口腔局部麻醉药抗菌机制的研究进展

doi:10.7518/gjkq.2024009

摘要/Abstract

摘要：

局部麻醉药是口腔门诊手术常用的药物，可以发挥麻醉镇痛效果，减轻患者的疼痛，使临床治疗顺利进行。此外，局部麻醉药还被发现具有抗菌效果，能有效抑制各种细菌和真菌的生长。本文总结了口腔治疗中常用的局部麻醉药（利多卡因、布比卡因、罗哌卡因、阿替卡因等）的抗菌性，探讨了药物抗菌作用的分子机制（包括改变细胞壁和细胞膜的通透性、直接损伤细胞膜、抑制蛋白质及遗传物质的合成、抑制细胞呼吸等），以及与其他药物（抗生素、肾上腺素、阿片类药物等）的相互作用，以期有助于口腔临床治疗对局部麻醉药的选择以及感染的预防与控制。

关键词: 局部麻醉药, 抗菌性, 口腔医学

Abstract:

Local anesthetic is a kind of drug commonly used in oral outpatient operations. It has anesthetic and analgesic effects, and it can alleviate the pain of patients and facilitate treatment. Many studies have shown that local anesthetics have antibacterial effects, and they can effectively inhibit the growth of various bacteria and fungi. In this paper, the antibacterial effects of local anesthetics commonly used in dentistry (lidocaine, bupivacaine, ropivacaine, articaine, etc.) were summarized, and their molecular mechanisms were discussed (including changes in cell wall and membrane permeability, direct damage to cell membranes, inhibition of protein and genetic material synthesis, inhibition of cell respiration, etc.). The interaction with other drugs (antibiotics, epinephrine, opioids, etc.) also were studied. This work will be helpful in the selection of local anesthetics in oral clinics and the prevention and control of infection.

Key words: local anesthetics, antibacterial, dentistry

中图分类号:

谭永臻,梁新华. 口腔局部麻醉药抗菌机制的研究进展[J]. 国际口腔医学杂志, 2024, 51(1): 74-81.

Tan Yongzhen,Liang Xinhua. Research progress on the antibacterial mechanism of oral local anesthetics[J]. Int J Stomatol, 2024, 51(1): 74-81.

图/表 1

表 1

参考文献 51

1	Booij LHDJ. Pain and impulse conduction[M]//Baart J, Brand H. Local anaesthesia in dentistry. Cham: Springer International Publishing, 2017: 1-17.
2	Boyce RA, Kirpalani T, Mohan N. Updates of topical and local anesthesia agents[J]. Dent Clin North Am, 2016, 60(2): 445-471.
3	Salgado-Peralvo AO, Peña-Cardelles JF, Kewalramani N, et al. Is antibiotic prophylaxis necessary before dental implant procedures in patients with orthopaedic prostheses? A systematic review[J]. Antibiotics (Basel), 2022, 11(1): 93.
4	Dammling C, Abramowicz S, Kinard B. Current concepts in prophylactic antibiotics in oral and ma-xillofacial surgery[J]. Oral Maxillofac Surg Clin North Am, 2022, 34(1): 157-167.
5	Szabó Z, Szentkirályi É, Kovács T, et al. Antibacterial effect of local anaesthetics[J]. Orv Hetil, 2021, 162(5): 171-176.
6	Lagadinou M, Onisor MO, Rigas A, et al. Anti-microbial properties on non-antibiotic drugs in the era of increased bacterial resistance[J]. Antibiotics (Basel), 2020, 9(3): 107.
7	Wang YH, Wang DR, Liu JY, et al. Local anesthesia in oral and maxillofacial surgery: a review of current opinion[J]. J Dent Sci, 2021, 16(4): 1055-1065.
8	Razavi BM, Fazly Bazzaz BS. A review and new insights to antimicrobial action of local anesthetics[J]. Eur J Clin Microbiol Infect Dis, 2019, 38(6): 991-1002.
9	Tustin A, Kim SJ, Chomsky A, et al. Antibacterial properties of 2% lidocaine and reduced rate of endophthalmitis after intravitreal injection[J]. Retina, 2014, 34(5): 935-942.
10	Kesici S, Demirci M, Kesici U. Antibacterial effects of lidocaine and adrenaline[J]. Int Wound J, 2019, 16(5): 1190-1194.
11	谭冠中, 刘侃, 陈继营, 等. 利多卡因对细菌培养影响的实验研究[J]. 中国矫形外科杂志, 2019, 27(14): 1302-1305.
	Tan GZ, Liu K, Chen JY, et al. Impact of lidocaine on bacterial culture: an experimental study[J].Orthoped J China, 2019, 27(14): 1302-1305.
12	Liu K, Ye LY, Sun W, et al. Does use of lidocaine affect culture of synovial fluid obtained to diagnose periprosthetic joint infection (PJI)? An in vitro study[J]. Med Sci Monit, 2018, 24: 448-452.
13	Stratford AF, Zoutman DE, Davidson JSD. Effect of lidocaine and epinephrine on staphylococcus aureus in a Guinea pig model of surgical wound infection[J]. Plast Reconstr Surg, 2002, 110(5): 1275-1279.
14	Srisatjaluk RL, Klongnoi B, Wongsirichat N. Antimicrobial effect of topical local anesthetic spray on oral microflora[J]. J Dent Anesth Pain Med, 2016, 16(1): 17-24.
15	Aldous WK, Jensen R, Sieck BM. Cocaine and lidocaine with phenylephrine as topical anesthetics: antimicrobial activity against common nasal pathogens[J]. Ear Nose Throat J, 1998, 77(7): 554-557.
16	Chandan SS, Faoagali J, Wainwright CE. Sensitivity of respiratory bacteria to lignocaine[J]. Pathology, 2005, 37(4): 305-307.
17	童寅, 严建平, 郑防军, 等. 利多卡因胶浆对双J管留置术后尿及双J管细菌培养的影响[J]. 中华临床医师杂志(电子版), 2019, 13(4): 277-280.
	Tong Y, Yan JP, Zheng FJ, et al. Effect of lidocaine glue on bacterial culture of urine and double-J stent after double-J stent indwelling[J]. Chin J Clinicians (Electro Ed), 2019, 13(4): 277-280.
18	Schorter L, Straubinger RK. Impact of four local anaes-thetics on growth and viability of in vitro cultured Borrelia burgdorferi sensu stricto, Borrelia bava-riensis and Borrelia afzelii [J]. Ticks Tick Borne Dis, 2021, 12(5): 101735.
19	Nai GA, Medina DAL, Martelli CAT, et al. Does washing medical devices before and after use decrease bacterial contamination? An in vitro study[J]. Medicine (Baltimore), 2021, 100(13): e25285.
20	Callahan ZM, Roberts AL, Christopher AN, et al. The effect of commonly used local anesthetic on bacterial growth[J]. J Surg Res, 2022, 274: 16-22.
21	Kesici S, Demirci M, Kesici U. Bacterial inhibition efficiency of prilocaine and bupivacaine[J]. Int Wound J, 2019, 16(5): 1185-1189.
22	Kesici S, Demırci M, Kesici U. Antimicrobial effects of fentanyl and bupivacaine[J]. Braz J Anesthesiol, 2020, 70(4): 357-363.
23	Bátai I, Kerényi M, Falvai J, et al. Bacterial growth in ropivacaine hydrochloride[J]. Anesth Analg, 2002, 94(3): 729-731.
24	Kampe S, Poetter C, Buzello S, et al. Ropivacaine 0.1% with sufentanil 1 microg/mL inhibits in vitro growth of Pseudomonas aeruginosa and does not promote multiplication of Staphylococcus aureus [J]. Anesth Analg, 2003, 97(2): 409-411.
25	Pelz K, Wiedmann-Al-Ahmad M, Bogdan C, et al. Analysis of the antimicrobial activity of local anaesthetics used for dental analgesia[J]. J Med Micro-biol, 2008, 57(Pt 1): 88-94.
26	Kose AA, Karabağgli Y, Kiremitci A, et al. Do local anesthetics have antibacterial effect on Staphylococcus aureus under in vivo conditions? An experimental study[J]. Dermatol Surg, 2010, 36(6): 848-852.
27	Kaewjiaranai T, Srisatjaluk RL, Sakdajeyont W, et al. The efficiency of topical anesthetics as antimicrobial agents: a review of use in dentistry[J]. J Dent Anesth Pain Med, 2018, 18(4): 223-233.
28	Johnson SM, Saint John BE, Dine AP. Local anesthetics as antimicrobial agents: a review[J]. Surg Infect (Larchmt), 2008, 9(2): 205-213.
29	薛昀, 吴新民, 张生锁, 等. 左旋布比卡因和甲磺酸罗哌卡因体外的抑菌作用[J]. 中华麻醉学杂志, 2005, 25(4): 293-294.
	Xue Y, Wu XM, Zhang SS, et al. Antibacterial effect of levobupivacaine and ropivacaine mesylate in vitro [J]. Chin J Anesthesiol, 2005, 25(4): 293-294.
30	Schmidt RM, Rosenkranz HS. Antimicrobial activity of local anesthetics: lidocaine and procaine[J]. J Infect Dis, 1970, 121(6): 597-607.
31	Leung YW, Rawal BD. Mechanism of action of te-tracaine hydrochloride against Pseudomonas aeruginosa [J]. J Infect Dis, 1977, 136(5): 679-683.
32	Lygre H, Moe G, Nerdal W, et al. Interaction of articaine hydrochloride with prokaryotic membrane lipids[J]. Acta Odontol Scand, 2009, 67(1): 1-7.
33	Efimova SS, Chulkov EG, Ostroumova OS. Lipid-mediated mode of action of local anesthetics on li-pid pores induced by polyenes, peptides and lipopeptides[J]. Colloids Surf B Biointerfaces, 2018, 166: 1-8.
34	Rodrigues IC, Rodrigues SC, Duarte FV, et al. The role of outer membrane proteins in UPEC antimicrobial resistance: a systematic review[J]. Membranes (Basel), 2022, 12(10): 981.
35	Kenney LJ, Anand GS. EnvZ/OmpR two-component signaling: an archetype system that can function noncanonically[J]. EcoSal Plus, 2020, 9(1):10.1128/ecosalplus.ESP-0001-2019.
36	Silva MT, Sousa JC, Polónia JJ, et al. Effects of local anesthetics on bacterial cells[J]. J Bacteriol, 1979, 137(1): 461-468.
37	Ohsuka S, Ohta M, Masuda K, et al. Lidocaine hydrochloride and acetylsalicylate kill bacteria by disrupting the bacterial membrane potential in different ways[J]. Microbiol Immunol, 1994, 38(6): 429-434.
38	江苏宏锦天药业有限公司. 钠离子通道阻断剂用于治疗抗生素对生物耐药性的新用途: CN101450056-B[P]. 2013-04-24.
	Jiangsu Hongjintian Pharmaceutical Co., Ltd. New uses of sodium channel blockers for the treatment of antibiotic resistance to biological agents: CN1014500-56B[P]. 2013-04-24.
39	Pina-Vaz C, Rodrigues AG, Sansonetty F, et al. Antifungal activity of local anesthetics against Candida species[J]. Infect Dis Obstet Gynecol, 2000, 8(3/4): 124-137.
40	Fazly Bazaz BS, Salt WG. Local anaesthetics as antibacterial agents: effects on cellular respiration and the leakage of cytoplasmic constituents[J]. Micro-bios, 1983, 37(149/150): 139-149.
41	El-Zahabi HSA, Nossier ES, Mousa SM, et al. Antibacterial and anticancer profiling of new benzocaine derivatives: design, synthesis, and molecular mechanism of action[J]. Arch Pharm, 2022, 355(4): e2100451.
42	That V, Nguyen S, Poon D, et al. Bioluminescent lux gene biosensors in oral streptococci: determination of complementary antimicrobial activity of minocycline hydrochloride with the anesthetic lidocaine/prilocaine or the antiseptic chlorhexidine[M]//Walchuck RE. Periodontitis: symptoms, treatment and prevention. New York: Nova Science Publi-shers, Inc., 2010: 141-165.
43	Khan HU, Nasir F, Maheen S, et al. Antibacterial and wound-healing activities of statistically optimized nitrofurazone- and lidocaine-loaded silica microspheres by the box-behnken design[J]. Molecules, 2022, 27(8): 2532.
44	朱浩, 张严伟, 刘润, 等. 抗生素佐剂与抗生素联用的抑菌作用研究进展[J]. 生物技术通报, 2022, 38(6): 66-73.
	Zhu H, Zhang YW, Liu R, et al. Research progress in antibiotic adjuvant and antibiotics in antibacterial aspects[J]. Biotechnol Bull, 2022, 38(6): 66-73.
45	Kesici U, Demirci M, Kesici S. Antimicrobial effects of local anaesthetics[J]. Int Wound J, 2019, 16(4): 1029-1033.
46	Pirbudak L, Karsligil T, Zer Y, et al. Antibacterial effect of bupivacaine and ropivacaine; effect of adjuvant drugs[J]. Pain Clin, 2005, 17(1): 73-80.
47	Tirupathi SP, Rajasekhar S. Buffered versus unbuffered local anesthesia for inferior alveolar nerve block injections in children: a systematic review[J]. J Dent Anesth Pain Med, 2020, 20(5): 271-279.
48	Aulestia-Viera PV, Braga MM, Borsatti MA. The effect of adjusting the pH of local anaesthetics in dentistry: a systematic review and meta-analysis[J]. Int Endod J, 2018, 51(8): 862-876.
49	Begec Z, Gulhas N, Toprak HI, et al. Comparison of the antibacterial activity of lidocaine 1% versus alkalinized lidocaine in vitro [J]. Curr Ther Res Clin Exp, 2007, 68(4): 242-248.
50	Odden JL, Kowalski RP, Friberg TR. Lidocaine gel interferes with the antibacterial activity of povido-neiodine[J]. Ophthalmic Surg Lasers Imaging Retina, 2021, 52(S1): S13-S16.
51	Xia JL, Lyons RJ, Lin MY, et al. Combination of lidocaine gel and povidone-iodine to decrease acquired infections in procedures performed using topi-cal anesthesia[J]. J Cataract Refract Surg, 2020, 46(7): 1047-1050.

Metrics

Viewed

Full text

Abstract

Cited

Shared

Discussed

菌种	丙胺卡因	地布卡因	丁卡因	苯佐卡因	利丙双卡因乳膏
金黄色葡萄球菌	+	N	N	N	+
化脓性链球菌	N	N	N	N	+
血链球菌	+	N	N	N	N
耐甲氧西林金黄色葡萄球菌	N	N	N	N	+
黏性放线菌	+	N	N	N	N
巨大芽孢杆菌	+	N	+	N	N
铜绿假单胞菌	+	+	+	N	+
奈瑟氏菌	+	N	N	N	N
大肠埃希菌	+	+	+	N	+
产气克雷伯菌	N	+	N	+	N
牙龈卟啉单胞菌	+	N	N	N	N
具核梭杆菌	+	N	N	N	N
白色念珠菌	+	N	N	N	N

[1]	戴清仪,郝昊,华成舸,黄波,杨征. 口腔及颅颌面部常见运动防护用具的研究进展[J]. 国际口腔医学杂志, 2023, 50(3): 366-373.
[2]	朱俊瑾,王剑. 钛种植体表面银纳米颗粒负载方法的进展[J]. 国际口腔医学杂志, 2021, 48(3): 334-340.
[3]	王欢,刘洋,戚孟春,李静怡,刘梦楠,孙红. 微弧氧化技术制备钛基种植体表面涂层的研究进展[J]. 国际口腔医学杂志, 2020, 47(4): 439-444.
[4]	于林彤,宋光泰. 铒激光在儿童口腔医学中的应用[J]. 国际口腔医学杂志, 2020, 47(3): 351-355.
[5]	卿凤,钱捷. 地理信息系统在口腔医学领域的应用与展望[J]. 国际口腔医学杂志, 2019, 46(3): 367-378.
[6]	刘梦齐,盖阔,蒋丽. 抗菌性口腔种植材料的研究进展[J]. 国际口腔医学杂志, 2018, 45(5): 516-521.
[7]	吴秦,赵铱民. 口腔医学领域的机器人研究及应用现状[J]. 国际口腔医学杂志, 2018, 45(5): 615-620.
[8]	曾越, 夏海斌, 王敏. 纳米材料改良义齿基托力学性能及抗菌性能的研究进展[J]. 国际口腔医学杂志, 2018, 45(4): 455-458.
[9]	梁静, 王凯, 吴家媛. CD24在口腔医学中的研究进展[J]. 国际口腔医学杂志, 2017, 44(5): 608-613.
[10]	朱远兵, 汪俊. 定制牙托膜片切牙区厚度变化的影响因素[J]. 国际口腔医学杂志, 2017, 44(5): 583-586.
[11]	哈茜陆海霞冯希平. 出生队列研究在口腔医学中的应用[J]. 国际口腔医学杂志, 2016, 43(5): 549-553.
[12]	周进茹,陈西文,李鑫,李紫嫣,朱智敏,陈文川. 美学教育在口腔修复研究生培养中的必要性探究[J]. 国际口腔医学杂志, 2016, 43(3): 263-267.
[13]	李鑫,周进茹,李紫嫣,陈文川. 第三代生物医用材料在口腔领域中的应用[J]. 国际口腔医学杂志, 2016, 43(3): 309-313.
[14]	李星1 张舒2 苏乃川2 李琳华1 王璟3. 口腔医学随机对照试验报告的质量研究[J]. 国际口腔医学杂志, 2014, 41(2): 156-161.
[15]	李晓宁综述樊明文杨雪超审校. 牙髓病治疗新材料BioAggregate的研究进展[J]. 国际口腔医学杂志, 2013, 40(4): 471-472.