title: Effects of levobupivacaine on wound healing.
abstract: BACKGROUND
  Local anesthetic infiltration along the incision may be used to provide surgical anesthesia or postoperative analgesia. However, the effect of local anesthetics on wound healing remains controversial. In this investigation, we evaluated the effects of levobupivacaine on wound healing.
  
  
  METHODS
  Sixty Wistar albino female rats weighing 230±20 g were included, with 10 rats in each group: group early c (early control): 3 mL isotonic saline; group early l1.25 (early levobupivacaine 1.25): 1.25 mg/kg per 3 mL levobupivacaine; group early l2.5 (early levobupivacaine 2.5): 2.5 mg/kg per 3 mL levobupivacaine; group late c (late control): 3 mL isotonic saline; group late l1.25 (late levobupivacaine 1.25): 1.25 mg/kg per 3 mL levobupivacaine; and group late l2.5 (late levobupivacaine 2.5): 2.5 mg/kg per 3 mL levobupivacaine. Rats in groups early c to early l2.5 were euthanized on the 8th day. Rats in groups late c to late l2.5 were euthanized on the 21st day. Wound tension strength, tissue hydroxyproline, and fibrotic index levels of the tissue samples from the early c and early l2.5 and late c and late l2.5 groups, respectively, on the 8th and 21st days were examined.
  
  
  RESULTS
  Levobupivacaine decreased wound tension strength on the 8th day, especially a 2.5 mg/kg dose (P<0.001), and increased it on the 21st day (P<0.001). It also increased the inflammatory response (P<0.001) and collagen synthesis (8th day, P=0.109; 21st day, P=0.103) on both the 8th and 21st days.
  
  
  CONCLUSIONS
  While levobupivacaine had a positive effect on wound healing during the early period, negative effects were observed thereafter. Additional studies at the molecular level are necessary to determine the cause of these apparently opposite effects.
authors.affiliation: Department of General Surgery, Okmeydani Training and Research Hospital, and Department of Pathology, University of Science, Istanbul, Turkey.
authors.forename: Sezgin
authors.initials: S
authors.lastname: Zeren
authors.forename: Sevgi
authors.initials: S
authors.lastname: Kesici
authors.forename: Ugur
authors.initials: U
authors.lastname: Kesici
authors.forename: Salim
authors.initials: S
authors.lastname: Isbilir
authors.forename: Ulku Aygen
authors.initials: UA
authors.lastname: Turkmen
authors.forename: Hulya
authors.initials: H
authors.lastname: Ulusoy
authors.forename: Vildan
authors.initials: V
authors.lastname: Karpuz
authors.forename: Omer
authors.initials: O
authors.lastname: Ozcan
authors.forename: Erdal
authors.initials: E
authors.lastname: Polat
authors.forename: Osman Metin
authors.initials: OM
authors.lastname: Ipcioglu
authors.forename: Musa Kazim
authors.initials: MK
authors.lastname: Sari
mesh_terms: D000779:Anesthetics, Local / Q000009:adverse effects / Q000627:therapeutic use*; D000818:Animals; D001706:Biopsy; D002045:Bupivacaine / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D049109:Cell Proliferation; D005260:Female; D005355:Fibrosis; D006909:Hydroxyproline / Q000032:analysis / Q000378:metabolism; D000077554:Levobupivacaine; D011184:Postoperative Period; D051381:Rats; D017208:Rats, Wistar; D012867:Skin / Q000737:chemistry; D013537:Sutures; D013718:Tensile Strength; D014945:Wound Healing / Q000187:drug effects*; D014947:Wounds and Injuries / Q000378:metabolism / Q000473:pathology*
chemical_list: D000779:Anesthetics, Local; D000077554:Levobupivacaine; D006909:Hydroxyproline; D002045:Bupivacaine