雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

Brain and Nerve No to Shinkei Volume 32, Issue 4 （April 1980）

Brain and Nerve 脳と神経 32巻4号（1980年4月発行）

Japanese English

原著

痙攣重積症に対するLidocaineの有用性 THE EFFICACY OF LIDOCAINE IN THE STATUS EPILEPTICUS 塚本澄雄 ¹ , 堀池信雄 ¹ , 久永学 ² , 内海庄三郎 ² Sumio Tsukamoto ¹ , Nobuo Horiike ¹ , Manabu Hisanaga ² , Shozaburo Utsumi ² ¹国立奈良病院脳神経外科 ²奈良医科大学脳神経外科 ¹The Div. of Neurosurgery, Nara National Hospital ²The Div. of Neurosurgery, Nara Medical University pp.363-368

発行日 1980年4月1日 Published Date 1980/4/1

DOI https://doi.org/10.11477/mf.1406204566

PDF(5389KB)

有料閲覧

Abstract 文献概要
1ページ目 Look Inside

Ⅰ．はじめに

　Lidocaineは，1948年，Swedenにて開発されたアミド型局所麻酔剤で，安全牲が高く，現在，局所麻酔剤として，最も広く使用されている。

　1950年Southworthら^7）により心室性不整脈にも有効であることが報告されて以来，さらに抗不整脈剤としても広く臨床的に用いられるに至つている。抗不整脈剤としては，主として静脈内投与により心臓手術時，心筋梗塞時，あるいはジギタリス中毒により出現する不整脈に対し，使用頻度が高い。

Lidocaine was tried to use in order to control the status epilepticus of diverse etiology. The fundamental basis, with which we expected its anticonvulsive effect, depended on the fact that Lidocaine had the strong membrane stabilizing action at the ectopic focus of the heart, especiallyHis-Purkinje fibers. Lidocaine depresses the slope of phase 4, that is the slow diastolic depolarization of the Purkinje fibers. Supposing that the epileptogenic discharge is caused by the over-excitation of certain site of the brain, it is similar to the mechanism of the cardiac arrhythmias originating from the ventricles where the phase 4 begets too steep.

The anticonvulsive action of Lidocaine was proved to be more effective than expected. The advantages of Lidocaine as an anticonvulsive agent are, from our experiences, summarized as follows:

1) The acting is fast.

The anticonvulsive action of Lidocaine developes about 20 or 30 seconds after one-shot intravenous injection, dosing 2 or 3 mg per kg of the body weight. The lasting of action is about 20 minutes.

2) Lidocaine does not decline the level of consciousness.

The anticonvulsants mostly manifest the hypnotic action prior to suppressing the convulsion, but Lidocaine does not change the level of consciousness within the therapeutic ranges.

3) Introducing to the maintenance therapy

Lidocaine, being used one-shot intravenously, can be sustained as the maintenance therapy for about 24 hours by the bottle drip in 4 mg/kg/h.

4) Insured safety

Lidocaine as an anticonvulsive drug was safe to use. There were no side actions affecting the vital signs of the patient within the therapeutic ranges.

Seven cases of status epilepticus were satisfacto-rily managed under the administration of Lidocaine. It is concluded that Lidocaine could be recommended as the anticonvulsive agent on emergency.