Department of Physical Medicine and Rehabilitation and Department of Orthopaedic Surgery, Federal University of São Paulo, São Paulo, Brazil.
PM R. 2011 Dec;3(12):1106-9. doi: 10.1016/j.pmrj.2011.05.027. Epub 2011 Oct 5.
To evaluate the effect of bupivacaine on muscle force and histology. We hypothesize that bupivacaine will worsen the muscle's physiological activity.
Controlled laboratory experiment.
Bupivacaine (0.5 mL, 0.5%) was injected into the mid belly and distal portions of the right gastrocnemius in 32 Wistar male rats (the left gastrocnemius was used as a control). After 5, 14, 21, and 28 days, in groups of 4, muscle force was evaluated and the animals were euthanized by an overdose of anesthetic for histologic evaluation. One-way analysis of variance was used to analyze data from force and weight measurements. Only the values of P < .05 were considered to be statistically significant.
Bupivacaine causes a process of degeneration-regeneration of the muscle fibers and it also causes a reduction in muscle force, which is significant at 2 and 3 weeks and does not normalize at 4 weeks. The muscle injury is obvious after 5 days, and the degenerative process is predominant at 2 and 3 weeks. We found an increase in muscle mass in the acute phase and a decrease in muscle force.
Although our results do not allow a direct clinical application, we believe that caution should be warranted when intramuscular bupivacaine is used.
评估布比卡因对肌肉力量和组织学的影响。我们假设布比卡因会恶化肌肉的生理活性。
对照实验室实验。
将布比卡因(0.5mL,0.5%)注射到 32 只雄性 Wistar 大鼠右腓肠肌的中部和远部(左侧腓肠肌作为对照)。在第 5、14、21 和 28 天,每组 4 只,评估肌肉力量,并用过量麻醉剂处死动物进行组织学评估。采用单因素方差分析对力和重量测量数据进行分析。只有 P <.05 的值才被认为具有统计学意义。
布比卡因导致肌肉纤维的变性-再生过程,也导致肌肉力量下降,在 2 周和 3 周时显著,4 周时未恢复正常。5 天后肌肉损伤明显,2 周和 3 周时以退行性过程为主。我们发现急性期肌肉质量增加,肌肉力量下降。
尽管我们的结果不允许直接进行临床应用,但我们认为在肌肉内使用布比卡因时应谨慎。