Vrachnis Ioannis, Gliatis John, Papachristou Dionysios, Sourouni Sofia, Kouzelis Antonis, Panagopoulos Andreas, Tyllianakis Minos
Department of Orthopaedics, Patras University Hospital, Patras, GRC.
Department of Orthopaedics, School of Medicine, University of Patras, Patras, GRC.
Cureus. 2024 Jan 28;16(1):e53103. doi: 10.7759/cureus.53103. eCollection 2024 Jan.
Introduction A constant infusion of local anesthetics through pain pumps has been shown to cause chondrolysis. However, there is no general consensus regarding the safety of a single intra-articular injection of local anesthetics. In this experimental study, we examined the rat cartilage for possible histological effects after a single intra-articular administration of lidocaine or ropivacaine. Material and methods Thirty-two male Sprague-Dawley rats, weighing 250-300 grams, were divided into two groups of 16 each. We injected 0.1 ml of either lidocaine 2% (20 mg/ml) or ropivacaine 0.75% (7.5 mg/ml) into the left knee of the rats. The right knee in both groups was used as a control, and an equal amount of normal saline was injected. Each group was further divided into subgroups of four, which were euthanized after one, seven, 21, and 60 days after the initial injection. Knees were excised and prepared for histopathological analysis. A modified version of the Mankin score was used for cartilage damage evaluation. Results No difference regarding cartilage damage was detected after the examination under light microscopy between lidocaine, ropivacaine, and placebo in all specimens. Time elapsed since the initial injection did not affect the results at any time point. Conclusion A single intra-articular injection of local anesthetic did not induce any histological changes in the rat cartilage. Further research is needed to demonstrate the safety of humans.
引言 通过疼痛泵持续输注局部麻醉剂已被证明会导致关节软骨溶解。然而，对于单次关节内注射局部麻醉剂的安全性尚无普遍共识。在本实验研究中，我们在大鼠单次关节内注射利多卡因或罗哌卡因后，检查了大鼠软骨的可能组织学效应。
材料与方法 32只体重250 - 300克的雄性Sprague-Dawley大鼠被分为两组，每组16只。我们向大鼠的左膝注射0.1毫升2%的利多卡因（20毫克/毫升）或0.75%的罗哌卡因（7.5毫克/毫升）。两组的右膝用作对照，注射等量的生理盐水。每组进一步分为四个亚组，在初次注射后1天、7天、21天和60天对其实施安乐死。切除膝关节并准备进行组织病理学分析。使用改良版的Mankin评分评估软骨损伤情况。
结果 在所有标本中，利多卡因、罗哌卡因和安慰剂在光学显微镜检查后未发现软骨损伤有差异。自初次注射以来的时间在任何时间点都未影响结果。
结论 单次关节内注射局部麻醉剂未在大鼠软骨中诱导任何组织学变化。需要进一步研究以证明对人类的安全性。
