Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Matsumoto City, Nagano, 390-8621, Japan.
Sci Rep. 2022 Jun 7;12(1):9409. doi: 10.1038/s41598-022-13628-w.
Ropivacaine-induced myotoxicity in surgically incised muscles has not been fully investigated. We evaluated the effects of infiltration anesthesia with ropivacaine on damage, inflammation and regeneration in the incised muscles of rats undergoing laparotomy. Ropivacaine or saline was infiltrated below the muscle fascia over the incised muscles. Pain-related behaviors and histological muscle damage were assessed. Macrophage infiltration at days 2 and 5 and proliferation of satellite cells at day 5 were detected by CD68 and MyoD immunostaining, respectively. Pain-related behaviors were inhibited by 0.25% and 0.5% of ropivacaine for 2 h after surgery. Single infiltration of 0.5% ropivacaine did not induce injury in intact muscles without incision, but single and repeated infiltration of 0.5% ropivacaine significantly augmented laparotomy-induced muscle injury and increased the numbers of CD68-positve macrophages and MyoD-positive cells compared to those in rats with infiltration of saline or 0.25% ropivacaine. In contrast, there were no significant differences in them between rats with saline infusion and rats with 0.25% ropivacaine infiltration. In conclusion, single or repeated subfascial infiltration of 0.25% ropivacaine can be used without exacerbating the damage and inflammation in surgically incised muscles, but the use of 0.5% ropivacaine may be a concern because of potentially increased muscle damage.
罗哌卡因诱导的切开肌肉肌毒性尚未得到充分研究。我们评估了腹剖术时在切开肌肉下的肌筋膜内浸润麻醉罗哌卡因对损伤、炎症和再生的影响。罗哌卡因或生理盐水浸润于切开的肌肉筋膜下。通过 CD68 和 MyoD 免疫染色分别检测术后第 2 天和第 5 天的巨噬细胞浸润和卫星细胞增殖。术后 2 小时，0.25%和 0.5%的罗哌卡因抑制与疼痛相关的行为。单一浸润 0.5%的罗哌卡因不会引起未切开的完整肌肉的损伤，但单一和重复浸润 0.5%的罗哌卡因显著增加了剖腹术引起的肌肉损伤，并增加了 CD68 阳性巨噬细胞和 MyoD 阳性细胞的数量，与生理盐水或 0.25%罗哌卡因浸润的大鼠相比。相比之下，生理盐水输注大鼠和 0.25%罗哌卡因浸润大鼠之间在它们之间没有显著差异。总之，单一或重复的筋膜下浸润 0.25%的罗哌卡因可以在不加重切开肌肉损伤和炎症的情况下使用，但使用 0.5%的罗哌卡因可能会引起关注，因为可能会增加肌肉损伤。
