Anesthetic Lidocaine Inhibits Cholinergic Contraction of the Mouse Small Intestine and Causes Disorders of the Human Gastrointestinal Tract

Lidocaine is one of the components of multimodal low-opioid anesthesia, which is commonly used in surgical procedures, especially in cardiac surgery. Lidocaine has been used in medicine for a long time as a local anesthetic, but after the invention of the method of its intravenous administration, questions arose about its possible side effects on the visceral system, in particular on the motility of the gastrointestinal tract. Therefore, the aim of our work was to investigate the main aspects of the use of lidocaine-based opioid-free anesthesia and its side effects and also to study the effect of lidocaine on the contractile activity of small intestine smooth muscle, namely the mouse ileum. We recorded the contractile activity of smooth muscles of the ileum of mice using the tensiometry method and found that lidocaine at the clinically relevant concentration range, i.e. 1.5, 3, and 5 μg/ml, inhibited carbachol-induced contractions by 16, 27 and 37%, respectively (n = 7). To determine the side effects of opioid-free anesthesia, we studied 60 patients with coronary artery disease undergoing coronary artery stenting with the administration of anesthesia based on lidocaine solution at different concentrations (1 and 2 mg/kg). The side effects included nausea and vomiting, which may indicate а disturbance of gastrointestinal motility, as well as numbness of the limbs, cheeks, tongue, etc. These results contribute to a better understanding of the spectrum of action of lidocaine, a popular anesthetic in surgery, on the visceral system and become an important basis for the future development of new schemes for the use of local anesthetics in clinical practice, particularly in surgical procedures.