Effect of bupivacaine enantiomers on Ca2+ release from sarcoplasmic reticulum in skeletal muscle

Perturbation of Ca2+ stores and store-operated Ca2+ influx by lidocaine in neuronal N2A and NG108-15 cells

In this report we examined the effects of lidocaine on Ca²⁺ homeostasis of neuronal cells using microfluorimetric measurement of cytosolic Ca²⁺ with fura 2 as probe. In mouse neuroblastoma N2A cells, 10 mM lidocaine caused Ca²⁺ release from the cyclopiazonic acid (CPA)-dischargeable pool and abolished ATP-triggered Ca²⁺ release. Lidocaine-triggered Ca²⁺ release was not affected by xestospongin C (XeC), an inositol 1,4,5-trisphosphate receptor (IP3R) inhibitor. N2A cells did not have functional ryanodine receptors (RYR) (absence of caffeine response) and we used differentiated NG108-15 cells (presence of caffeine response) for further experiments. Caffeine-triggered Ca²⁺ release was unaffected by a brief lidocaine exposure, but was eliminated after a prolonged treatment of lidocaine, suggesting lidocaine abolished caffeine action possibly not by interfering caffeine binding but via Ca²⁺ store depletion. Lidocaine-elicited Ca²⁺ release was unaffected by XeC or a high concentration of ryanodine, suggesting Ca²⁺ release was not via IP3R or RYR. Lidocaine did not affect nigericin-dischargeable lysosomal Ca²⁺ stores. Lastly, we observed that lidocaine suppressed CPA-induced store-operated Ca²⁺ influx in both N2A cells and differentiated NG108-15 cells. Our results suggest two novel actions of lidocaine in neuronal cells, namely, depletion of Ca²⁺ store (via an IP3R- and RYR-independent manner) and suppression of store-operated Ca²⁺ influx.

Focal skeletal muscle uptake of 99mTechnetium-hydroxymethylene diphosphonate following peroneal nerve blocks in horses

We have observed focal skeletal muscle uptake of 99mTechnetium-hydroxymethylene diphosphonate (Tc-HDP), which could mimic a tibial lesion, in horses following peroneal nerve blocks. To characterize this observation further, 45 bone phase scintigrams were performed in 12 horses undergoing peroneal nerve blocks. Scans were performed before, and 1, 3, 7, and 14 days postblock. The superficial and deep branches of the peroneal nerve were blocked by injecting 10 ml of 2% mepivacaine in one limb and 20 ml in the other. Images were evaluated for uptake at the block site and uptake likely to mimic a tibial lesion. Regions of interest were placed over the block site and distal tibia. Count density ratios were used to estimate change in uptake intensity over time. The overall proportion affected was 0.52 (95% confidence interval [CI], 0.36-0.68; P < 0.001) 1 day postblock and 0.24 (95% CI, 0.13-0.40; P = 0.005) 3 days postblock. The overall proportion likely to mimic a tibial lesion was 0.19 (95% CI, 0.09-0.33; P < 0.001) 1 day postblock and 0.21 (95% CI, 0.09-0.40; P = 0.005) 3 days postblock. Focal skeletal muscle uptake was seen in only one horse 7 days postblock. Increased uptake intensity was associated with higher local anesthetic dose (P = 0.042). Peroneal nerve blocks cause focal skeletal muscle uptake of 99mTc-HDP on bone phase scintigraphy. This occurs in approximately 50% of blocked limbs and can mimic a tibial lesion on the lateral view in approximately 20% of blocked limbs.