Gazi Hospital, Gazi University, Faculty of Medicine, Department of Orthopaedics and Traumatology, 06200 Ankara, Turkey.
Gazi University , Faculty of Medicine, Department of Medical Genetics, 06200 Ankara, Turkey.
Bone Joint J. 2014 Jul;96-B(7):989-94. doi: 10.1302/0301-620X.96B7.33005.
Ketamine has been used in combination with a variety of other agents for intra-articular analgesia, with promising results. However, although it has been shown to be toxic to various types of cell, there is no available information on the effects of ketamine on chondrocytes. We conducted a prospective randomised controlled study to evaluate the effects of ketamine on cultured chondrocytes isolated from rat articular cartilage. The cultured cells were treated with 0.125 mM, 0.250 mM, 0.5 mM, 1 mM and 2 mM of ketamine respectively for 6 h, 24 hours and 48 hours, and compared with controls. Changes of apoptosis were evaluated using fluorescence microscopy with a 490 nm excitation wavelength. Apoptosis and eventual necrosis were seen at each concentration. The percentage viability of the cells was inversely proportional to both the duration and dose of treatment (p = 0.002 and p = 0.009). Doses of 0.5 mM, 1 mM and 2mM were absolutely toxic. We concluded that in the absence of solid data to support the efficacy of intra-articular ketamine for the control of pain, and the toxic effects of ketamine on cultured chondrocytes shown by this study, intra-articular ketamine, either alone or in combination with other agents, should not be used to control pain. Cite this article: Bone Joint J 2014; 96-B:989-94.
氯胺酮已与多种其他药物联合应用于关节内镇痛，取得了良好的效果。然而，尽管已经证明氯胺酮对多种类型的细胞具有毒性，但目前尚无关于氯胺酮对软骨细胞影响的信息。我们进行了一项前瞻性随机对照研究，以评估氯胺酮对分离自大鼠关节软骨的培养软骨细胞的影响。将培养的细胞分别用 0.125mM、0.250mM、0.5mM、1mM 和 2mM 的氯胺酮处理 6 小时、24 小时和 48 小时，并与对照组进行比较。使用 490nm 激发波长的荧光显微镜评估细胞凋亡的变化。在每个浓度下都观察到凋亡和最终坏死。细胞的存活率与处理的持续时间和剂量呈反比（p=0.002 和 p=0.009）。0.5mM、1mM 和 2mM 的剂量是绝对有毒的。我们得出结论，在缺乏确凿数据支持关节内氯胺酮控制疼痛的疗效以及本研究表明氯胺酮对培养软骨细胞的毒性作用的情况下，关节内氯胺酮，无论是单独使用还是与其他药物联合使用，都不应用于控制疼痛。引用本文：Bone Joint J 2014;96-B:989-94.
