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Plasma protein binding of lidocaine during hypothermic conditions

Department of Pediatric Anesthesiology and Intensive Care The Karolinska Institute and Hospital

L. Herngren

Department of Clinical Pharmacology, The Karolinska Institute and Hospital, Stockholm

The effect of hypothermia on the protein binding of lidocaine in plasma from six healthy volunteers was studied in vitro. A significant increase (p <0.001) in the unbound fraction of lidocaine was found at 24°C (38.3 [SD 7.0] %) compared to 37°C (30.7 [SD 6.0] %). A further reduction in temperature to 10°C resulted in a slight but not statistically significant increase in the free fraction of the drug (39.9 [SD 10.2] %). As a conclusion, hypothermia enhances the transfer of lidocaine over the blood-brain barrier. In order to avoid unwanted side effects or frank toxicity, caution is recommended when administering highly protein-bound drugs during hypothermic conditions.

Perfusion, Vol. 8, No. 3, 221-224 (1993)
DOI: 10.1177/026765919300800304


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