Piper Samantha L, Kim Hubert T
J Bone Joint Surg Am. 2008 May;90(5):986-91. doi: 10.2106/JBJS.G.01033.
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.
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.
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).
In vitro, 0.5% ropivacaine is significantly less toxic than 0.5% bupivacaine in both intact human articular cartilage and chondrocyte culture.
已表明布比卡因是术后关节腔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。罗哌卡因在关节腔内镇痛方面与布比卡因效果相同，且全身毒性较小。我们比较了人关节软骨细胞在暴露于布比卡因、罗哌卡因和生理盐水对照后在体外的活力。
从五名患者的股骨头或胫骨平台获取宏观正常的人关节软骨。将这些患者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24小时后，使用软骨外植体的活/死活力/细胞毒性试剂盒以及培养的软骨细胞的CellTiter-Glo发光细胞活力测定法测量软骨细胞活力。
与布比卡因相比，罗哌卡因处理后软骨外植体中的软骨细胞活力显著更高（分别为94.4%±9.0%和78%±12.6%；p = 0.0004）。与生理盐水相比，罗哌卡因处理后的活力无差异（分别为94.4%±9.0%和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活力显著更高（为生理盐水溶液组值的63.9%±19%，而布比卡因为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比0.5%布比卡因的毒性显著更低。
