ABSORPTION OF ALKALIZED INTRAVESICAL LIDOCAINE IN NORMAL AND INFLAMED BLADDERS: A SIMPLE METHOD FOR IMPROVING BLADDER ANESTHESIA
2001; Lippincott Williams & Wilkins; Volume: 165; Issue: 6 Part 1 Linguagem: Inglês
10.1016/s0022-5347(05)66238-6
ISSN1527-3792
AutoresRichard A. Henry, Lindsey Patterson, Nicole Avery, Robert Tanzola, Debbie Tod, Duncan Hunter, J. Curtis Nickel, Álvaro Morales,
Tópico(s)Anesthesia and Pain Management
ResumoNo AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Jun 2001ABSORPTION OF ALKALIZED INTRAVESICAL LIDOCAINE IN NORMAL AND INFLAMED BLADDERS: A SIMPLE METHOD FOR IMPROVING BLADDER ANESTHESIA RICHARD HENRY, LINDSEY PATTERSON, NICOLE AVERY, ROBERT TANZOLA, DEBBIE TOD, DUNCAN HUNTER, J. CURTIS NICKEL, and ALVARO MORALES RICHARD HENRYRICHARD HENRY , LINDSEY PATTERSONLINDSEY PATTERSON , NICOLE AVERYNICOLE AVERY , ROBERT TANZOLAROBERT TANZOLA , DEBBIE TODDEBBIE TOD , DUNCAN HUNTERDUNCAN HUNTER , J. CURTIS NICKELJ. CURTIS NICKEL , and ALVARO MORALESALVARO MORALES View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)66238-6AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Pharmacokinetic studies have shown that intravesical lidocaine is not sufficiently absorbed by human bladders to achieve significant serum levels and it only provides a superficial local anesthetic effect. We investigated the pharmacokinetics of alkalized intravesical lidocaine in healthy volunteers and patients with interstitial cystitis to determine a safe dose of buffered lidocaine, the effect of interstitial cystitis on lidocaine uptake and the acute local anesthetic effect on bladder pain in interstitial cystitis. Materials and Methods: An initial dose finding study was done in 12 healthy volunteers using 4, 5 and 6 mg./kg. 5% lidocaine buffered with 8.4% sodium bicarbonate. Serial lidocaine levels were measured for 3 hours. Serum measurement was repeated in 12 patients with interstitial cystitis using 5 mg./kg. 5% lidocaine with sodium bicarbonate daily for 2 days. Patients rated pain before and during treatment. Results: Healthy volunteers and patients with interstitial cystitis had similar lidocaine absorption profiles with a peak of 1.06 μg./ml. (range 0.66 to 1.71) and 1.3 (range 0.2 to 2.0) at about 30 minutes. Mean pain score in the interstitial cystitis group decreased from a baseline of 6.0 to 1.8 on day 1 and 0.6 on day 2. There were complaints of urethral discomfort after voiding the buffered lidocaine in each group. Conclusions: Alkalization provides safe and predictable lidocaine absorption into the bladder, as indicated by therapeutic systemic levels in healthy and inflamed bladders. 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Google Scholar From the Departments of Anesthesiology, Urology and Epidemiology, Queen's University, Kingston, Ontario, Canada© 2001 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byButrick C (2014) Should Local Anesthetic Bladder Cocktails Include Sodium Bicarbonate?Journal of Urology, VOL. 191, NO. 4, (896-897), Online publication date: 1-Apr-2014.Nickel J, Shoskes D and Irvine-Bird K (2009) Clinical Phenotyping of Women With Interstitial Cystitis/Painful Bladder Syndrome: A Key to Classification and Potentially Improved ManagementJournal of Urology, VOL. 182, NO. 1, (155-160), Online publication date: 1-Jul-2009.Henry R (2008) Re: Safety and Efficacy of the Use of Intravesical and Oral Pentosan Polysulfate Sodium for Interstitial Cystitis: A Randomized Double-Blind Clinical TrialJournal of Urology, VOL. 180, NO. 1, (411-413), Online publication date: 1-Jul-2008.Vera P, Wang X and Meyer-Siegler K (2008) Neural Control of Substance P Induced Up-Regulation and Release of Macrophage Migration Inhibitory Factor in the Rat BladderJournal of Urology, VOL. 180, NO. 1, (373-378), Online publication date: 1-Jul-2008. Volume 165Issue 6 Part 1June 2001Page: 1900-1903 Advertisement Copyright & Permissions© 2001 by American Urological Association, Inc.Keywordsbladderlidocaineanesthetic, localpharmacokineticscystitis, interstitialMetricsAuthor Information RICHARD HENRY More articles by this author LINDSEY PATTERSON More articles by this author NICOLE AVERY More articles by this author ROBERT TANZOLA More articles by this author DEBBIE TOD More articles by this author DUNCAN HUNTER More articles by this author J. CURTIS NICKEL More articles by this author ALVARO MORALES More articles by this author Expand All Advertisement PDF downloadLoading ...
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