Çevik Osman, Gergin Özlem Öz, Yildiz Karamehmet, Bayram Adnan, Canöz Özlem, Halici Mehmet, Baran Münevver, Yay Arzu, Polat Sait
Erciyes University, Medical Faculty, Department of Anesthesiology, Kayseri, Turquia.
Kayseri Education and Research Hospital, Department of Anesthesiology, Kayseri, Turquia.
Braz J Anesthesiol. 2018 Nov-Dec;68(6):605-612. doi: 10.1016/j.bjan.2018.06.013. Epub 2018 Sep 7.
A single dose injection or continuous infusion of local anesthetics into the joint space is considered to be a well-defined analgesia technique. The aim of this study was to investigate the chondrotoxic and apoptotic effects of single-dose intra-articular injection of levobupivacaine and bupivacaine on rabbit knee joint tissues.
The animals were allocated into two groups each containing 20 rabbits. 0.5% levobupivacaine (Group L) and 0.5% bupivacaine (Group B) were applied intra-articularly to the left posterior joints of rabbits. At the same time, normal saline was applied to the right posterior leg knee joints of rabbits in both groups and used as a control (Group S). At the end of the 7th and 28th days after the intraarticular injections, ten randomly chosen rabbits in each group were killed by applying intraperitoneal thiopental. Sections of cartilage tissue samples were stained for light microscopic examinations and the TUNEL method was used to investigate apoptotic cells.
As a result of immunofluorescence microscopic examination, the number of apoptotic cells in Group B at day 7 and day 28 were both significantly higher than Group L and S ( < 0.05). Also, the number of apoptotic cells in Group L at day 7 and day 28 were both significantly higher than Group S ( < 0.05).
We found that bupivacaine is more chondrotoxic than other anesthetic agent and increases the number of apoptotic cells. These results indicated that bupivacaine caused high chondrotoxic damage and it led to more apoptotic activation than levobupivacaine.
向关节腔内单次注射或持续输注局部麻醉剂被认为是一种明确的镇痛技术。本研究的目的是探讨单次关节腔内注射左旋布比卡因和布比卡因对兔膝关节组织的软骨毒性和凋亡作用。
将动物分为两组,每组20只兔子。将0.5%左旋布比卡因(L组)和0.5%布比卡因(B组)关节腔内注射到兔子的左后关节。同时,两组兔子右后腿膝关节均注射生理盐水作为对照(S组)。关节腔内注射后第7天和第28天结束时,每组随机选取10只兔子腹腔注射硫喷妥钠处死。取软骨组织样本切片进行光镜检查,采用TUNEL法检测凋亡细胞。
免疫荧光显微镜检查结果显示,B组第7天和第28天的凋亡细胞数均显著高于L组和S组(P<0.05)。此外,L组第7天和第28天的凋亡细胞数也均显著高于S组(P<0.05)。
我们发现布比卡因比其他麻醉剂具有更强的软骨毒性,并增加了凋亡细胞的数量。这些结果表明,布比卡因造成了更高的软骨毒性损伤,并且比左旋布比卡因导致了更多的凋亡激活。