Objectives: 

One-lung ventilation (OLV) during thoracic surgery may induce an inflammatory response that can contribute to the induction and propagation of frequently occurring postoperative respiratory distress. Lidocaine is a commonly used local anesthetic agent which has also been found to possess anti-inflammatory activity in several disorders. However, the specific effects of this drug on the alterations secondary to pulmonary ischemia/reperfusion (I/R) have been little explored.

The aim of this study is to investigate the effect of OLV on the pulmonary inflammatory response and to assess a possible immunomodulatory effect of lidocaine.

Materials: 

Eighteen pigs undergoing thoracic surgery with OLV were randomly assigned to one of these study groups: animals receiving anesthesia with intravenously applied propofol alone (group 1) or plus lidocaine (group 2) and sham group (group 3). Samples of bronchoalveolar lavage (BAL) and blood were taken before and after OLV to measure inflammatory mediators (tumor necrosis factor alpha (TNF), interleukin 2 (IL-2) and metaloproteinases 2 (MMP2),3 (MMP3)and 9 (MMP9)). Lung tissue from both collapsed and ventilated lungs were also analyzed for inflammatory mediators' expression (TNF, IL-1, MCP1).

Results: 

OLV significantly increased pulmonary expression of TNF (p<0,01), IL-1 (p<0,01) and MCP1 (p<0,05) in the collapsed lung. OLV also increased TNF expression in the ventilated lung. OLV effects were partially blocked by lidocaine. OLV increased both BAL and plasma levels of TNF (p<0,01), MMP2 (p<0,01) and MMP9 (p<0,05) levels and again these effects were partially blocked by lidocaine.

Conclusions: 

These results indicate that the inflammatory response induced by OLV could be attenuated by IV administration of lidocaine, suggesting a possible protective effect for this anesthetic against pulmonary injury secondary to OLV.