, Cavalcanti AL. Anestésicos locais em odontologia: uma revisão de literatura. Publ UEPG Ci Biol Saúde. 2005;11(2):35-42.

Harmatz, A. Local Anesthetics: Uses and Toxicities. Surg Clin N Am. 2009;89(3):587-98.

Sawynok J. Topical and Peripherally Acting Analgesics. Pharmacol Rev. 2003;55(1):1-20.

Priest BT. Future potential and status of selective sodium channel blockers for the treatment of pain. Curr Opin Drug Discov Devel. 2009;12(5):682-92.

Jensen TS, Madsen CS, Finnerup NB. Pharmacology and treatment of neuropathic pains. Curr Opin Neurol. Curr Opin Neurol. 2009;22(5):467-74.

Devers A, GalerBS. Topical lidocaine patch relieves a variety of neuropathic pain conditions: an open-label study. Clin J Pain. 2000;16(3):205-8.

Sampathkumar P, Drage LA, Martin DP. Herpes zoster (shingles) and postherpetic neuralgia. Mayo Clin Proc. 2009;84(3):274-80.

Hempenstall K, Nurmikko TJ, Johnson RW, A'Hern RP, Rice AS. Analgesic therapy in postherpetic neuralgia: a quantitative systematic review. PLoS Med. 2005;2(7):e164:0628-44.

Wallace MS. Calcium and sodium channel antagonists for the treatment of pain. Clin J Pain. 2000;16(2 Suppl):S80-5.

Yeng LT, Godinho FLF, Teixeira MJ. Síndrome complexa de dor regional. In: Teixeira MJ. Dor: contexto interdisciplinar. Curitiba: Maio; 2003. p. 217-30.

Affaitati G, Fabrizio A, Savini A, Lerza R, Tafuri E, Costantini R, et al. A randomized, controlled study comparing a lidocaine patch, a placebo patch, and anesthetic injection for treatment of trigger points in patients with myofascial pain syndrome: evaluation of pain and somatic pain thresholds. Clin Ther. 2009;31(4):705-20.

Metsavaht L, Metsavaht O, Metsavaht R. Mesoterapia anátomo-clínica na dor músculo-esquelética. In: Teixeira MJ. Dor: contexto interdisciplinar. Curitiba: Maio: 2003. p. 673-88.

Braun W. Lombalgias. In: Teixeira MJ. Dor: contexto interdisciplinar. Curitiba: Maio; 2003. p. 464-72.

Lima ICM, Seguchi HHK, Imamura M, Saito ET, Pinho CP, Imamura ST. Tratamento da lombalgia crônica pela inativação de pontosgatilho miofasciais: experiência da Divisão de Medicina Física da FMUSP. Acta Fisiatr. 1999;6(1):10-13.

Kaweski S. Topical anesthetic creams. Plast Reconstr Surg. 2008;121(6):2161-5.

Eldelman A, Weiss JM, Lau J, Carr DB. Topical anesthetics for dermal instrumentation: a systematic review of randomized, controlled trials. Ann Emerg Med. 2005;46(4):343-51.

Tang MB, Goon AT, Goh CL. Study on the efficacy of ELA-Max (4% liposomal lidocaine) compared with EMLA cream (eutectic mixture of local anesthetics) using thermosensory threshold analysis in adult volunteers. J Dermatolog Treat. 2004;15(2):84-7.

Eichenfield LF, Funk A, Fallon-Friedlander S, Cunningham BB. A clinical study to evaluate the efficacy of ELA-Max (4% liposomal lidocaine) as compared with eutectic mixture of local anesthetics cream for pain reduction of venipuncture in children. Pediatrics. 2002;109(6):1093-9.

Kanai A, Kumaki C, Niki Y, Suzuki A, Tazawa T, Okamoto H. Efficacy of a metered-dose 8% lidocaine pump spray for patients with post-herpetic neuralgia. Pain Med. 2009;10(5):902-9.

Kanai A, Segawa Y, Okamoto T, Koto M, Okamoto H. The analgesic effect of a metered-dose 8% lidocaine pump spray in posttraumatic peripheral neuropathy: a pilot study. Anesth Analg. 2009;108(3):987-91.

Burashnikov A, Di Diego JM, Zygmunt AC, Belardinelli L, Antzelevitch C. Atrial-selective sodium channel block as a strategy for suppression of atrial fibrillation. Ann N Y Acad Sci. 2008;1123:105-12.

Hanck DA, Nikitina E, McNulty MM, Fozzard HA, Lipkind GM, Sheets MF. Using lidocaine and benzocaine to link sodium channel molecular conformations to state-dependent antiarrhythmic drug affinity. Circ Res. 2009;105(5):492-9.

Mehanna AS. Cardiac agents: cardiac glycosides, antianginal and antiarhytmic drugs. in: Williams DA, Foye WO, Lemke TL. Foye's Principles of Medicinal Chemistry. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2002. p. 497-517.

Gracies JM, Simpson D. Neuromuscular blockers. Phys Med Rehabil Clin N Am. 1999;10(2):357-83.

Taivainen T, Meretoja OA, Rosenberg PH. The effect of epidural bupivacaine on vecuronium-induced neuromuscular blockade in children. Acta Anaesthesiol Scand.1994;38(5):453-6.

Cardoso LSM, Martins CR, Tardelli MA. Efeitos da lidocaína por via venosa sobre a farmacodinâmica do rocurônio. Rev Bras Anestesiol. 2005;55(4):371-80.

Cao H, Kass IS, Cottrell JE, Bergold PJ. Pre or postinsult administration of lidocaine or thiopental attenuates cell death in rat hippocampal slice cultures caused by oxygen-glucose deprivation. Anesth Analg. 2005;101(4):1163-9.

Lei B, Cottrell JE, Kass IS. Neuroprotective effect of low-dose lidocaine in a rat model of transient focal cerebral ischemia. Anesthesiology. 2001;95(2):445-51.

Lei B, Popp S, Capuano-Waters C, Cottrell JE, Kass IS. Lidocaine attenuates apoptosis in the ischemic penumbra and reduces infarct size after transient focal cerebral ischemia in rats. Neuroscience. 2004;125(3):691-701.

Montcalm-Smith EA, Fahlman A, Kayar SR. Pharmacological interventions to decompression sickness in rats: comparison of five agents. Aviat Space Environ Med. 2008;79(1):7-13.

Herroeder S, Pecher S, Schönherr ME, Kaulitz G, Hahnenkamp K, Friess H, et al. Systemic lidocaine shortens length of hospital stay after colorectal surgery: a double-blinded, randomized, placebo-controlled trial. Ann Surg. 2007;246(2):192-200.

Kaba A, Laurent SR, Detroz BJ, Sessler DI, Durieux ME, Lamy ML, Joris JL. Intravenous lidocaine infusion facilitates acute rehabilitation after laparoscopic colectomy. Anesthesiology. 2007;106(1):11-8.

De Amici D, Ramaioli F, Ceriana P, Percivalle E. Antiviral activity of local anaesthetic agents. J Antimicrob Chemother. 1996;37(3):635.

Cassuto J, Sinclair R, Bonderovic M. Anti-inflammatory properties of local anesthetics and their present and potential clinical implications. Acta Anaesthesiol Scand. 2006;50(3):265-82.

Morais-Almeida M, Gaspar A, Marinho S, Rosado-Pinto J. Allergy to local anesthetics of the amide group with tolerance to procaine. Allergy. 2003;58(8):827-8.

Ball C, Westhorpe R. Local anaesthetics--procaine (Novocaine, Ethocaine). Anaesth Intensive Care. 2004;32(3):303.

Petri Jr, WA. Penicillins, Cephalosporins, and other ß-Lactam Antibiotics. In: Hardmons J. Goodman and Gillman's the pharmacologic basis of therapeutics. 11th ed. Columbus, OH: McGraw Hill; 2006. p. 1127-54.

Darmstadt GL, Batra M, Zaidi AK. Parenteral antibiotics for the treatment of serious neonatal bacterial infections in developing country settings. Pediatr Infect Dis J. 2009 Jan;28(1 Suppl):S37-42.

Yeng LT, Kaziyama HHS, Teixeira MF. Síndrome dolorosa miofascial. In: Teixeira MJ. Dor: contexto interdisciplinar. Curitiba: Maio; 2003. p. 271-87.

McMillan AS, Nolan A, Kelly PJ. The efficacy of dry needling and procaine in the treatment of myofascial pain in the jaw muscles. J Orofac Pain. 1997;11(4):307-14.

Jin WG, Shin SC. Preparation and evaluation of procaine gels for the enhanced local anesthetic action. Arch Pharm Res. 2008;31(2):235-41.

Villar-Garea A, Fraga MF, Espada J, Esteller M. Procaine Is a DNA-demethylating agent with growthinhibitory effects in human cancer cells. Cancer Res. 2003;63(16):4984-9.

Stresemann C, Brueckner B, Musch T, Stopper H, Lyko F. Functional diversity of DNA methyltransferase inhibitors in human cancer cell lines. Cancer Res. 2006;66(5):2794-2800.

Castellano S, Kuck D, Sala M, Novellino E, Lyko F, Sbardella G. Constrained analogues of procaine as novel small molecule inhibitors of DNA methyltransferase-1. J Med Chem. 2008;51(7):2321-5.

Viale M, Vannozzi MO, Mandys V, Esposito M. Timedependent influence of procaine hydrochloride on cisplatin antitumor activity in P388 tumor bearing mice. Anticancer Res. 2001;21(1A):485-87.

Mariggiò MA, Cafaggi S, Ottone M, Parodi B, Vannozzi MO, Mandys V, et al. Inhibition of cell growth, induction of apoptosis and mechanism of action of the novel platinum compound cis-diaminechloro-[2-(diethylamino) ethyl 4-amino-benzoate, N(4)]-chloride platinum (II) monohydrochloride monohydrate. Invest New Drugs. 2004;22(1):3-16.

Ognio E, Chiavarina B, Caviglioli G, Lapide M, Viale M. Transplacental passage of Pt after treatment with the new triamine complex cis-diaminechloro-[2-(diethylamino) ethyl 4-amino-benzoate, N4]-chloride platinum (II) monohydrochloride monohydrate. Arch Toxicol. 2004;78(10):584-8.

Kasaba T, Onizuka S, Takasaki M. Procaine and mepivacaine have less toxicity in vitro than other clinically used local anesthetics. Anesth Analg. 2003;97(1):85-90.

Le Coz, J. Mésothérapie em médicine générale. Paris: Masson: 1993.

Urbanek B, Kapral S. Levobupivacaine for regional anesthesia. A systematic review. Anaesthesist. 2006;55(3):296-313.

Cavalcante VO, Rocha RO, Teixeira MJ. Agentes Anestésicos e Toxina Botulínica no Tratamento da Dor. In: Teixeira MJ. Dor: contexto interdisciplinar. Curitiba: Maio; 2003. p.726-38.

Boddy AP, Mehta S, Rhodes M. The effect of intraperitoneal local anesthesia in laparoscopic cholecystectomy: a systematic review and meta-analysis. Anesth Analg. 2006;103(3):282-8.

Bisgaard T. Analgesic treatment after laparoscopic cholecystectomy: a critical assessment of the evidence. Anesthesiology. 2006;104(4):835-46.

Papadima A, Lagoudianakis EE, Antonakis P, Filis K, Makri I, Markogiannakis H, et al. Repeated intraperitoneal instillation of levobupivacaine for the management of pain after laparoscopic cholecystectomy. Surgery. 2009;146(3):475-82.

Castro FE, Garcia JB. Preemptive analgesia with epidural bupivacaine and S(+)ketamine in abdominal hysterectomy. Rev Bras Anestesiol. 2005;55(1):28-39.

Dahl JB, MØiniche S. Pre-emptive analgesia. Br Med Bull. 2004;71:13-27.

Batra YK, Mahajan R, Bangalia SK, Nagi ON, Dhillon MS. Bupivacaine/ketamine is superior to intra-articular ketamine analgesia following arthroscopic knee surgery. Can J Anaesth. 2005;52(8):832-6.

Petrenko AB, Yamakura T, Baba H, Shimoji K. The role of N-methyl-D-aspartate (NMDA) receptors in pain: a review. Anesth Analg. 2003;97(4):1108-16.

Bondok RS, Abd El-Hady AM. Intra-articular magnesium is effective for postoperative analgesia in arthroscopic knee surgery. Br J Anaesth. 2006;97(3):389-92.

Elsharnouby NM, Eid HE, Abou Elezz NF, Moharram AN. Intraarticular injection of magnesium sulphate and/or bupivacaine for postoperative analgesia after arthroscopic knee surgery. Anesth Analg. 2008;106(5):1548-52.

Elia N, Culebras X, Mazza C, Schiffer E, Tramèr MR. Clonidine as an adjuvant to intrathecal local anesthetics for surgery: systematic review of randomized trials. Reg Anesth Pain Med. 2008;33(2):159-67.

Pöpping DM, Elia N, Marret E, Wenk M, Tramèr MR. Clonidine as an adjuvant to local anesthetics for peripheral nerve and plexus blocks: a metaanalysis of randomized trials. Anesthesiology. 2009;111(2):406-15.

Tang R, Evans H, Chaput A, Kim C. Multimodal analgesia for hip arthroplasty. Orthop Clin North Am. 2009;40(3):377-87.

Milligan KR, Convery PN, Weir P, Quinn P, Connolly D. The efficacy and safety of epidural infusions of levobupivacaine with and without clonidine for postoperative pain relief in patients undergoing total hip replacement. Anesth Analg. 2000;91(2):393-7.

Araújo DR, Pinto LMA, Braga AFA, Paula E. Formulações de anestésicos locais de liberação controlada: aplicações terapêuticas. Rev Bras Anestesiol. 2003;53(5):663-71.

Moraes CM, Abrami P, Gonçalves MM, Andréo Filho N, Fernandes AS, Paula E, Fraceto LF. Preparação e caracterização físico-química de complexos de inclusão entre anestésicos locais e hidroxipropil-ß-ciclodextrina. Quim Nova. 2007;30(4):777-84.

Pachuk CJ, Ciccarelli RB, Samuel M, Bayer ME, Troutman RD, Zurawski DV, et al. Characterization of a new class of DNA delivery complexes formed by the local anesthetic bupivacaine. Biochim Biophys Acta. 2000;1468(1-2):20-30.

Hollmann MW, Durieux ME, Graf BM. Novel local anaesthetics and novel indications for local anaesthetics. Curr Op Anaesth. 2001;14(6):741-9.

Pina-Vaz C, Rodrigues AG, Sansonetty F, Martinez-de-Oliveira J, Fonseca AF, Mårdh PA. Antifungal activity of local anesthetics against Candida species. Infect Dis Obstet Gynecol. 2000;8(3-4):124-37.

Leone S, Di Cianni S, Casati A, Fanelli G. Pharmacology, toxicology, and clinical use of new long acting local anesthetics, ropivacaine and levobupivacaine. Acta Biomed. 2008;79(2):92-105.

Whiteside JB, Wildsmith JAW. Developments in local anaesthetic drugs. Br J Anesth. 2001;87(1):27-35.

Di Cianni S, Rossi M, Casati A, Cocco C, Fanelli G. Spinal anesthesia: an evergreen technique. Acta Biomed. 2008;79(1):9-17.

Scholz A. Mechanisms of (local) anaesthetics on voltage-gated sodium and other ion channels. Br J Anaesth. 2002;89(1):52-61.

Hollmann MW, Wieczorek KS, Smart M, Durieux ME. Epidural anesthesia prevents hypercoagulation in patients undergoing major orthopedic surgery. Reg Anesth Pain Med. 2001;26(3):215-22.

Hönemann CW, Hahnenkamp K, Podranski T, Strumper D, Hollmann MW, Durieux ME. Local anesthetics inhibit thromboxane A2 signaling in Xenopus oocytes and human K562 cells. Anesth Analg 2004;99(3):930-37.

Blumenthal S, Borgeat A, Pasch T, Reyes L, Booy C, Lambert M, Schimmer RC, Beck-Schimmer B. Ropivacaine decreases inflammation in experimental endotoxin-induced lung injury. Anesthesiology. 2006;104(5):961-9.

Groeben H, Grosswendt T, Silvanus MT, Pavlakovic G, Peters J. Airway anesthesia alone does not explain attenuation of histamine-induced bronchospasm by local anesthetics: a comparison of lidocaine, ropivacaine, and dyclonine. Anesthesiology. 2001;94(3):423-8.

Groeben H, Peters J. Lidocaine exerts its effect on induced bronchospasm by mitigating reflexes, rather than by attenuation of smooth muscle contraction. Acta Anaesthesiol Scand. 2007;51(3):359-64.

Johnson SM, Saint John BE, Dine AP. Local anesthetics as antimicrobial agents: a review. Surg Infect (Larchmt). 2008;9(2):205-13.

Aydin ON, Eyigor M, Aydin N. Antimicrobial activity of ropivacaine and other local anaesthetics. Eur J Anaesthesiol. 2001;18(10):687-94.

Bátai I, Kerényi M, Falvai J, Szabó G. Bacterial growth in ropivacaine hydrochloride. Anesth Analg. 2002;94(3):729-31.

Publicado

2010-03-09

Edição

Seção

Artigo de Revisão

Como Citar

1.
Muri EMF, Sposito MM de M, Metsavaht L. Efeitos secundários potencialmente desejáveis dos anestésicos locais. Acta Fisiátr. [Internet]. 9º de março de 2010 [citado 6º de maio de 2024];17(1):28-33. Disponível em: https://www.revistas.usp.br/actafisiatrica/article/view/103307