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Anesth Analg 2001;93:1293-1296
© 2001 International Anesthesia Research Society

OBSTETRIC ANESTHESIA

An Analysis of Excitatory Amino Acids, Nitric Oxide, and Prostaglandin E2 in the Cerebrospinal Fluid of Pregnant Women: The Effect on Labor Pain

Ming-Man Hsu*{dagger}, Yen-Yen Chou*{dagger}, Yi-Chen Chang*{dagger}, Tz-Chong Chou{dagger}, and Chih-Shung Wong*{dagger}

*Department of Anesthesiology, National Defense Medical Center and Tri-Service General Hospital; {dagger}Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China

Address correspondence and reprint requests to Chih-Shung Wong, Department of Anesthesiology, National Defense Medical Center and Tri-Service General Hospital, 325, Chenggung Rd., Section 2, Nei-Hu, 114, Taipei, Taiwan, ROC. Address e-mail to w82556{at}ndmctsgh.edu.tw

It is still unclear which neurotransmitters are involved in labor pain. We measured the concentrations of excitatory amino acids, nitric oxide, and prostaglandin E2 in the cerebrospinal fluid (CSF) of pregnant women, particularly in those with labor pain. The patients included in the study consisted of women who underwent cesarean delivery either with labor pain (Labor Pain group, n = 40) or without labor pain (Nonlabor Pain group, n = 58). All patients received spinal anesthesia (intrathecal injection of 10–12 mg of bupivacaine) for the operation, and 2 mL of CSF was collected before bupivacaine injection. Concentrations of aspartate and glutamate (0.50 ± 0.06 µM and 0.79 ± 0.10 µM, respectively) were significantly larger in the Labor Pain group than in the Nonlabor Pain group (0.35 ± 0.03 µM and 0.54 ± 0.04 µM, P < 0.05). There were no significant differences in the concentrations of nitric oxide and prostaglandin E2 between the groups. A positive correlation was found between CSF concentrations of excitatory amino acids and labor pain.

IMPLICATIONS: The excitatory amino acids, aspartate and glutamate, play a role in labor pain. N-methyl-D-aspartate receptor antagonists may be useful for labor pain and postlabor uterine contraction pain relief.




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Simple Quantitative HPLC Method for Measuring Physiologic Amino Acids in Cerebrospinal Fluid without Pretreatment
Clin. Chem., March 1, 2004; 50(3): 665 - 669.
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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 © 2001 by the International Anesthesia Research Society.