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PAIN MEDICINE

Bupivacaine’s Action on the Carrageenan-Induced Inflammatory Response in Mice: Cytokine Production by Leukocytes After Ex-Vivo Stimulation

Laboratoire d’Anesthésie, Université de Paris-Sud, Cedex, France

Address correspondence and reprint requests to Jean-Xavier Mazoit, MD, PhD, Laboratoire d’anesthésie, Faculté de Médecine, 94276 Le Kremlin Bicêtre, Cedex, France. Address e-mail to jean-xavier.mazoit{at}kb.u-psud.fr.

We aimed to study the effect of bupivacaine on the systemic response elicited by intraplantar injection of carrageenan. To that purpose, we studied the effects of carrageenan, bupivacaine, or both on the production of tumor necrosis factor (TNF)-, interleukin (IL)-1ß, and IL-10 by whole blood cultured in the presence of lipopolysaccharide (LPS) and of heat-killed Staphylococcus Aureus Cowan (SAC). Mice received a hindpaw injection of carrageenan with or without encapsulated IM bupivacaine given contralaterally. Whole blood was sampled 15 h later and cultured for 24 h with LPS or SAC. The amounts of TNF-, IL-1ß, and IL-10 in the supernatants were measured. In the presence of LPS or SAC, proinflammatory cytokine (TNF- and IL-1ß) production was increased after carrageenan. Bupivacaine prevented this inflammatory response: 992 ± 102 versus 2146 ± 338 versus 919 ± 116 pg/mL for TNF- (bupivacaine + carrageenan versus carrageenan versus control after LPS stimulation). This effect of bupivacaine was less after SAC stimulation. Moreover, IL-10 was not involved in the inhibition of proinflammatory cytokine production observed after treatment by bupivacaine alone. These experiments show that carrageenan-induced hindpaw inflammation modifies the blood cell reactivity to LPS and SAC and that bupivacaine regulates the systemic response elicited by carrageenan. Furthermore, IL-10 does not seem to be a factor of the antiinflammatory response induced by bupivacaine. The precise mechanism underlying this effect of bupivacaine remains to be clarified.

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