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Sciatic nerve block with bupivacaine-loaded microspheres prevents hyperalgesia in an inflammatory animal model

[Le bloc du nerf sciatique réalisé avec de la bupivacaïne encapsulée dans des microsphères prévient l’hyperalgésie dans un modèle inflammatoire animal]

Jean-Pierre Estèbe, MD PhD^*,,, Marc E. Gentili, MD^*,, Pascal Le Corre, PHARMD PhD, Roger Le Verge, PHARMD PhD, Jacques-Philippe Moulinoux, MD PhD and Claude Ecoffey, MD^*

^* From the Service d’Anesthésie Réanimation Chirurgicale 2,
Laboratoire de Pharmacie Galénique et Biopharmacie, and
Laboratoire GRETAC Université Rennes 1, Rennes, France.

Address correspondence to: Dr. Jean-Pierre Estèbe, Service d’Anesthésie Réanimation 2, CHRU de Rennes, Hôpital Hôtel Dieu, 2 rue de l’Hôtel Dieu, 35000 Rennes, France. Phone: 33 2 99 87 30 09; Fax: 33 2 99 87 30 19; E-mail: jean-pierre.estebe{at}chu-rennes.fr

Purpose: The aim of this study was to evaluate the effect of different durations of local anesthetic neural blockade on hyperalgesia after carrageenan infiltration in a rat model.

Methods: Inflammation was obtained by injection of carrageenan in the righ hind paw. Hyperalgesia was determined by measuring the threshold of response to increasing mechanical stimuli on the contralateral and on the ipsilateral paw. The development of edema was measured. After identification of the sciatic nerve by nerve stimulation, blockade was performed either one hour before or after carrageenan infiltration. Animals were randomly assigned into three groups: without sciatic nerve block (control group; n = 20), block with bupivacaine (B) and block with bupivacaine-loaded microspheres (B-Ms) injection before or after carrageenan infiltration (n = 10 for each group).

Results: Carrageenan infiltration in the control group induced a severe ipsilateral and contralateral hyperalgesia. After blockade with B (duration = 2 ± 0.5 hr) hyperalgesia was present and delayed only by the duration of the local anesthetic effect. A longer duration of block achieved with B-Ms (duration greater than five hours), was associated with the absence of development of both ipsilateral and contralateral hyperalgesia. No preemptive effect was recorded.

Conclusion: B-Ms as a drug delivery system prolongs the duration of neural blockade and avoids hyperalgesia phenomena in this rat model of inflammation.

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