A histological study of local anesthetic-induced muscle degeneration and regeneration in the monkey.

Small amounts (1-2 ml) of local anesthetics (bupivacaine, lidocaine, and mepivacaine) were injected into the abductor pollicis brevis muscles of 35 monkeys. Control muscles were injected with saline. The muscles were preserved for histology from 4.5 h to 48 days after the injection. Histological damage to muscle fibers was evident from the time of the first sampling. Invasion of damaged muscle fibers by phagocytic cells was prominent by 2-3 days postinjection. At 4 to 5 days, areas of muscle fiber damage were characterized by dense concentrations of phagocytes and mononuclear myoblastic cells. At 6 days, fields of early myotubes were evident. Maturation of myotubes into immature cross-striated muscle fibers occurred over the next week. Occasional myotubes or immature regenerating muscle fibers were seen as late as 28 days. The topographical pattern of muscle fiber degeneration and regeneration showed a concentration along the surfaces of muscle fascicles or, if intrafascicular, around the presumed site of injection.