Department of Orthopaedic Surgery, New England Musculoskeletal Institute, University of Connecticut Health Center, Farmington, Connecticut 06030, USA.
Arthroscopy. 2011 Aug;27(8):1118-22. doi: 10.1016/j.arthro.2011.02.036. Epub 2011 Jun 25.
This study evaluates the effect of low doses of epinephrine contained in common arthroscopic irrigation solutions on viability of in vitro human articular chondrocytes during short-term exposure.
Isolated cultured human chondrocytes were treated with culture medium, normal saline solution, 1:300,000 epinephrine solution (equivalent to 10 mL of 1:1,000 epinephrine added to a 3-L saline solution bag), or 1:3,000,000 epinephrine solution (equivalent to 1 mL of 1:1,000 epinephrine added to a 3-L saline solution bag) for 1 hour (N = 84). Twenty-four hours after treatment, chondrocyte viability was measured. Statistical analysis was performed with an analysis of variance with Bonferroni post-test.
Chondrocyte viability was significantly better when exposed to normal saline solution alone versus high-dose 1:300,000 epinephrine (87.9% ± 5.4% v 74.6% ± 9.4%, P < .05). Exposure to low-dose 1:3,000,000 epinephrine had significantly better survival versus high-dose 1:300,000 epinephrine (85.0% ± 8.3% v 74.6% ± 9.4%, P < .05). There was no difference in viability after exposure to low-dose 1:3,000,000 epinephrine versus normal saline solution (85.0% ± 8.3% v 87.9% ± 5.4%, P > .05).
In vitro, normal saline solution and low-dose 1:3,000,000 epinephrine are significantly less toxic than high-dose 1:300,000 epinephrine to cultured human articular chondrocytes.
This in vitro study suggests that arthroscopic irrigation fluid containing 1:3,000,000 epinephrine is less chondrotoxic than solutions containing 1:300,000 epinephrine. Surgeons may wish to use the least amount of epinephrine required for adequate visual clarity during surgery. This study does not establish a contraindication to the use of higher doses of epinephrine.
本研究评估了常见关节镜灌洗溶液中低剂量肾上腺素对体外人关节软骨细胞短期暴露时活力的影响。
分离培养的人软骨细胞用培养液、生理盐水、1:300000 肾上腺素溶液（相当于将 10 毫升 1:1000 肾上腺素加入到 3 升生理盐水袋中）或 1:3000000 肾上腺素溶液（相当于将 1 毫升 1:1000 肾上腺素加入到 3 升生理盐水袋中）处理 1 小时（N = 84）。处理 24 小时后，测量软骨细胞活力。采用方差分析和 Bonferroni 后检验进行统计学分析。
与高剂量 1:300000 肾上腺素（87.9% ± 5.4%比 74.6% ± 9.4%，P <.05）相比，单独使用生理盐水溶液时软骨细胞活力明显更好。与高剂量 1:300000 肾上腺素相比，低剂量 1:3000000 肾上腺素的存活率明显更高（85.0% ± 8.3%比 74.6% ± 9.4%，P <.05）。与生理盐水溶液相比，低剂量 1:3000000 肾上腺素暴露后活力无差异（85.0% ± 8.3%比 87.9% ± 5.4%，P >.05）。
在体外，与高剂量 1:300000 肾上腺素相比，生理盐水溶液和低剂量 1:3000000 肾上腺素对培养的人关节软骨细胞毒性明显较小。
这项体外研究表明，含有 1:3000000 肾上腺素的关节镜灌洗液比含有 1:300000 肾上腺素的灌洗液对软骨的毒性更小。外科医生可能希望在手术中使用足够清晰的视觉所需的最小量的肾上腺素。本研究并未确定使用更高剂量肾上腺素的禁忌证。
