title: Effect of levobupivacaine on articular chondrocytes: an in-vitro investigation.
abstract: BACKGROUND
  Intra-articular injection of local anaesthetics is a technique commonly used to enhance postoperative analgesia following arthroscopic surgery. However, the potential for cartilage damage due to toxicity of intra-articular local anaesthetics is a concern. Most studies indicate that the toxic effect is drug and time dependent.
  
  
  OBJECTIVE
  The objective of this study is to compare the in-vitro chondrotoxic effect of levobupivacaine on human cartilage with saline and bupivacaine.
  
  
  METHODS
  An experimental study.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Adult patients undergoing knee surgery.
  
  
  METHODS
  Human articular cartilage was harvested and removed from five patients during knee replacement surgery. Chondrocytes were cultured and divided into three groups exposed to bupivacaine 0.5%, levobupivacaine 0.5% or physiological saline for 15, 30 or 60 min.
  
  
  METHODS
  Viability of human cartilage cells after contact with the different study drugs at different durations of exposure using two techniques: live/dead cell viability flow cytometry analysis and trypan blue exclusion assay.
  
  
  RESULTS
  At 1 h of exposure, chondrocyte mortality in cartilage explants was significantly greater after treatment with levobupivacaine or bupivacaine than with saline (25.9% ± 14.1, 20.7% ± 10.4 and 9.6% ± 5.4, respectively). No differences between groups were found when exposure to the experimental drug was limited to 15 or 30 min.
  
  
  CONCLUSIONS
  In-vitro 0.5% levobupivacaine is more chondrotoxic than saline in human articular cartilage after 1 h of exposure. Bupivacaine seems to be less chondrotoxic than levobupivacaine. With shorter exposures, no clear chondrotoxic effect was shown.
authors.affiliation: From the Department of Health Sciences, University of Jaén (J C-M, ADD-M), Department of Anesthesiology, Complejo Hospitalario de Jaén (MP), Jaén, the Department of Anatomy, University of Granada, Granada (JAM-C), and the Department of Orthopaedic Surgery, Hospital Reina Sofia, Córdoba, Spain (ADD-M).
authors.forename: Jesús
authors.initials: J
authors.lastname: Cobo-Molinos
authors.forename: Mercedes
authors.initials: M
authors.lastname: Poncela-Garcia
authors.forename: Juan A
authors.initials: JA
authors.lastname: Marchal-Corrales
authors.forename: Alberto D
authors.initials: AD
authors.lastname: Delgado-Martinez
mesh_terms: D000328:Adult; D000779:Anesthetics, Local / Q000494:pharmacology* / Q000633:toxicity; D002045:Bupivacaine / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000633:toxicity; D002358:Cartilage, Articular / Q000187:drug effects* / Q000502:physiology; D016923:Cell Death / Q000187:drug effects / Q000502:physiology; D002470:Cell Survival / Q000187:drug effects / Q000502:physiology; D019902:Chondrocytes / Q000187:drug effects* / Q000502:physiology; D005434:Flow Cytometry / Q000379:methods; D006801:Humans; D007270:Injections, Intra-Articular; D000077554:Levobupivacaine
chemical_list: D000779:Anesthetics, Local; D000077554:Levobupivacaine; D002045:Bupivacaine