Fletcher D, Kayser V, Guilbaud G
Département d'Anesthésie Réanimation Hôpital, Bicêtre, 78 avenue du général, Leclerc, 94275 Kremlin Bicêtre, France Unité de Physiopharmacologie du Système Nerveux, INSERM unité 161, 2 rue d'Alésia, 75014 Paris, France.
Pain. 1997 Feb;69(3):303-309. doi: 10.1016/S0304-3959(96)03227-7.
The mechanical allodynia and edema related to a subcutaneous carrageenin injection are increased by a conditioning carrageenin injection 7 days before (Guilbaud et al., 1992). In the present study, the possibility of preventing this by bupivacaine infiltration was tested. In the first part of the experiment, the time course of a carrageenin induced inflammation of the right hind paw was assessed in animals receiving local anesthetic injection (0.2 ml of bupivacaine 0.5% solution with epinephrine) either 5 min before (BUPI PRE group) or 60 min after (BUPI POST group) the carrageenin injection (0.2 ml of 1% solution). Control groups received saline (0.2 ml) with the same timing. In the second part of the experiment, 7 days later, a carrageenin injection was performed either in the right or the left hind paw. Mechanical allodynia and edema were evaluated by the vocalization threshold to paw pressure (VTPP) and paw circumference (PC) in both hind paws at 1, 2, 4, 24 h and 7 days after both carrageenin injections. The first carrageenin injection induced mechanical allodynia and edema maximal at 240 min (42% reduction of VTPP; 23% increase in PC) and the influence of bupivacaine on the VTPP and PC was similar to previous results (Fletcher et al., 1996). The second ipsilateral carrageenin injection induced a more pronounced inflammation in the control groups and BUPI POST group than the first injection (P < 0.001). In contrast, the increase in allodynia and edema was less intense in the BUPI PRE group than in the other groups (P < 0.0001 and P < 0.02 respectively). Bupivacaine injections had no effect on allodynia and edema related to a second contra-lateral carrageenin injection. These results suggest that bupivacaine infiltration, when administered before the first conditioning injection of carrageenin, can prevent the reinforcement of mechanical allodynia and edema related to a second ipsilateral injection of carrageenin 7 days later.
与皮下注射角叉菜胶相关的机械性异常性疼痛和水肿,在7天前预先注射角叉菜胶进行预处理后会加重(吉尔博等,1992年)。在本研究中,测试了通过布比卡因浸润来预防这种情况的可能性。在实验的第一部分,在角叉菜胶注射(0.2 ml 1%溶液)前5分钟(布比卡因预处理组)或注射后60分钟(布比卡因后处理组)接受局部麻醉剂注射(0.2 ml含肾上腺素的0.5%布比卡因溶液)的动物中,评估角叉菜胶诱导的右后爪炎症的时间进程。对照组在相同时间接受生理盐水(0.2 ml)注射。在实验的第二部分,7天后,在右后爪或左后爪注射角叉菜胶。在两次角叉菜胶注射后的1、2、4、24小时和7天,通过后爪对爪部压力的发声阈值(VTPP)和爪周长(PC)评估机械性异常性疼痛和水肿。第一次角叉菜胶注射诱导的机械性异常性疼痛和水肿在240分钟时达到最大值(VTPP降低42%;PC增加23%),布比卡因对VTPP和PC的影响与先前结果相似(弗莱彻等,1996年)。第二次同侧角叉菜胶注射在对照组和布比卡因后处理组中诱导的炎症比第一次注射更明显(P < 0.001)。相比之下,布比卡因预处理组的异常性疼痛和水肿增加程度低于其他组(分别为P < 0.0001和P < 0.02)。布比卡因注射对与第二次对侧角叉菜胶注射相关的异常性疼痛和水肿没有影响。这些结果表明,在第一次预处理注射角叉菜胶之前给予布比卡因浸润,可以预防7天后第二次同侧注射角叉菜胶相关的机械性异常性疼痛和水肿的增强。