Farmer Travis, Morris S Craig, Quigley Robert, Amin Nirav H, Wongworawat Montri D, Syed Hasan M
Department of Orthopaedic Surgery, Loma Linda University, 11406 Loma Linda Drive, Suite 218, Loma Linda, CA 92354, USA.
Department of Pediatric Orthopaedic Surgery, Children's Hospital at Erlanger, 910 Blackford Street, Chattanooga, TN 37403, USA.
Adv Pharmacol Pharm Sci. 2020 Jan 4;2020:5794187. doi: 10.1155/2020/5794187. eCollection 2020.
The purpose of this study is to determine whether (1) liposomal bupivacaine is chondrotoxic; (2) the chondrotoxicity of liposomal bupivacaine differs from standard bupivacaine; and (3) chondrotoxic effects are time dependent.
We obtained 72 10 mm articular cartilage plugs from 12 fresh bovine distal femoral knee joints and exposed them to either saline, 0.5% bupivacaine, or liposomal bupivacaine for either 30 or 90 minutes. Twenty-four hours after treatment, chondrocyte viability was measured with the use of a fluorescent live/dead assay. An ANOVA test of variance was performed followed by a Holm-Sidak test to make pairwise comparisons across conditions. Student's -test was used to compare means.
Percent viability of cells exposed to liposomal bupivacaine for 30 minutes was less versus saline control (53.9% ± 21.5% vs. 73.7 ± 18.4%, =0.035), and this remained significant at 90 minutes (49.1% ± 20.3% vs. 67.2% ± 25.6%, < 0.001). Liposomal bupivacaine had less chondrotoxic effects when compared with bupivacaine after 90 minutes, with greater viability (49.1% ± 20.3% vs. 21.4% ± 14.0%, =0.003). Chondrotoxicity was found to be time dependent within the bupivacaine group (percent viability at 30 min: 45.5 ± 18.2%, 90 min: 21.4 ± 14.0%, =0.001); however, liposomal bupivacaine did not demonstrate a significant time-dependent chondrotoxic relationship (=0.583).
Bupivacaine and liposomal bupivacaine are both toxic to chondrocytes. Liposomal bupivacaine is less chondrotoxic than standard bupivacaine and does not demonstrate a time-dependent toxicity.
本研究旨在确定（1）脂质体布比卡因是否具有软骨毒性；（2）脂质体布比卡因的软骨毒性是否与标准布比卡因不同；以及（3）软骨毒性作用是否具有时间依赖性。
我们从12个新鲜的牛股骨远端膝关节获取了72个10毫米的关节软骨塞，并将它们分别暴露于生理盐水、0.5%布比卡因或脂质体布比卡因中30分钟或90分钟。处理24小时后，使用荧光活/死检测法测量软骨细胞活力。进行方差分析，随后进行霍尔姆-西达克检验以对不同条件进行两两比较。使用学生t检验比较均值。
暴露于脂质体布比卡因30分钟的细胞活力百分比低于生理盐水对照组（53.9%±21.5%对73.7±18.4%，P=0.035），90分钟时这一差异仍具有统计学意义（49.1%±20.3%对67.2%±25.6%，P<0.001）。90分钟后，脂质体布比卡因的软骨毒性作用比布比卡因小，细胞活力更高（49.1%±20.3%对21.4%±14.0%，P=0.003）。在布比卡因组中发现软骨毒性具有时间依赖性（30分钟时细胞活力百分比：45.5±18.2%，90分钟时：21.4±14.0%，P=0.001）；然而，脂质体布比卡因未显示出显著的时间依赖性软骨毒性关系（P=0.583）。
布比卡因和脂质体布比卡因对软骨细胞均有毒性。脂质体布比卡因的软骨毒性低于标准布比卡因，且未显示出时间依赖性毒性。
