Comparison of a bupivacaine peripheral nerve block and systemic ketoprofen on peripheral inflammation and hyperalgesia in rats.
OBJECTIVE
Local anaesthetics via a nerve block can attenuate inflammation. However, their effects have never been compared with the anti-inflammatory effects of systemic NSAIDs. The aim of this study was to compare the effects of bupivacaine via sciatic block with a systemic NSAID on oedema and hyperalgesia and on indices of systemic inflammation as measured by cytokines and prostaglandin E2 production in a model of peripheral inflammation in rats.


METHODS
Rats (n=56) randomly received three injections: a left subcutaneous hind paw injection (carrageenan or physiological saline); a left sciatic block (bupivacaine or physiological saline); and a systemic injection (ketoprofen or physiological saline). Six hours later, local oedema, thermal and mechanical hyperalgesia as well as cerebrospinal fluid prostaglandin E2 concentration and tumour necrosis factor-alpha and interleukin 1beta-stimulated production in whole blood cultures were measured.


RESULTS
A sciatic block with bupivacaine as well as a systemic injection of NSAID significantly decreased the oedema and the thermal and mechanical hyperalgesia induced by carrageenan. Oedema was decreased by approximately 12%, and thermal and mechanical thresholds were increased by three-fold to fourfold and 1.5-2-fold, respectively. They both inhibited the increased production of prostaglandin E2 in cerebrospinal fluid and tumour necrosis factor-alpha and interleukin 1beta in stimulated whole blood induced by carrageenan. There was no further benefit of the combination of a sciatic block and systemic NSAID.


CONCLUSIONS
In the current study, a bupivacaine block alone achieved the same anti-inflammatory effect as systemic NSAID or as when the same block is combined with a NSAID.
Université Paris-Sud, Laboratoire d'Anesthésie, Le Kremlin Bicêtre, France.
Evelyne
E
Combettes
Dan
D
Benhamou
Jean-Xavier
JX
Mazoit
Hélène
H
Beloeil
D000779:Anesthetics, Local / Q000008:administration & dosage*; D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage*; D015232:Dinoprostone / Q000134:cerebrospinal fluid; D004195:Disease Models, Animal; D004487:Edema / Q000209:etiology / Q000517:prevention & control; D006930:Hyperalgesia / Q000209:etiology / Q000276:immunology / Q000517:prevention & control*; D007249:Inflammation / Q000150:complications / Q000276:immunology / Q000517:prevention & control*; D018836:Inflammation Mediators / Q000097:blood / Q000134:cerebrospinal fluid; D007279:Injections, Subcutaneous; D053583:Interleukin-1beta / Q000097:blood; D007660:Ketoprofen / Q000008:administration & dosage*; D008297:Male; D009407:Nerve Block; D010147:Pain Measurement; D017288:Pain Threshold / Q000187:drug effects; D051381:Rats; D017207:Rats, Sprague-Dawley; D011930:Reaction Time; D012584:Sciatic Nerve / Q000187:drug effects*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D018836:Inflammation Mediators; D053583:Interleukin-1beta; D014409:Tumor Necrosis Factor-alpha; D007660:Ketoprofen; D015232:Dinoprostone; D002045:Bupivacaine