Peng Hui-Ming, Xiao Ke, Zhu Wei, Wang Ying-Jie, Bian Yan-Yan, Wang Wei, Qian Wen-Wei, Weng Xi-Sheng
Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China.
Front Pharmacol. 2022 Mar 24;13:769577. doi: 10.3389/fphar.2022.769577. eCollection 2022.
Periarticular injections with a combination of local anesthetics, non-steroidal anti-inflammatory analgesics (NSAIDs), and epinephrine are becoming increasingly popular in the perioperative analgesia of artificial joint replacement. However, data on the efficacy and safety of local injection NSAIDs are still scarce. The purpose of this study was to investigate the efficacy and safety of a local injection of Flurbiprofen Ester Lipid microspheres into the inflammatory model of femoral shaft closed fractures in rats. A systemic inflammatory model was induced in SD rats (60) by closed femoral shaft fracture; 12 non-fractured rats were used as the blank control group (group A). The systemic inflammation model of 60 rats was divided into 5 groups (12 in each group); Group B: intramuscular injectionof the same amount of normal saline at different time points as a negative control; Group C: intravenous injection of Flurbiprofen Ester microspheres (4.5 mg/kg) at different time points; Group D: intramuscular injection of Flurbiprofen Ester microspheres (2.25 mg/kg) at different time points; Group E: intramuscular injection of Flurbiprofen Ester microspheres (4.5 mg/kg) at different time points; Group F: intramuscular injection of Flurbiprofen Ester microspheres (9 mg/kg) at different time points. The behavioral test observed the behavior of the rats. Then, the inflammation factors of CRP, IL-6, COX-1, COX-2 and TNF-αby ELISA were recorded. Through the behavioral test it could be found that the effect of the intramuscular and intravenous injections of Flurbiprofen Ester microspheres was similar. Fracture rats with a local injection of Flurbiprofen Ester microspheres showed lower inflammation levels measured by COX-1, CRP, and TNF-α compared with the control group. Pathological sections at 24, 48, and 96 h after surgery did not display any local muscle necrosis at the local injection site. These findings suggested that a Flurbiprofen Ester microsphere muscular injection exhibited a similar effect to an intravenous injection. The local injection of Flurbiprofen Ester microspheres significantly reduced the inflammatory response in fracture rats and did not increase the risk of muscle necrosis, suggesting its feasibility in local injection analgesia.
将局部麻醉药、非甾体类抗炎镇痛药（NSAIDs）和肾上腺素联合用于关节周围注射，在人工关节置换围手术期镇痛中越来越普遍。然而，关于局部注射NSAIDs疗效和安全性的数据仍然很少。本研究的目的是探讨在大鼠股骨干闭合性骨折炎症模型中局部注射氟比洛芬酯脂质微球的疗效和安全性。通过闭合性股骨干骨折在60只SD大鼠中诱导全身炎症模型；12只未骨折的大鼠作为空白对照组（A组）。将60只大鼠的全身炎症模型分为5组（每组12只）；B组：在不同时间点肌肉注射等量生理盐水作为阴性对照；C组：在不同时间点静脉注射氟比洛芬酯微球（4.5mg/kg）；D组：在不同时间点肌肉注射氟比洛芬酯微球（2.25mg/kg）；E组：在不同时间点肌肉注射氟比洛芬酯微球（4.5mg/kg）；F组：在不同时间点肌肉注射氟比洛芬酯微球（9mg/kg）。行为测试观察大鼠的行为。然后，通过ELISA记录CRP、IL-6、COX-1、COX-2和TNF-α的炎症因子。通过行为测试发现，肌肉注射和静脉注射氟比洛芬酯微球的效果相似。与对照组相比，局部注射氟比洛芬酯微球的骨折大鼠经COX-1、CRP和TNF-α测量的炎症水平较低。术后24、48和96小时的病理切片在局部注射部位未显示任何局部肌肉坏死。这些结果表明，氟比洛芬酯微球肌肉注射与静脉注射效果相似。局部注射氟比洛芬酯微球可显著降低骨折大鼠的炎症反应，且不会增加肌肉坏死风险，表明其在局部注射镇痛中的可行性。
