Karpie John C, Chu Constance R
Cartilage Restoration Laboratory, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA.
Am J Sports Med. 2007 Oct;35(10):1621-7. doi: 10.1177/0363546507304719. Epub 2007 Jul 30.
BACKGROUND: Intra-articular lidocaine is commonly used. PURPOSE: This study was conducted to determine whether short-term exposures to 1% and 2% lidocaine are toxic to articular chondrocytes, whether this is due to pH, and whether an intact articular surface is protective. STUDY DESIGN: Controlled laboratory study. METHODS: Fresh bovine articular chondrocytes in alginate bead cultures were treated with 1% or 2% lidocaine or buffered saline (pH 7.4, 7.0, and 5.0) for 15, 30, or 60 minutes. Chondrocytes were then analyzed for viability by flow cytometry 1 hour, 1 day, and 1 week later. Bovine osteochondral cores with and without the superficial 1 mm of cartilage removed were submerged in either 0.9% saline (pH 7.4) or in 1% or 2% lidocaine for 30 minutes and assessed for viability using fluorescent microscopy. RESULTS: Chondrocyte viability decreased after just 15-minute exposures to 1% lidocaine. Longer exposures to 1% and 2% lidocaine further reduced chondrocyte viability. Chondrotoxicity of 2% lidocaine was greater than 1% lidocaine. There was no difference in chondrocyte viability after exposures to saline solutions of pH 7.4, 7.0, or 5.0. An intact articular surface did not affect lidocaine's chondrotoxic effects. CONCLUSION: Results show dose- and time-dependent cytotoxic effects of lidocaine on bovine articular chondrocytes. Reduction of pH alone did not decrease chondrocyte viability, and the intact articular surface was not protective. CLINICAL RELEVANCE: Although lidocaine chondrotoxicity was less than previously reported with bupivacaine, these observations suggest that local anesthetics as a class of drugs may negatively affect articular cartilage.
背景:关节内注射利多卡因是常用的方法。 目的:本研究旨在确定短期暴露于1%和2%利多卡因是否对关节软骨细胞有毒性,这是否归因于pH值,以及完整的关节表面是否具有保护作用。 研究设计:对照实验室研究。 方法:将新鲜牛关节软骨细胞置于藻酸盐珠培养物中,分别用1%或2%利多卡因或缓冲盐水(pH值7.4、7.0和5.0)处理15、30或60分钟。然后在1小时、1天和1周后通过流式细胞术分析软骨细胞的活力。将去除或未去除表层1毫米软骨的牛骨软骨芯置于0.9%盐水(pH值7.4)或1%或2%利多卡因中浸泡30分钟,并用荧光显微镜评估其活力。 结果:仅暴露于1%利多卡因15分钟后,软骨细胞活力就下降。更长时间暴露于1%和2%利多卡因会进一步降低软骨细胞活力。2%利多卡因的软骨毒性大于1%利多卡因。暴露于pH值7.4、7.0或5.0的盐溶液后,软骨细胞活力没有差异。完整的关节表面不影响利多卡因的软骨毒性作用。 结论:结果表明利多卡因对牛关节软骨细胞具有剂量和时间依赖性的细胞毒性作用。单独降低pH值并不会降低软骨细胞活力,完整的关节表面也没有保护作用。 临床意义:尽管利多卡因的软骨毒性低于先前报道的布比卡因,但这些观察结果表明,局部麻醉药作为一类药物可能会对关节软骨产生负面影响。
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