title: Cataract surgery complications: an in vitro model of toxic effects of ropivacaine and lidocaine.
abstract: BACKGROUND
  Intraoperative lidocaine is widely used in controlling discomfort during cataract surgery. However, recent studies have confirmed the toxic effect of lidocaine on ganglion cells. Ropivacaine is an anesthetic recently introduced in clinical practice that couples a long anesthetic effect with a mild vasoconstrictive action.
  
  
  OBJECTIVE
  The aim of this study was an in vitro evaluation of the efficacy of ropivacaine in reducing the degenerative effects usually observed during lidocaine treatment.
  
  
  METHODS
  Ropivacaine and lidocaine toxicity has been evaluated in murine fibroblasts 3T6 by measuring percentage of cell death, cell growth inhibition, and DNA degradation. The choice of this cellular line is motivated by the presence of a complete apoptotic system that can be assimilated to the endothelium precursor cells.
  
  
  RESULTS
  We observed that lidocaine 0.25% decreases cell viability and causes DNA degradation in murine fibroblasts 3T6, whereas ropivacaine 0.5% does not cause any cellular or molecular degenerative effect.
  
  
  CONCLUSIONS
  Our in vitro studies confirm that ropivacaine is less toxic than lidocaine to these cells. Therefore, in vivo studies in the anterior chamber could be useful to evaluate the effects of ropivacaine versus lidocaine in intracameral anesthesia in cataract surgery.
authors.affiliation: Department of Geriatric Sciences, Sapienza University of Rome, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Pescosolido
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Scarsella
authors.forename: Marco
authors.initials: M
authors.lastname: Tafani
authors.forename: Marcella
authors.initials: M
authors.lastname: Nebbioso
mesh_terms: D000577:Amides / Q000633:toxicity*; D000818:Animals; D002387:Cataract Extraction / Q000009:adverse effects*; D002460:Cell Line; D002470:Cell Survival / Q000187:drug effects / Q000502:physiology; D005347:Fibroblasts / Q000187:drug effects / Q000473:pathology; D008012:Lidocaine / Q000633:toxicity*; D051379:Mice; D010149:Postoperative Pain / Q000139:chemically induced* / Q000517:prevention & control; D000077212:Ropivacaine
chemical_list: D000577:Amides; D000077212:Ropivacaine; D008012:Lidocaine