title: Effects of topical ropivacaine on eicosanoids and neurotransmitters in the rectum of patients with distal ulcerative colitis.
abstract: BACKGROUND
  Topical administration of lidocaine has been suggested to have beneficial clinical effects in patients with active ulcerative colitis, but the mechanism of action, if any, remains obscure. As local anaesthetics may exert anti-inflammatory actions through their inhibition of nervous reflexes, we have studied the local effects of a single rectal dose of ropivacaine gel on rectal concentrations of eicosanoids and neurotransmittors in patients with relapsing ulcerative colitis.
  
  
  METHODS
  In a randomized, double-blind, placebo-controlled study, concentrations of leukotriene B4, thromboxane B2 and prostaglandin E2 in rectal dialysates and concentrations of substance P, neurokinin A, somatostatin, vasoactive intestinal polypeptide and calcitonin gene-related peptide in rectal biopsies from 19 patients with active, distally located, ulcerative colitis were measured before and after rectal administration of a 200-mg dose of ropivacaine- or placebo-gel by use of radioimmunoassays. For comparison with normal conditions, concentrations of neuropeptides were measured in another 19 patients with relapsing ulcerative colitis and 14 controls with non-inflamed colon.
  
  
  RESULTS
  No significant changes in concentrations of eicosanoids or neuropeptides were observed after ropivacaine or placebo administration. Baseline concentrations of all neuropeptides, except somatostatin, were significantly lower in active ulcerative colitis than in controls with non-inflamed colon.
  
  
  CONCLUSIONS
  These findings reveal no evidence of anti-inflammatory actions by ropivacaine in active ulcerative colitis and thus provide no rationale for topical treatment with local anaesthetics.
authors.affiliation: Dept. of Medical Gastroenterology, Hvidovre Hospital, Denmark.
authors.forename: J G
authors.initials: JG
authors.lastname: Hillingsø
authors.forename: J
authors.initials: J
authors.lastname: Kjeldsen
authors.forename: P T
authors.initials: PT
authors.lastname: Schmidt
authors.forename: T N
authors.initials: TN
authors.lastname: Rasmussen
authors.forename: B
authors.initials: B
authors.lastname: Fisher-Hansen
authors.forename: J J
authors.initials: JJ
authors.lastname: Holst
authors.forename: K
authors.initials: K
authors.lastname: Lauristen
authors.forename: K
authors.initials: K
authors.lastname: Bukhave
authors.forename: J
authors.initials: J
authors.lastname: Rask-Madsen
mesh_terms: D000285:Administration, Rectal; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000577:Amides / Q000008:administration & dosage*; D000704:Analysis of Variance; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001707:Biopsy, Needle; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000188:drug therapy*; D004311:Double-Blind Method; D015777:Eicosanoids / Q000032:analysis*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000737:chemistry / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009479:Neuropeptides / Q000032:analysis*; D011336:Probability; D012007:Rectum / Q000737:chemistry / Q000187:drug effects; D012016:Reference Values; D000077212:Ropivacaine; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D015777:Eicosanoids; D009479:Neuropeptides; D000077212:Ropivacaine