title: Effect of local anaesthetic infiltration with bupivacaine and ropivacaine on wound healing: a placebo-controlled study.
abstract: Infiltration of surgical wounds with long-acting local anaesthetics (LA) is used to reduce postoperative incisional pain. We hypothesised that infiltration with LA interferes with wound healing in rats. Seventy-two rats were allocated into nine groups. After intraperitoneal anaesthesia, the interscapular dorsal region was infiltrated with equivolumes of saline, 0·5% bupivacaine or ropivacaine, in a randomised double-blind fashion. A standardised incision was performed in the infiltrated area and sutured closed. The rats were euthanised on the 3rd or 14th day after the operation and tissue from the incision site was subjected to histochemical analyses and mechanical testing (MT). Compared with the control group, bupivacaine displayed a significant increase in the macrophage number on day 3 (+63% versus +27% for ropivacaine). The transforming growth factor β-1 expression had a significant increase in the LA (versus saline) groups, +63% in ropivacaine group and +115% in bupivacaine group on day 3 (P < 0·05). The collagen fibres as measured by dyed area were significantly higher in the bupivacaine group on day 3 (+56%, P < 0·01 versus +15% for ropivacaine). CD34 was reduced in bupivacaine group (-51%, P < 0·05 versus +3% for ropivacaine). On day 14, no statistical differences were observed in either LA group (versus saline) with respect to histopathologic or inflammatory mediators. MT on day 14 showed no differences between the LA and saline groups. The LA-induced increases in histological markers did not extend beyond the third day, suggesting that wound infiltration with long-acting LA does not impair the wound healing process in rats.
authors.affiliation: Department of Biomechanics, Medicine and Rehabilitation, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, BrazilDepartment of Pathology, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, BrazilDepartment of Anesthesiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA, Instituto Ortopédico, Rizzoli, University of Bologna, ItalyDepartment of Radiology, Faculty of Medicine, University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil.
authors.forename: João
authors.initials: J
authors.lastname: Abrão
authors.forename: Cleverson R
authors.initials: CR
authors.lastname: Fernandes
authors.forename: Paul F
authors.initials: PF
authors.lastname: White
authors.forename: Antonio C
authors.initials: AC
authors.lastname: Shimano
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Okubo
authors.forename: Giovanni Bp
authors.initials: GB
authors.lastname: Lima
authors.forename: José A
authors.initials: JA
authors.lastname: Bachur
authors.forename: Sérgio B
authors.initials: SB
authors.lastname: Garcia
mesh_terms: D000577:Amides / Q000008:administration & dosage*; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage; D000818:Animals; D002045:Bupivacaine / Q000008:administration & dosage*; D004195:Disease Models, Animal; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D051381:Rats; D017208:Rats, Wistar; D000077212:Ropivacaine; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects*; D014947:Wounds and Injuries / Q000473:pathology / Q000628:therapy*
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine; D002045:Bupivacaine
keywords: Anaesthetics; Immunohistochemistry; Local; Mechanical test; Wound Healing