Attenuation of ischaemic injury in the equine jejunum by administration of systemic lidocaine.
Authors: Cook V L, Jones Shults J, McDowell M, Campbell N B, Davis J L, Blikslager A T
Journal: Equine veterinary journal
Summary
# Editorial Summary: Systemic Lidocaine and Ischaemic Jejunal Injury Endotoxin translocation through damaged mucosa remains a critical complication following colic surgery, yet conventional anti-inflammatory protocols may inadvertently compromise the mucosal healing process—a concern that prompted investigation into lidocaine's potential beyond its established role in managing post-operative ileus. Cook and colleagues examined whether systemic lidocaine administration could mitigate intestinal damage in an ischaemic injury model, capitalising on its emerging anti-inflammatory properties distinct from conventional NSAIDs. The research demonstrated that lidocaine treatment significantly reduced mucosal injury severity and attenuated the inflammatory cascade associated with ischaemic-reperfusion damage in jejunal tissue. These findings have meaningful implications for post-colic management protocols: given that flunixin meglumine—commonly administered for analgesia and endotoxaemia—may paradoxically impair mucosal repair, lidocaine could offer a complementary pharmacological approach that supports tissue recovery whilst maintaining systemic anti-endotoxin benefits. Equine practitioners should consider the timing and combination of anti-inflammatory and analgesic agents in colic cases, particularly where ischaemic injury is suspected, as optimising mucosal protection during the critical post-operative window may substantially improve survival outcomes.
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Practical Takeaways
- •Consider systemic lidocaine administration as an adjunct treatment to reduce inflammation and promote mucosal healing in horses post-colic surgery
- •Be cautious with flunixin meglumine use post-operatively as it may delay mucosal repair in ischaemic intestinal tissue
- •Preventing endotoxin translocation through improved mucosal recovery is critical to reducing post-operative colic mortality
Key Findings
- •Systemic lidocaine has novel anti-inflammatory effects that may improve mucosal recovery after ischaemic injury
- •Flunixin meglumine retards mucosal repair in ischaemic-injured tissue
- •Endotoxin absorption across ischaemic-injured mucosa is a major cause of mortality after colic surgery