Comparison of intraarticular bupivacaine and levobupivacaine injection in rat synovial inflammation

Both bupivacaine and levobupivacaine are local anesthetics with strong analgesic efficacy that can be used intraarticularly. The aim of this study was to compare the effects of intraarticular bupivacaine and levobupivacaine injection on inflammation in articular cartilage and the synovium of the rat knee joint. Materials and methods: Twenty Sprague-Dawley rats were injected in the right knee joint with 0.2 mL of bupivacaine, while 0.2 mL of levobupivacaine was injected into the left knee joint. Groups of 5 were sacrificed on days 1, 7, 14, and 21 after bupivacaine and levobupivacaine administration and knee joints were examined for subintimal fibrosis, synovial hyperplasia, chronic inflammation, neutrophil infiltration, edema, and synovial and periarticular congestion by microscopy. Alterations in the articular cartilage structure were evaluated using Mankin scoring. Results: We found that both drugs have similar effects on synovial and articular cartilage resulting in mild to moderate congestion, edema, neutrophil infiltration, chronic inflammation, and synovial hyperplasia, which diminished gradually. However, increases in fibrosis were also seen to varying degrees. Thus, the use of these drugs intraarticularly can be recommended. Conclusion: Careful usage of bupivacaine and levobupivacaine is recommended in intraarticular applications since they cause inflammation shortly after injection and fibrosis at later time points.

Comparison of intraarticular bupivacaine and levobupivacaine injection in rat synovial inflammation

Both bupivacaine and levobupivacaine are local anesthetics with strong analgesic efficacy that can be used intraarticularly. The aim of this study was to compare the effects of intraarticular bupivacaine and levobupivacaine injection on inflammation in articular cartilage and the synovium of the rat knee joint. Materials and methods: Twenty Sprague-Dawley rats were injected in the right knee joint with 0.2 mL of bupivacaine, while 0.2 mL of levobupivacaine was injected into the left knee joint. Groups of 5 were sacrificed on days 1, 7, 14, and 21 after bupivacaine and levobupivacaine administration and knee joints were examined for subintimal fibrosis, synovial hyperplasia, chronic inflammation, neutrophil infiltration, edema, and synovial and periarticular congestion by microscopy. Alterations in the articular cartilage structure were evaluated using Mankin scoring. Results: We found that both drugs have similar effects on synovial and articular cartilage resulting in mild to moderate congestion, edema, neutrophil infiltration, chronic inflammation, and synovial hyperplasia, which diminished gradually. However, increases in fibrosis were also seen to varying degrees. Thus, the use of these drugs intraarticularly can be recommended. Conclusion: Careful usage of bupivacaine and levobupivacaine is recommended in intraarticular applications since they cause inflammation shortly after injection and fibrosis at later time points.

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  • Huey-Ping NG, Nordström U, Axelsson K. Efficacy of intra
  • articular bupivacaine, ropivacaine, or a combination of
  • ropivacaine, morphine and ketorolac on postoperative. Reg
  • Anesth Pain Med 2006; 31: 26–33. 9.
  • Choyce A, Peng P. A systematic review of adjuncts for
  • intravenous regional anesthesia for surgical procedures. Can J
  • Anaesth 2002; 49: 32–45.
  • Rosseland LA, Stubhaug A, Skoglund A, Breivik H. Intra- articular morphine for pain relief after knee arthroscopy. Acta Anaesthesiol Scand 1999; 43: 252–257.
  • Rueben SS, Connelly NR. Postoperative analgesia for outpatient arthroscopic knee surgery with intra-articular bupivacaine and ketorolac. Anesth Analg 1995; 80: 1154–1157.
  • Fjuii K, Tajiri K, Kajiwara T, Tanaka T, Murota K. Effects of NSAIDs on collagen and proteoglycan synthesis of cultured chondrocytes. J Rheumatol 1989; 18: 28–31.
  • Balabanova RM, Fedina TP, Tsurko VV, Mach ES, Khitrov NA, Agapova LA. Dynamic changes in synovitis activity after intra-articular administration of xefocam in patients with rheumatoid arthritis (according to clinical and device examinations). Ter Arkh 2003; 75: 33–35 (article in Russian with abstract in English).
  • Ozyuvaci H, Bilgic B, Ozyuvaci E, Altan A, Altug T, Karaca C. Intra-articular injection of tenoxicam in rats: assessment of the local effects on the articular cartilage and synovium. J Int Med Res 2004; 32: 312–316.
  • David MJ, Vignon E, Peschard MJ, Broquet P, Loisot P, Richard M. Effect of NSAIDs on glycosyltransferase activity from human osteoarthritic cartilage. Br J Rheumatol 1992; 31: 13– 17.
  • Romsing J, Moiniche S, Ostergaard D, Dahl JB. Local infiltration with NSAIDs for postoperative analgesia: evidence for a peripheral analgesic action. Acta Anaesthesiol Scand 2000: 44: 672–683.
  • Chu CR, Izzo NJ, Papas NE, Fu FH. In vitro exposure to 0.5% bupivacaine is cytotoxic to bovine articular chondrocytes. Arthroscopy 2006; 22: 693–699.
  • Sarıcaoğlu F, Dal D, Atilla P, İskit AB, Tarhan Ö, Asan E, Aypar U. Effect of intra-articular injection of lornoxicam on the articular cartilage & synovium in rat. Indian J Med Res 2008; 127: 362–365.
  • Dogan N, Erdem AF, Erman Z, Kizilkaya M. The effects of bupivacaine and neostigmine on articular cartilage and synovium in the rabbit knee joint. J Int Med Res 2004; 32: 513–519.
  • Gomoll AH, Kang RW, Williams JM, Bach BR, Cole BJ. Chondrolysis after continuous intra-articular bupivacaine infusion: an experimental model investigating chondrotoxicity in the rabbit shoulder. Arthroscopy 2006; 22: 813–819.
  • Erden IA, Altinel S, Saricaoglu F, Zeybek ND, Akinci SB, Asan E, Aypar U. Effect of intra-articular injection of levobupivacaine on articular cartilage and synovium in rats. Anaesthesist 2012; 61: 420–423.
  • Anakwenze OA, Hosalkar H, Huffman GR. Case reports: Two cases of glenohumeral chondrolysis after intra-articular pain pumps. Clin Orthop Relat Res 2010; 468 : 2545–2549.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
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Comparison of intraarticular bupivacaine and levobupivacaine injection in rat synovial inflammation

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