主页 > 医学讨论 >
【drug-news】罗哌卡因和布比卡因对人体关节软骨
Samantha L. Piper, BA1 and Hubert T. Kim, MD, PhD2
1 360 Frederick Street #3, San Francisco, CA 94117. E-mail address: Samantha.piper@ucsf.edu
2 SFVAMC (112), 4150 Clement Street, San Francisco, CA 94121. E-mail address: kimh@orthosurg.ucsf.edu
Investigation performed at the San Francisco VA Medical Center, San Francisco, California
Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.
--------------------------------------------------------------------------------
Background: It has been shown that bupivacaine, the most commonly used local anesthetic for postoperative intra-articular use, is cytotoxic to bovine articular chondrocytes in vitro. Ropivacaine is as effective as bupivacaine for intra-articular analgesia and has less systemic toxicity. We compared the in vitro viability of human articular chondrocytes after exposure to bupivacaine, ropivacaine, and saline solution control.
Methods: Macroscopically normal human articular cartilage was harvested from the femoral head or tibial plateau of five patients. Full-thickness cartilage explants and cultured chondrocytes isolated from these patients were treated with 0.9% normal saline solution, 0.5% ropivacaine, or 0.5% bupivacaine for thirty minutes. Twenty-four hours after treatment, chondrocyte viability was measured with use of the LIVE/DEAD Viability/Cytotoxicity Kit for cartilage explants and with use of the CellTiter-Glo Luminescent Cell Viability Assay for cultured chondrocytes.
Results: Chondrocyte viability in cartilage explants was significantly greater after treatment with ropivacaine as compared with bupivacaine (94.4% ± 9.0% compared with 78% ± 12.6%; p = 0.0004). There was no difference in viability after treatment with ropivacaine as compared with saline solution (94.4% ± 9.0% compared with 95.8% ± 5.7%; p = 0.6). The viability of cultured chondrocytes was significantly greater after treatment with ropivacaine as compared with bupivacaine (63.9% ± 19% as compared with 37.4% ± 12% of the value in the saline solution group; p < 0.0001).
Conclusions: In vitro, 0.5% ropivacaine is significantly less toxic than 0.5% bupivacaine in both intact human articular cartilage and chondrocyte culture.
Clinical Relevance: Although bupivacaine is the most commonly used local anesthetic for intra-articular analgesia, the demonstrated toxicity to human articular chondrocytes is cause for concern. The present study demonstrated that ropivacaine is less chondrotoxic than bupivacaine and, therefore, may be safer for intra-articular analgesia.
本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 罗哌卡因和布比卡因对人体关节软骨毒性作用的比较
Samantha L. Piper, BA1 and Hubert T. Kim, MD, PhD2
1 360 Frederick Street #3, San Francisco, CA 94117. E-mail address: Samantha.piper@ucsf.edu
2 SFVAMC (112), 4150 Clement Street, San Francisco, CA 94121. E-mail address: kimh@orthosurg.ucsf.edu
Background: It has been shown that bupivacaine, the most commonly used local anesthetic for postoperative intra-articular use, is cytotoxic to bovine articular chondrocytes in vitro. Ropivacaine is as effective as bupivacaine for intra-articular analgesia and has less systemic toxicity. We compared the in vitro viability of human articular chondrocytes after exposure to bupivacaine, ropivacaine, and saline solution control.
背景：布比卡因是术后关节内最常用的局麻药，它己经对试管内牛关节软骨细胞显示出细胞溶解作用。罗哌卡因消除关节内疼痛的效果和布比卡因一样，并且全身毒性反应更低。我们比较了人体关节软骨细胞在体外接触布比卡因、罗哌卡因和生理盐水对照组后的细胞活性。
Methods: Macroscopically normal human articular cartilage was harvested from the femoral head or tibial plateau of five patients. Full-thickness cartilage explants and cultured chondrocytes isolated from these patients were treated with 0.9% normal saline solution, 0.5% ropivacaine, or 0.5% bupivacaine for thirty minutes. Twenty-four hours after treatment, chondrocyte viability was measured with use of the LIVE/DEAD Viability/Cytotoxicity Kit for cartilage explants and with use of the Cell Titer-Glo Luminescent Cell Viability Assay for cultured chondrocytes.
方法：从5名患者的股骨头和胫骨平台上采集肉眼可见的正常人体关节软骨。把从人体中分离的全层软骨移出并做软骨细胞培养，分别经生理盐水、0.5%布比卡因、0.5%罗哌卡因处理30分钟。处理后24小时，使用活的/死的、有活力的/有毒性的体外软骨试剂盒和Titer-Glo发光细胞活性软骨细胞测定法对软骨细胞活性进行测量。Results: Chondrocyte viability in cartilage explants was significantly greater after treatment with ropivacaine as compared with bupivacaine (94.4% ± 9.0% compared with 78% ± 12.6%; p = 0.0004). There was no difference in viability after treatment with ropivacaine as compared with saline solution (94.4% ± 9.0% compared with 95.8% ± 5.7%; p = 0.6). The viability of cultured chondrocytes was significantly greater after treatment with ropivacaine as compared with bupivacaine (63.9% ± 19% as compared with 37.4% ± 12% of the value in the saline solution group; p < 0.0001).
阅读本文的人还阅读：
作者:admin@医学,生命科学 2010-10-28 17:11
医学,生命科学网