The Effects of S(???)-, R(+)-, and Racemic Bupivacaine on Lysophosphatidate-Induced Priming of Human Neutrophils

Abstract

Overactive inflammatory responses underlie several perioperative disorders. Compared with racemic bupivacaine and other anesthetics, S(-)-bupivacaine appears particularly effective in suppressing neutrophil priming, a process responsible in part for the overactive neutrophil response.

Young patients with shoulder chondrolysis following arthroscopic shoulder surgery treated with total shoulder arthroplasty

“…Several articles have noted the inhibitory effect of bupivacaine on neutrophil function. 11,20,30 Additionally, the cytotoxicity of bupivacaine has also been demonstrated in vitro on bovine articular chondrocytes 6 and in vivo in the rabbit shoulder. 10 In this series, at least 9 patients had intra-articular pain pump catheters inserted during the index arthroscopy, and 2 of them had diagnostic tests suggestive of infection.…”

Anesthetic Pharmacology: Reflections of a Section Editor

“…Local anesthetics attenuate ischemic-reperfusion injury and the accompanying inflammatory responses, possibly by attenuating cytokine-induced cell injury (20 -22). They impair immune function (23,24). Similar properties have been described for propofol (25,26) and volatile anesthetics (27).…”

Do Amide Local Anesthetics Play a Therapeutic Role in the Perioperative Management of Cancer Patients?

“…46 In addition, PMN activation and priming are also attenuated by local anesthetics. [47][48][49][50] Together with other evidence of certain protective, anti-inflammatory effects on the endothelium, 51,52 these results might indicate a potential beneficial effect of the use of local anesthetics in patients undergoing cancer surgery, as the extravasation of CTCs during the perioperative period might be impeded by the preservation of endothelial barrier function and by a decrease in the adhesion of leukocytes and cancer cells to the endothelium and their subsequent transendothelial migration.…”