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

Abstract:

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.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Sukiennik A,Carr DB,Bonney I,Marchand JE,Wurm H,Sant GR

doi

10.1213/01.ane.0000099362.01312.3a

subject

Has Abstract

pub_date

2004-03-01 00:00:00

pages

846-50, table of contents

issue

3

eissn

0003-2999

issn

1526-7598

journal_volume

98

pub_type

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