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BMC Anesthesiology
Published in: BMC Anesthesiology 1/2018

Open Access 01-12-2018 | Research article

Procaine and saline have similar effects on articular cartilage and synovium in rat knee

Authors: Aysun Ankay Yilbas, Basak Akca, Berkem Buyukakkus, Elham Bahador Zirh, Dilara Zeybek, Filiz Uzumcugil, Fatma Saricaoglu

Published in: BMC Anesthesiology | Issue 1/2018

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Abstract

Background

Intra-articular local anaesthetics are widely used for providing postoperative analgesia and decreasing the need for opioids. Procaine has proven positive effects in carpal tunnel syndrome and chondromalacia patella. However, the effect of procaine on articular cartilage has not yet been studied. The aim of this study was to evaluate the effects of intra-articular procaine injection on the articular cartilage and the synovium.

Methods

Twenty adult Sprague-Dawley rats were enrolled in the study. After providing anaesthesia and aseptic conditions, 0.25 ml of 10% procaine was injected to the right knee joint, and 0.25 ml of normal saline (as control group) was injected to the left knee joint. Knee joint samples were obtained from four rats in each group after appropriate euthanasia on days 1, 2, 7, 14 and 21. The histological sections of the articular and periarticular regions and the synovium were evaluated by two histologists, and inflammatory changes were graded according to a five-point scale in a blinded manner. The apoptosis of chondrocytes was determined by the caspase-3 indirect immunoperoxidase method.

Results

There were no significant differences in inflammation between procaine and saline groups at any of the time intervals. Slight inflammatory infiltration due to injection was seen in both groups on the 1st day. Haemorrhage was observed in both groups at days 1 and 2, and the difference between groups was not found to be significant. No significant difference was detected in the percentage of apoptotic chondrocytes between groups at any of the time intervals.

Conclusions

Injection of procaine seems safe to use intra-articularly based on this in vivo study on rat knee cartilage. However, further studies investigating both the analgesic and histopathological effects of procaine on damaged articular cartilage and synovium models are needed.
Literature
1.
Piper SL, Kramer JD, Kim HT, Feeley BT. Effects of local anesthetics on articular cartilage. Am J Sports Med. 2011;39:2245–53.CrossRefPubMed
2.
Chu CR, Coyle CH, Chu CT, Szczodry M, Seshadri V, Karpie JC, et al. In vivo effects of single intra-articular injection of 0.5% bupivacaine on articular cartilage. J Bone Joint Surg Am. 2010;92:599–608.CrossRefPubMed
3.
Gomoll AH, Yanke AB, Kang RW, Chubinskaya S, Williams JM, Bach BR, et al. Long-term effects of bupivacaine on cartilage in a rabbit shoulder model. Am J Sports Med. 2009;37:72–7.CrossRefPubMed
4.
Egli S, Pfister M, Ludin SM, Puente de la Vega K, Busato A, Fischer L. Long-term results of therapeutic local anesthesia (neural therapy) in 280 referred refractory chronic pain patients. BMC Complement Altern Med. 2015;15:200.CrossRefPubMedPubMedCentral
5.
Weinschenk S, Brocker K, Hotz L, Strowitzki T, Joos S, HUNTER (Heidelberg University Neural Therapy Education and Research) Group. Successful therapy of vulvodynia with local anesthetics: a case report. Forsch Komplementmed. 2013;20:138–43.CrossRefPubMed
6.
Hui F, Boyle E, Vayda E, Glazier RH. A randomized controlled trial of a multifaceted integrated complementary-alternative therapy for chronic herpes zoster-related pain. Altern Med Rev. 2012;17:57–68.PubMed
7.
Hauser RA, Sprague IS. Outcomes of prolotherapy in chondromalacia patella patients: improvements in pain level and function. Clin Med Insights Arthritis Musculoskelet Disord. 2014;17:13–20.
8.
Dolganiuc A, Radu D, Olinescu A, Vrabiescu A. Procain and diethylaminoethanol influence on the release of free oxygen radicals by polymorphonuclear leukocytes, in rabbits and humans. Roum Arch Microbiol Immunol. 1998;57:23–32.PubMed
9.
Cassuto J, Sinclair R, Bonderovic M. Anti-inflammatory properties of local anesthetics and their present and potential clinical implications. Acta Anaesthesiol Scand. 2006;50:265–82.CrossRefPubMed
10.
Erden IA, Altinel S, Saricaoglu F, Zeybek ND, Akinci SB, Asan E, et al. Effect of intra-articular injection of levobupivacaine on articular cartilage and synovium in rats. Anaesthesist. 2012;61:420–3.CrossRefPubMed
11.
Thomas CM, Fuller CJ, Whittles CE, Sharif M. Chondrocyte death by apoptosis is associated with the initiation and severity of articular cartilage degradation. Int J Rheum Dis. 2011;14:191–8.CrossRefPubMed
12.
Jacobs TF, Vansintjan PS, Roels N, Herregods SS, Verbruggen G, Herregods LL, et al. The effect of lidocaine on the viability of cultivated mature human cartilage cells: an in vitro study. Knee Surg Sports Traumatol Arthrosc. 2011;19:1206–13.CrossRefPubMed
13.
Grishko V, Xu M, Wilson G, Pearsall AW 4th. Apoptosis and mitochondrial dysfunction in human chondrocytes following exposure to lidocaine, bupivacaine, and ropivacaine. J Bone Joint Surg Am. 2010;92:609–18.CrossRefPubMed
14.
Karpie JC, Chu CR. Lidocaine exhibits dose- and time-dependent cytotoxic effects on bovine articular chondrocytes in vitro. Am J Sports Med. 2007;35:1621–7.CrossRefPubMed
15.
Johnson ME, Uhl CB, Spittler KH, Wang H, Gores GJ. Mitochondrial injury and caspase activation by the local anesthetic lidocaine. Anesthesiology. 2004;10:1184–94.CrossRef
16.
Dragoo JL, Braun HJ, Kim HJ, Phan HD, Golish SR. The in vitro chondrotoxicity of single-dose local anesthetics. Am J Sports Med. 2012;40:794–9.CrossRefPubMed
17.
Dragoo JL, Korotkova T, Kanwar R, Wood B. The effect of local anesthetics administered via pain pump on chondrocyte viability. Am J Sports Med. 2008;36:1484–8.CrossRefPubMed
18.
Dogan N, Erdem AF, Erman Z, Kizilkaya M. The effects of bupivacaine and neostigmine on articular cartilage and synovium in the rabbit knee joint. J Int Med Res. 2004;32:513–9.CrossRefPubMed
19.
Irwin W, Fontaine E, Agnolucci L, Penzo D, Betto R, Bortolotto S, et al. Bupivacaine myotoxicity is mediated by mitochondria. J Biol Chem. 2002;277:12221–7.CrossRefPubMed
20.
Kurkcuoglu BS, Donmez M, Altinel S, Akinci SB, Saricaoglu F, Aypar U. Comparison of intraarticular bupivacaine and levobupivacaine injection in rat synovial inflammation. Turk J Med Sci. 2014;44:540–5.CrossRefPubMed
21.
Vrăbiescu A, Radu D, Dolganiuc A, Bordea M, Olinescu A. Analysis by flow cytometry of the subpopulations of lymphocytes from the peripheral blood of procain or diethylaminoethanol treated rabbits. Roum Arch Microbiol Immunol. 1998;57:111–24.PubMed
22.
Karadaş O, Tok F, Ulaş UH, Odabaşi Z. The effectiveness of triamcinolone acetonide vs. procaine hydrochloride injection in the management of carpal tunnel syndrome: a double-blind randomized clinical trial. Am J Phys Med Rehabil. 2011;90:287–92.CrossRefPubMed
23.
Bai F, Michel R, Rossignol P. Effects of procaine on the oxidative phosphorylation of brain mitochondria from senescent rats. Mech Ageing Dev. 1984;26(2-3):277–82.CrossRefPubMed
24.
Zink W, Zausig YA, Graf BM. Intra-articular injection of levobupivacaine. Anaesthesist. 2013;62:231–2.CrossRefPubMed
25.
Fischer L, Ludin SM, Puente de la Vega K, Sturzenegger M. Neuralgia of the glossopharyngeal nerve in a patient with posttonsillectomy scarring: recovery after local infiltration of procaine-case report and pathophysiologic discussion. Case Rep Neurol Med. 2015;2015:560546.PubMedPubMedCentral
Metadata
Title
Procaine and saline have similar effects on articular cartilage and synovium in rat knee
Authors
Aysun Ankay Yilbas
Basak Akca
Berkem Buyukakkus
Elham Bahador Zirh
Dilara Zeybek
Filiz Uzumcugil
Fatma Saricaoglu
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Anesthesiology / Issue 1/2018
Electronic ISSN: 1471-2253
DOI
https://doi.org/10.1186/s12871-018-0513-9

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