The effect of short-term epidural local anesthetic blockade on urinary levels of substance P in interstitial cystitis.

Autor:	Sukiennik A; Departments of Anesthesia and Urology, Tufts-New England Medical Center, Boston, Massachusetts 02111, USA., Carr DB, Bonney I, Marchand JE, Wurm H, Sant GR
Jazyk:	angličtina
Zdroj:	Anesthesia and analgesia [Anesth Analg] 2004 Mar; Vol. 98 (3), pp. 846-50, table of contents.
DOI:	10.1213/01.ane.0000099362.01312.3a
Abstrakt:	Unlabelled: We investigated the effect of epidural local anesthetic blockade on urinary substance P levels in five patients suffering from painful flare-ups of interstitial cystitis. Urine was collected in 24-h intervals commencing at the onset of an epidural bolus of 0.25% bupivacaine followed by maintenance epidural infusions of 0.05% bupivacaine. Substance P was measured by radioimmunoassay. After initiation of the epidural infusion, urinary substance P levels increased and then declined in all patients. All patients reported a decrease in pain intensity. We hypothesize that acute release, followed by depletion, of substance P from bladder sensory nerve endings accounts for the transient increase of peptide levels in urine and may contribute to the decrease in pain intensity during a 3-day epidural infusion. Implications: Substance P levels in urine initially increased and then declined in a series of 5 patients who achieved pain control by epidural local anesthetic infusion during a flare-up of interstitial cystitis.
Databáze:	MEDLINE
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