利多卡因、布比卡因对关节软骨细胞活性的对比研究  

THE EFFECTS OF LIDOCAINE AND BUPIVACAINE ON CELL VIABILITY IN AN ARTICULAR CARTILAGE ORGAN CULTURE MODEL

作　　者：雷昌斌 王东 曹锡文[1] 唐新文[1] 陈占昆[3] LEI Chang-Bin;WANG Dong;CAO Xi-Wen;TANG Xin-Wen;CHEN Zhan-Kun(Department of Orthopedics,Affiliated Hospital of Xiangnan University,Chenzhou 423000,China;Depart-ment of Orthopaedic,Ferguson Lab University of Pittsburgh,Pittsburgh 15213,America;joint disease Insti-tute,People＇s Hospital of Peking University,Beijing 100044,China)

机构地区：[1]湘南学院附属医院骨科,郴州423000 [2]Ferguson Lab University of Pittsburgh,Pittsburgh 15213 [3]北京大学人民医院关节病研究所,北京100044

出　　处：《中国疼痛医学杂志》2018年第6期440-444,共5页Chinese Journal of Pain Medicine

基　　金：北京市海淀区科学技术委员会基金资助项目(K20110111L);湘南学院校级课题(2016XJ52)

摘　　要：目的:通过模拟类似人体关节腔生理环境,制作关节软骨培养模型,评估利多卡因、布比卡因对软骨细胞毒性的时间及浓度效应,以及软骨细胞膜对软骨细胞的保护效应。方法:取女性骨性关节炎病人膝关节置换术中切除的残余正常股骨外髁关节软骨,用环钻取直径4 mm的圆形新鲜全层厚度正常软骨,放入含2.5 ml培养基的24孔板中培养,切除正常软骨表面1 mm制作损伤模型。使用通过不同浓度的利多卡因和布比卡因以及不同作用时间分别浸泡处理关节软骨,阴性对照组均为0.9%生理盐水,然后测定关节软骨的细胞活性的变化,评估利多卡因、布比卡因对正常及损伤关节软骨的细胞毒性作用。结果:浓度效应组中药物作用时间固定为1 h,1%和2%利多卡因作用下的软骨细胞活性分别为80.9±1.3%和72.1±1.0%。0.25%和0.5%布比卡因细胞活性分别为78.4%±2.5%和70.4±1.0%,各组间P<0.05。时间效应组中经过1%利多卡因作用30、60、120 min后正常软骨细胞活性分别为79.1±1.5%、69.8±3.1%、56±10.7%,损伤组分别为76.5±1.5%、66.9±3.9%、52.2±10.7%。其中正常组与损伤组在30 min有统计学差异(P<0.05)。而经0.25%布比卡因分别作用30、60、120 min后,正常软骨组细胞活性为88.2±4.7%、78.7±3.6%、63.7±3.7%,损伤组则为79.7±2.2%、71.4±4.1%、56.5±6.5%,其中正常组与损伤组在30及60 min有统计学差异(P<0.05)。结论:仿生理状态下生物学特性和结构均完整的关节软骨经利多卡因、布比卡因处理后,随着作用时间延长和浓度增加,软骨细胞的活性明显降低,且利多卡因较布比卡因毒性低。关节软骨表膜对软骨细胞提供保护作用。Objective： Intra-articular local anesthetic injection is widely used for pain relief after arthroscopic surgery and osteoarthritis. This study is to evaluate the effects of lidocaine and bupivacaine on cell viability using articular cartilage organ culture and the protective effect of chondrocyte membrane on chondrocytes. Methods： The residual normal parts of the femoral condyle resected in knee arthroplasty for female patients with osteoarthritis were used as test materials. Normal cartilages with full thickness in the diameter of 4mm were harvested by round drill, and remove of joint surface lmm making damage group model. The articular cartilage was exposed to the lidocaine （1% and 2%） and bupivacaine （0.25%, 0.5%）, for different durations （30, 60 and 120 min）. Results： After exposing to 1% and 2% lidocaine 1 hour, the cell viabilitys of articular carti- lage would were 80.9±1.3% and 72.1±1% respectively. While after exposing to 0.25% and 0.5% bupivacaine lhour, the cell viability 78.4%± 2.5, 70.4±1.0% respectively. When the articular cartilage was cultured in 1% lidocaine for 30, 60, 120 rains, the cell viability of the normal group was decreased to 79.1±1.5%, 69.8±3.1%,56±10.7% and the cell viability of the injury group decreased to 76.5±1.5%,66.9±3.9%,52.2±10.7% respec- tively. And while the cell viability of the normal group was changed to 88.2±4.7%,78.7±3.6%,63.7±3.7%, the injury group decreased to 79.7±2.2%,71.4±4.1%,56.5±6.5%,when cultured in the 0.25% bupivacaine for 30mins,60mins and 120mins. Conclusions： Using biologically and structurally intact articular cartilage we found that local anesthetics bupivacaine and lidocaine have a detrimental effect on chondrocyte viability in a dose- and time-dependent manner. The osteoarthritic articular cartilage might be more vulnerable to local anes- thetics than normal articular cartilage.

关 键 词：软骨细胞 利多卡因 布比卡因 细胞毒性 软骨细胞溶解 

分 类 号：R684.3[医药卫生—骨科学]