Effects of local anesthetics on human bladder contractility.
OBJECTIVE
We investigated the invitro effects of local anesthetics on the contractility of the human bladder.


METHODS
By measuring the invitro isometric contractions of human bladder strips, we determined the effects of tetracaine, bupivacaine, lidocaine, and ropivacaine on the basal spontaneous contractions and contractions induced by various stimuli, namely, KCl (60 mM), carbachol (CCh), and electrical field stimulation (EFS). The effect of local anesthetic agents on Ca(2+)-independent sustained tonic contraction (SuTC) of the detrusor was also investigated.


RESULTS
Local anesthetics increased phasic and tonic spontaneous contractile activity dose dependently in the concentration range 1-500 muM, but abolished phasic activity at higher concentrations. Local anesthetic agents inhibited nerve-mediated contraction (EFS, 0.8 msec) in a concentration-dependent manner (ropivacaine > tetracaine = bupivacaine > lidocaine), and inhibited non-nerve mediated contractions induced by KCl, long pulse EFS (direct muscle stimulation, 100 msec), and CCh. Inhibitory potency on non-nerve mediated contraction was for long pulse EFS: ropivacaine = tetracaine > bupivacaine = lidocaine and for KCl- and CCh-induced contractions: ropivacaine > tetracaine > bupivacaine = lidocaine. Higher concentrations of local anesthetics were needed to inhibit non-nerve-mediated bladder contraction than nerve-mediated contraction. SuTC was suppressed by all local anesthetics concentration dependently.


CONCLUSIONS
Our study demonstrates that local anesthetics have inhibitory effects on the contraction of human bladder as induced by different stimulants and concentrations. Their effects and differences suggest that they may be considered potentially useful as diagnostic and therapeutic agents for bladder dysfunction.
Oh
Seung-June
SJ
Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Paick
Sung Hyun
SH
Lim
Dae Jung
DJ
Lee
Eunsik
E
Lee
Sang Eun
SE
D000577:Amides / Q000494:pharmacology; D000779:Anesthetics, Local / Q000494:pharmacology*; D002045:Bupivacaine / Q000494:pharmacology; D002217:Carbachol / Q000494:pharmacology; D018679:Cholinergic Agonists / Q000494:pharmacology; D004558:Electric Stimulation; D006801:Humans; D066298:In Vitro Techniques; D007537:Isometric Contraction / Q000187:drug effects*; D008012:Lidocaine / Q000494:pharmacology; D009130:Muscle, Smooth / Q000187:drug effects / Q000294:innervation / Q000502:physiology; D011189:Potassium Chloride / Q000494:pharmacology; D000077212:Ropivacaine; D013748:Tetracaine / Q000494:pharmacology*; D001743:Urinary Bladder / Q000187:drug effects* / Q000294:innervation / Q000502:physiology*
D000577:Amides; D000779:Anesthetics, Local; D018679:Cholinergic Agonists; D013748:Tetracaine; D011189:Potassium Chloride; D000077212:Ropivacaine; D002217:Carbachol; D008012:Lidocaine; D002045:Bupivacaine