Chondrotoxicity of Local Anesthetics: Liposomal Bupivacaine Is Less Chondrotoxic than Standard Bupivacaine. (4th January 2020)

• Record Type: Journal Article
• Authors: Farmer, Travis; Morris, S. Craig; Quigley, Robert; Amin, Nirav H.; Wongworawat, Montri D.; Syed, Hasan M.
• Other Names: Oike Masahiro Academic Editor.
• Is Part Of: Advances in pharmacological and pharmaceutical sciences. Volume 2020(2020)
• Publication Date: 2020-01-04
• Subjects: Pharmacology -- Periodicals; 615.1
• DOI: 10.1155/2020/5794187
• Languages: English
• ISSNs: 2633-4682

Abstract

Abstract : Objective . The purpose of this study is to determine whether (1) liposomal bupivacaine is chondrotoxic; (2) the chondrotoxicity of liposomal bupivacaine differs from standard bupivacaine; and (3) chondrotoxic effects are time dependent. Materials and Methods . We obtained 72 10 mm articular cartilage plugs from 12 fresh bovine distal femoral knee joints and exposed them to either saline, 0.5% bupivacaine, or liposomal bupivacaine for either 30 or 90 minutes. Twenty-four hours after treatment, chondrocyte viability was measured with the use of a fluorescent live/dead assay. An ANOVA test of variance was performed followed by a Holm–Sidak test to make pairwise comparisons across conditions. Student's t -test was used to compare means. Results . Percent viability of cells exposed to liposomal bupivacaine for 30 minutes was less versus saline control (53.9% ± 21.5% vs. 73.7 ± 18.4%, p = 0.035 ), and this remained significant at 90 minutes (49.1% ± 20.3% vs. 67.2% ± 25.6%, p < 0.001 ). Liposomal bupivacaine had less chondrotoxic effects when compared with bupivacaine after 90 minutes, with greater viability (49.1% ± 20.3% vs. 21.4% ± 14.0%, p = 0.003 ). Chondrotoxicity was found to be time dependent within the bupivacaine group (percent viability at 30 min: 45.5 ± 18.2%, 90 min: 21.4 ± 14.0%, p = 0.001 ); however, liposomal bupivacaine did not demonstrate a significant time-dependent chondrotoxic relationship (p = 0.583 ). Conclusions . Bupivacaine and liposomal bupivacaine are both toxic to chondrocytes. Liposomal bupivacaine is less chondrotoxic than standard bupivacaine and does not demonstrate a time-dependent toxicity.