Toxic effects of local anesthetics on rat fibroblasts: An in-vitro study.

Autor:	Hones KM; Department of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, FL, USA., Hao KA; College of Medicine, University of Florida, Gainesville, FL, USA., Wright JO; Department of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, FL, USA., Wright TW; Department of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, FL, USA., Hartzell J; Department of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, FL, USA., Myara DA; Department of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, FL, USA., Levings PP; Department of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, FL, USA., Badman B; Department of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, FL, USA., Ghivizzani SC; Department of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, FL, USA., Watson Levings RS; Department of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, FL, USA. Electronic address: watsors@ortho.ufl.edu.
Jazyk:	angličtina
Zdroj:	Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association [J Orthop Sci] 2024 Apr 25. Date of Electronic Publication: 2024 Apr 25.
DOI:	10.1016/j.jos.2024.04.003
Abstrakt:	Background: Infusion catheters facilitate a controlled infusion of local anesthetic (LA) for pain control after surgery. However, their potential effects on healing fibroblasts are unspecified. Methods: Rat synovial fibroblasts were cultured in 12-well plates. Dilutions were prepared in a solution containing reduced-serum media and 0.9% sodium chloride in 1:1 concentration. Each well was treated with 500 μl of the appropriate LA dilution or normal saline for 15- or 30-min. LA dilutions included: 0.5% ropivacaine HCl, 0.2% ropivacaine HCl, 1% lidocaine HCl and epinephrine 1:100,000, 1% lidocaine HCl, 0.5% bupivacaine HCl and epinephrine 1:200,000, and 0.5% bupivacaine HCl. This was replicated three times. Dilution of each LA whereby 50% of the cells were unviable (Lethal dose 50 [LD50]) was analyzed. Results: LD50 was reached for lidocaine and bupivacaine, but not ropivacaine. Lidocaine 1% with epinephrine is toxic at 30-min at 1/4 and 1/2 sample dilutions. Bupivacaine 0.5% was found to be toxic at 30-min at 1/2 sample dilution. Bupivacaine 0.5% with epinephrine was found to be toxic at 15- and 30-min at 1/4 sample dilution. Lidocaine 1% was found to be toxic at 15- and 30-min at 1/2 sample dilution. Ropivacaine 0.2% and 0.5% remained below LD50 at all time-points and concentrations, with 0.2% demonstrating the least cell death. Conclusions: Though pain pumps are generally efficacious, LAs may inhibit fibroblasts, including perineural fibroblast and endoneurial fibroblast-like cells, which may contribute to persistent nerve deficits, delayed neurogenic pain, and negatively impact healing. Should a continuous infusion be used, our data supports ropivacaine 0.2%. Level of Evidence: Basic Science Study; Animal model. Competing Interests: Conflict of interest One author has a consultancy agreement with LinkBio Corp. not related to this study. One author receives royalties and is a consultant for Exactech, Inc. not related to this study. The remaining authors, their immediate families, and any affiliated research foundations with which they are affiliated, did not receive any financial payments or other benefits from any commercial entity related to the subject of this article. (Copyright © 2024 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.)
Databáze:	MEDLINE
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