[Anesthetic management of patients with interstitial cystitis during intravesical resiniferatoxin therapy].
The management of patient with interstitial cystitis (IC) remains a challenge because no single agent has proven effective. IC is a chronic sterile inflammatory disease of the bladder of unknown etiology characterized by urinary frequency, urgenecy, nocturia and lower abdominal pain. We experienced anesthetic management of five patients with IC during intravesical resiniferatoxin (RTX) therapy. RTX is associated with irritative urinary symptom during bladder instillation. The patients with IC had bladder instillation with 100 ml of 10(-8) M RTX solution for 30 min. The first patient received combined spinal-epidural anesthesia (CSEA), and the others general anesthesia. The patient with regional anesthesia had no critical troubles related to circulatory status during the procedure, but increases of blood pressure after instillation of RTX were observed in two patients receiving general anesthesia. In spite of the increase in blood pressure during general anesthesia, regional anesthesia should not be used, because the effect of RTX on the spinal cord has to be maintained.
Komura
Masayoshi
M
Department of Anesthesia, Sagamihara National Hospital, Sagamihara 228-8522.
Kuroiwa
Masayuki
M
Numazawa
Kanako
K
Yamada
Tetsuo
T
Hoka
Sumio
S
D000283:Administration, Intravesical; D000368:Aged; D000767:Anesthesia, Epidural; D000768:Anesthesia, General / Q000379:methods*; D000775:Anesthesia, Spinal; D018856:Cystitis, Interstitial / Q000188:drug therapy*; D004224:Diterpenes / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
D004224:Diterpenes; C024353:resiniferatoxin