Effect of levobupivacaine on articular chondrocytes

Cobo-Molinos, Jesús; Poncela-Garcia, Mercedes; Marchal-Corrales, Juan A.; Delgado-Martínez, A.D.

doi:10.1097/eja.0000000000000115

Cited by 12 publications

(11 citation statements)

References 10 publications

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“…They found that exposure to 0.5% bupivacaine for 15 or 30 minutes did not affect chondrocyte viability; however, when the exposure time was increased to 1 hour, there was more chondrotoxicity noted when compared to normal saline controls (20.7 ± 10.4% compared to 9.6 ± 5%). However this finding was not statistically significant . In this study, 0.5% levobupivacaine showed greater trends toward chondrotoxicity than 0.5% bupivacaine did …”

Section: Resultscontrasting

confidence: 71%

“…However this finding was not statistically significant . In this study, 0.5% levobupivacaine showed greater trends toward chondrotoxicity than 0.5% bupivacaine did …”

Section: Resultscontrasting

confidence: 71%

“…Two studies analyzed exposure to levobupivacaine with concentrations ranging from 0.13% to 0.5%, whereas only one study evaluated mepivacaine exposure to chondrocytes, with concentrations ranging from 0.03125% to 2% …”

Section: Resultsmentioning

confidence: 99%

“…A cumulative score of 7 was the highest achievable score. Three of the 16 studies achieved a score of 3 or less, whereas all other studies had either 4 or 5 points (Table ).…”

Section: Methodsmentioning

confidence: 99%

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Chondrotoxic Effects of Local Anesthetics on Human Knee Articular Cartilage: A Systematic Review

Jayaram¹,

Kennedy

Yeh

et al. 2019

PM&R

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Objective To review the current literature on the effects of intraarticular local anesthetics on human knee articular cartilage. Literature Survey PubMed; MEDLINE; SCOPUS; PEDro; CINAHL databases (1/1990‐06/1/2018) were searched for local anesthetic effects on human knee articular cartilage. Methodology Sixteen studies met the inclusion criteria, with outcome measures assessing chondrocyte viability, morphology, and histology. A systematic review was performed using PRISMA guidelines. Synthesis Seven studies were identified evaluating lidocaine, with five of them demonstrating statistically significant chondrotoxic effects. Fourteen studies examined bupivacaine, with all but one study demonstrating a chondrotoxic effect. Eight studies examined ropivacaine and found a dose‐dependent chondrotoxicity starting at 0.75%. Two studies evaluated levobupivacaine showing chondrotoxicity, with one study showing it to be more chondrotoxic than bupivacaine. One study looked at mepivacaine and showed it to have more chondrotoxicity than ropivacaine. When studied the chondrotoxicity was found to be both dose and time dependent. Also, the addition of corticosteroids appeared to worsen the chondrotoxic effects. Conclusions Lidocaine, bupivacaine, ropivacaine, levobupivacaine, and mepivacaine were reported to have dose‐ and time‐dependent deleterious effects on chondrocytes that appeared to be made worse by the coadministration of corticosteroids. Ropivacaine at concentrations of 0.5% or less was found to be the least chondrotoxic anesthetic. Level of Evidence I

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Section: Resultscontrasting

confidence: 71%

“…However this finding was not statistically significant . In this study, 0.5% levobupivacaine showed greater trends toward chondrotoxicity than 0.5% bupivacaine did …”

Section: Resultscontrasting

confidence: 71%

Section: Resultsmentioning

confidence: 99%

“…A cumulative score of 7 was the highest achievable score. Three of the 16 studies achieved a score of 3 or less, whereas all other studies had either 4 or 5 points (Table ).…”

Section: Methodsmentioning

confidence: 99%

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Chondrotoxic Effects of Local Anesthetics on Human Knee Articular Cartilage: A Systematic Review

Jayaram¹,

Kennedy

Yeh

et al. 2019

PM&R

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“…Previous meta-analyses have demonstrated that the single-dose IA morphine34, bupivacaine567, ropivacaine8, clonidine9 or the combination of morphine and bupivacaine1011 were effective in pain relief. However, it is commonly known that IA local anesthetics must be used cautiously due to the concern of chondrotoxicity12, especially for bupivacaine13141516171819, levobupivacaine131419, ropivacaine13141617, mepivacaine17 and lidocaine13161820.…”

mentioning

confidence: 99%

Analgesic effect and safety of single-dose intra-articular magnesium after arthroscopic surgery: a systematic review and meta-analysis

Zeng

Wei

et al. 2016

Sci Rep

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To examine the analgesic effect and safety of single-dose intra-articular (IA) magnesium (Mg) after arthroscopic surgery. Pubmed, Embase and Cochrane library were searched through in January 2016. Eight RCTs and eight experimental studies were included. The IA Mg exhibited a significantly lower pain score when compared with placebo (MD, −0.41, 95% CI, −0.78 to −0.05, p = 0.03). There was no significant difference between Mg and bupivacaine in terms of pain relief and the time to first analgesic request. Furthermore, statistically significant differences both in pain score (MD, −0.62, 95% CI, −0.81 to −0.42, p < 0.00001) and time to first analgesic request (MD, 6.25, 95% CI, 5.22 to 7.29, p < 0.00001) were observed between Mg plus bupivacaine and bupivacaine alone. There was no statistically significant difference among the various groups with respect to adverse reactions. Most of the included in vitro studies reported the chondrocyte protective effect of Mg supplementation. There were also two in vivo studies showing the cartilage protective effect of IA Mg. The single-dose IA Mg following arthroscopic surgery was effective in pain relief without increasing adverse reactions, and it could also enhance the analgesic effect of bupivacaine. In addition, Mg seemed to possess the cartilage or chondrocyte protective effect based on experimental studies.

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Local Anesthetics

Dontukurthy¹,

Kalstein²,

Yarmush³

2016

Side Effects of Drugs Annual

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Effect of levobupivacaine on articular chondrocytes

Abstract: In-vitro 0.5% levobupivacaine is more chondrotoxic than saline in human articular cartilage after 1 h of exposure. Bupivacaine seems to be less chondrotoxic than levobupivacaine. With shorter exposures, no clear chondrotoxic effect was shown.

Cited by 12 publications

References 10 publications

Chondrotoxic Effects of Local Anesthetics on Human Knee Articular Cartilage: A Systematic Review

Chondrotoxic Effects of Local Anesthetics on Human Knee Articular Cartilage: A Systematic Review

Analgesic effect and safety of single-dose intra-articular magnesium after arthroscopic surgery: a systematic review and meta-analysis

Local Anesthetics

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