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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
The differential effects of bupivacaine and lidocaine on prostaglandin E
2
release, cyclooxygenase gene expression and pain in a clinical pain model
Anesthesia and Analgesia, Volume 106, No. 1, Year 2008
Notification
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Description
BACKGROUND: In addition to blocking nociceptive input from surgical sites, long-acting local anesthetics might directly modulate inflammation. In the present study, we describe the proinflammatory effects of bupivacaine on local prostaglandin E2 (PGE2) production and cyclooxygenase (COX) gene expression that increases postoperative pain in human subjects. METHODS: Subjects (n = 114) undergoing extraction of impacted third molars received either 2% lidocaine or 0.5% bupivacaine before surgery and either rofecoxib 50 mg or placebo orally 90 min before surgery and for the following 48 h. Oral mucosal biopsies were taken before surgery and 48 h after surgery. After extraction, a microdialysis probe was placed at the surgical site for PGE2 and thromboxane B2 (TXB2) measurements. RESULTS: The bupivacaine/rofecoxib group reported significantly less pain, as assessed by a visual analog scale, compared with the other three treatment groups over the first 4 h. However, the bupivacaine/placebo group reported significantly more pain at 24 h and PGE2 levels during the first 4 h were significantly higher than the other three treatment groups. Moreover, bupivacaine significantly increased COX-2 gene expression at 48 h as compared with the lidocaine/placebo group. Thromboxane levels were not significantly affected by any of the treatments, indicating that the effects seen were attributable to inhibition of COX-2, but not COX-1. CONCLUSIONS: These results suggest that bupivacaine stimulates COX-2 gene expression after tissue injury, which is associated with higher PGE2 production and pain after the local anesthetic effect dissipates. © 2008 by International Anesthesia Research Society.
Authors & Co-Authors
Gordon, S. M.
United States, Baltimore
University of Maryland School of Dentistry
Chuang, Brian P.
Unknown Affiliation
Wang, Xiaomin
United States, Bethesda
National Institute of Nursing Research Ninr
Hamza, May A.
Egypt, Cairo
Faculty of Medicine - Ain Shams University
Rowan, Janet S.
Unknown
Clinical Research Center
Brahim, Jaime S.
United States, Bethesda
National Institute of Dental and Craniofacial Research Nidcr
Dionne, Raymond A.
Unknown Affiliation
Statistics
Citations: 53
Authors: 7
Affiliations: 5
Identifiers
Doi:
10.1213/01.ane.0000296474.79437.23
ISSN:
00032999
Research Areas
Genetics And Genomics
Health System And Policy
Violence And Injury