Park Jinuk, Sutradhar Bibek C, Hong Gyeongmi, Choi Seok H, Kim Gonhyung
Laboratory of Veterinary Surgery, College of Veterinary Medicine, Chungbuk National University, Cheongju, Korea.
Vet Anaesth Analg. 2011 Mar;38(2):127-33. doi: 10.1111/j.1467-2995.2010.00590.x.
OBJECTIVE: To compare the chondrotoxicity of bupivacaine, lidocaine, and mepivacaine in equine articular chondrocytes in vitro. STUDY DESIGN: Prospective, experimental study. STUDY MATERIAL: Equine articular chondrocytes. METHODS: Primary cultured equine chondrocytes were exposed to 0.5% bupivacaine, 2% lidocaine, or 2% mepivacaine for 30 or 60 minutes. After treatment, cell viability was evaluated by trypan blue exclusion and the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) colorimetric assay in a dose dependent manner. Apoptosis and necrosis of chondrocytes were analyzed with the double staining of Hoechst 33258 and propidium iodide using fluorescence microscopy, and the results were confirmed using flow cytometry. RESULTS: After 30-minute exposure, trypan blue exclusion assay revealed that cell viability of 0.5% bupivacaine group was 28.73±8.44%, and those of 2% lidocaine and 2% mepivacaine were 66.85±6.03% and 86.27±2.00%, respectively. The viability of chondrocytes after saline treatment was 95.95±2.75%. The results of MTT assay and fluorescence microscopy had similar tendency with trypan blue assay. Each result showed that bupivacaine was the most toxic of the three local anaesthetics. Mepivacaine was less toxic than lidocaine. The results of the viability test suggest that bupivacaine and lidocaine exhibit a marked chondrotoxicity, and that this is mainly due to necrosis rather than apoptosis. CONCLUSIONS AND CLINICAL RELEVANCE: Bupivacaine may induce detrimental chondrotoxicity when administered intra-articularly, especially in patients with joint disease, and we suggest that it should be used cautiously in equine practice. Mepivacaine may be an alternative to both bupivacaine and lidocaine.
目的:在体外比较布比卡因、利多卡因和甲哌卡因对马关节软骨细胞的软骨毒性。 研究设计:前瞻性实验研究。 研究材料:马关节软骨细胞。 方法:将原代培养的马软骨细胞暴露于0.5%布比卡因、2%利多卡因或2%甲哌卡因中30或60分钟。处理后,通过台盼蓝排斥法和3-(4,5-二甲基噻唑-2-基)-2,5-二苯基四氮唑溴盐(MTT)比色法以剂量依赖方式评估细胞活力。使用荧光显微镜通过Hoechst 33258和碘化丙啶双重染色分析软骨细胞的凋亡和坏死情况,并使用流式细胞术确认结果。 结果:暴露30分钟后,台盼蓝排斥试验显示0.5%布比卡因组的细胞活力为28.73±8.44%,2%利多卡因组和2%甲哌卡因组分别为66.85±6.03%和86.27±2.00%。生理盐水处理后软骨细胞的活力为95.95±2.75%。MTT试验和荧光显微镜检查结果与台盼蓝试验有相似趋势。每个结果表明,布比卡因是三种局部麻醉剂中毒性最大的。甲哌卡因的毒性低于利多卡因。活力测试结果表明,布比卡因和利多卡因表现出明显的软骨毒性,且这主要是由于坏死而非凋亡所致。 结论及临床意义:关节内注射布比卡因可能会引起有害的软骨毒性,尤其是在患有关节疾病的患者中,我们建议在马的临床实践中应谨慎使用。甲哌卡因可能是布比卡因和利多卡因的替代品。
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