title: [Comparative effects of vitamin C on the effects of local anesthetics ropivacaine, bupivacaine, and lidocaine on human chondrocytes].
abstract: BACKGROUND
  Intra-articular injections of local anesthetics are commonly used to enhance post-operative analgesia following orthopedic surgery as arthroscopic surgeries. Nevertheless, recent reports of severe complications due to the use of intra-articular local anesthetic have raised concerns.
  
  
  OBJECTIVE
  The study aims to assess use of vitamin C in reducing adverse effects of the most commonly employed anesthetics - ropivacaine, bupivacaine and lidocaine - on human chondrocytes.
  
  
  METHODS
  The chondrocyte viability following exposure to 0.5% bupivacaine or 0.75% ropivacaine or 1.0% lidocaine and/or vitamin C at doses 125, 250 and 500μM was determined by Live/Dead assay and annexin V staining. Expression levels of caspases 3 and 9 were assessed using antibodies by Western blotting. Flow cytometry was performed to analyze the generation of reactive oxygen species.
  
  
  RESULTS
  On exposure to the local anesthetics, chondrotoxicity was found in the order ropivacaine<bupivacaine<lidocaine. Vitamin C effectively improved the reduced chondrocyte viability and decreased the raised apoptosis levels following exposure to anesthesia. At higher doses, vitamin C was found efficient in reducing the generation of reactive oxygen species and as well down-regulate the expressions of caspases 3 and 9.
  
  
  CONCLUSIONS
  Vitamin C was observed to effectively protect chondrocytes against the toxic insult of local anesthetics ropivacaine, bupivacaine and lidocaine.
authors.affiliation: Departamento de Anestesiologia, Hospital Central Xinxiang da Província de Henan, Xinxiang, China. Electronic address: juntian2004@gmail.com.
authors.forename: Jun
authors.initials: J
authors.lastname: Tian
authors.affiliation: Departamento de Anestesiologia, Hospital Central Xinxiang da Província de Henan, Xinxiang, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
keywords: Anestésicos locais; Bupivacaine; Bupivacaína; Chondrocytes; Condrócitos; Lidocaine; Lidocaína; Local anesthetics; Ropivacaine; Ropivacaína; Vitamin C; Vitamina C