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Anesth Analg 2008; 107:1587-1591
© 2008 International Anesthesia Research Society
doi: 10.1213/ane.0b013e31818200aa
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ANESTHETIC PHARMACOLOGY

Low-Dose Systemic Bupivacaine Prevents the Development of Allodynia After Thoracotomy in Rats

Jin Woo Shin, MD, PhD{dagger}, Carlo Pancaro, MD*, Chi Fei Wang, PhD*, and Peter Gerner, MD*

From the *Pain Research Center, Department of Anesthesiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA; and {ddagger}Department of Anesthesiology and Pain Medicine, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, South Korea.

Address correspondence and reprint requests to Dr. Pancaro, Department of Anesthesiology, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis St., Boston, MA 02115. Address e-mail to carlopancaro{at}hotmail.com.

BACKGROUND: Chronic pain after thoracotomy has been recently reproduced in a rat model that allows investigation of the effect of drugs that might reduce the incidence of allodynia after thoracotomy. Previous studies suggest that intrathecal or systemic morphine, clonidine, neostigmine, and gabapentin reduce the incidence of allodynia in the rat postthoracotomy pain model. Our purpose was to test whether intercostal and systemic injection of bupivacaine prevented the development of allodynia in an animal model of chronic intercostal neuropathic pain.

METHODS: Male Sprague-Dawley rats were anesthetized and the right 4th and 5th ribs surgically exposed. The pleura were opened and the ribs were retracted for 1 h. Intercostal or systemic bupivacaine 1 mg (0.2 mL at 0.5%) was injected before and after surgery, or before surgery; a control group underwent rib retraction and did not receive any drug. Rats were tested for mechanical allodynia at a predetermined area around the incision site during the 3 wk after surgery.

RESULTS: Allodynia developed in 43% of the animals that did not receive bupivacaine (control group); in contrast, allodynia developed in only 6%, 12%, and 12% of those animals that received intercostal bupivacaine before surgery, after surgery, or systemically before surgery, respectively.

DISCUSSION: Previous studies suggest that allodynia after rib retraction can be prevented by opioids, {alpha}2-adrenergic agonists, neostigmine, and gabapentin. The current results suggest that bupivacaine is effective in preventing mechanical allodynia, whether given by intercostal injection before or after surgery, or systemically before surgery.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2008 by the International Anesthesia Research Society.