Evaluation of continuous infusion of lidocaine on gastrointestinal tract function in normal horses

Objective - To determine the effect of continuous infusion of lidocaine on fecal transit time in normal horses. Study Design - Experimental randomized cross-over study. Animals - Healthy horses (n=6). Methods - Barium-filled microspheres were administered to horses by nasogastric intubation and feces were collected every 2 hours for 4 days. A bolus of 2% lidocaine (1.3 mg/kg) was administered randomly, followed by a continuous infusion of lidocaine (0.05 mg/kg/min) for 3 days or an equivalent volume of saline. The washout period was 10 days. Variables assessed included defecation frequency, weight of feces produced, intestinal transit time (number of microspheres observed on radiographs), fecal moisture content, borborygmus score, heart and respiratory rate, and signs of lidocaine toxicity (e.g., ataxia, CNS depression). Results - During the first 24 hours of lidocaine administration, mean (+/- SD) fecal output (10.8 +/- 6.9 kg) was decreased compared with controls (15 +/- 4.9 kg). Mean (+/- SEM) time for passing 50% of the barium-filled microspheres was shorter in controls (42 +/- 1.13 hours) compared with the lidocaine group (50 +/- 1.32 hours). Conclusions - Continuous infusion of lidocaine increases the transit time of feces in normal horses. Clinical Relevance - Clinicians need to be aware of the effects of using a continuous infusion of lidocaine on the transit time of feces in normal horses, with a potential for exacerbating those effects when combined with drugs that decrease motility and in horses with medical colic (e.g., impaction) or where a diagnosis has not been made. (C) Copyright 2008 by The American College of Veterinary Surgeons.