Comparison of ropivacaine and bupivacaine toxicity in human articular chondrocytes
Comparison of ropivacaine and bupivacaine toxicity in human articular chondrocytes
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DOI：
10.2106/jbjs.g.01033
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发表时间：
2008-05-01
影响因子：
5.3
通讯作者：
Kim, Hubert T.
中科院分区：
文献类型：
--
作者：
Piper, Samantha L.;Kim, Hubert T.
背景资料：研究表明，布比卡因是术后关节内最常用的局部麻醉剂，在体外对牛关节软骨细胞具有细胞毒性。罗哌卡因在关节内镇痛方面与布比卡因一样有效，且全身毒性较小。我们比较了暴露于布比卡因，罗哌卡因，和生理盐水solution control.Methods：从5例患者的股骨头或胫骨平台收获宏观正常的人关节软骨后，人关节软骨细胞在体外的活力。从这些患者分离的全层软骨外植体和培养的软骨细胞用0.9%生理盐水溶液、0.5%罗哌卡因或0.5%布比卡因处理30分钟。处理后24小时，使用LIVE/DEAD Viability/Cytotoxicity Kit测量软骨外植体的软骨细胞活力，使用CellTiter-Glo Luminescent Cell Viability Assay测量培养的软骨细胞的软骨细胞活力。与布比卡因相比，罗哌卡因治疗后软骨外植体中的软骨细胞活力显著增加（94.4%+/- 9.0%与78%+/- 12.6%; p = 0.0004）。与生理盐水溶液相比，罗哌卡因治疗后的存活率无差异（94.4% ± 9.0%与95.8% ± 5.7%; p = 0.6）。与布比卡因相比，罗哌卡因处理后培养的软骨细胞的活力显著增加（63.9%+/- 19%，相比之下，生理盐水组的值为37.4%+/- 12%; p < 0.0001）。在体外，0.5%罗哌卡因在完整的人关节软骨和软骨细胞培养中的毒性明显低于0.5%布比卡因。虽然布比卡因是关节内镇痛最常用的局部麻醉剂，但对人关节软骨细胞的毒性值得关注。目前的研究表明，罗哌卡因是较低的软骨毒性比布比卡因，因此，可能是更安全的关节内镇痛。
Background: It has been shown that bupivacaine, the most commonly used local anesthetic for postoperative intra-articular use, is cytotoxic to bovine articular chondrocytes in vitro. Ropivacaine is as effective as bupivacaine for intra-articular analgesia and has less systemic toxicity. We compared the in vitro viability of human articular chondrocytes after exposure to bupivacaine, ropivacaine, and saline solution control.Methods: Macroscopically normal human articular cartilage was harvested from the femoral head or tibial plateau of five patients. Full-thickness cartilage explants and cultured chondrocytes isolated from these patients were treated with 0.9% normal saline solution, 0.5% ropivacaine, or 0.5% bupivacaine for thirty minutes. Twenty-four hours after treatment, chondrocyte viability was measured with use of the LIVE/DEAD Viability/Cytotoxicity Kit for cartilage explants and with use of the CellTiter-Glo Luminescent Cell Viability Assay for cultured chondrocytes.Results: Chondrocyte viability in cartilage explants was significantly greater after treatment with ropivacaine as compared with bupivacaine (94.4%+/- 9.0% compared with 78%+/- 12.6%; p = 0.0004). There was no difference in viability after treatment with ropivacaine as compared with saline solution (94.4% 9.0% compared with 95.8% +/- 5.7%; p = 0.6). The viability of cultured chondrocytes was significantly greater after treatment with ropivacaine as compared with bupivacaine (63.9%+/- 19% as compared with 37.4%+/- 12% of the value in the saline solution group; p < 0.0001).Conclusions: In vitro, 0.5% ropivacaine is significantly less toxic than 0.5% bupivacaine in both intact human articular cartilage and chondrocyte culture.Clinical Relevance: Although bupivacaine is the most commonly used local anesthetic for intra-articular analgesia, the demonstrated toxicity to human articular chondrocytes is cause for concern. The present study demonstrated that ropivacaine is less chondrotoxic than bupivacaine and, therefore, may be safer for intra-articular analgesia.