title: Effects of adding epinephrine to arthroscopic irrigation fluid on cultured chondrocyte survival in vitro.
abstract: OBJECTIVE
  This study evaluates the effect of low doses of epinephrine contained in common arthroscopic irrigation solutions on viability of in vitro human articular chondrocytes during short-term exposure.
  
  
  METHODS
  Isolated cultured human chondrocytes were treated with culture medium, normal saline solution, 1:300,000 epinephrine solution (equivalent to 10 mL of 1:1,000 epinephrine added to a 3-L saline solution bag), or 1:3,000,000 epinephrine solution (equivalent to 1 mL of 1:1,000 epinephrine added to a 3-L saline solution bag) for 1 hour (N = 84). Twenty-four hours after treatment, chondrocyte viability was measured. Statistical analysis was performed with an analysis of variance with Bonferroni post-test.
  
  
  RESULTS
  Chondrocyte viability was significantly better when exposed to normal saline solution alone versus high-dose 1:300,000 epinephrine (87.9% ± 5.4% v 74.6% ± 9.4%, P < .05). Exposure to low-dose 1:3,000,000 epinephrine had significantly better survival versus high-dose 1:300,000 epinephrine (85.0% ± 8.3% v 74.6% ± 9.4%, P < .05). There was no difference in viability after exposure to low-dose 1:3,000,000 epinephrine versus normal saline solution (85.0% ± 8.3% v 87.9% ± 5.4%, P > .05).
  
  
  CONCLUSIONS
  In vitro, normal saline solution and low-dose 1:3,000,000 epinephrine are significantly less toxic than high-dose 1:300,000 epinephrine to cultured human articular chondrocytes.
  
  
  CONCLUSIONS
  This in vitro study suggests that arthroscopic irrigation fluid containing 1:3,000,000 epinephrine is less chondrotoxic than solutions containing 1:300,000 epinephrine. Surgeons may wish to use the least amount of epinephrine required for adequate visual clarity during surgery. This study does not establish a contraindication to the use of higher doses of epinephrine.
authors.affiliation: Department of Orthopaedic Surgery, New England Musculoskeletal Institute, University of Connecticut Health Center, Farmington, Connecticut 06030, USA.
authors.forename: Alan B C
authors.initials: AB
authors.lastname: Dang
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: McCarthy
authors.forename: Alexis B C
authors.initials: AB
authors.lastname: Dang
authors.forename: David M
authors.initials: DM
authors.lastname: Chowaniec
authors.forename: Augustus D
authors.initials: AD
authors.lastname: Mazzocca
mesh_terms: D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D002470:Cell Survival / Q000187:drug effects; D002478:Cells, Cultured; D019902:Chondrocytes / Q000187:drug effects*; D004305:Dose-Response Relationship, Drug; D004837:Epinephrine / Q000009:adverse effects*; D006801:Humans; D066298:In Vitro Techniques; D008297:Male; D007507:Therapeutic Irrigation; D014662:Vasoconstrictor Agents / Q000009:adverse effects*
chemical_list: D014662:Vasoconstrictor Agents; D004837:Epinephrine