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Kesici S, Kesici U, Ulusoy H, Erturkuner P, Turkmen A, Arda O. [Effects of local anesthetics on wound healing]. Rev Bras Anestesiol 2018; 68:375-382. [PMID: 29884529 DOI: 10.1016/j.bjan.2018.01.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 01/02/2018] [Accepted: 01/20/2018] [Indexed: 10/14/2022] Open
Abstract
INTRODUCTION Local anesthetic infiltration is used widely for post-operative analgesia in many situations. However the effects of local anesthetics on wound healing are not demonstrated clearly. This study planned to evaluate the effects of lidocaine, prilocaine, bupivacaine and levobupivacaine on wound healing, primarily on wound tensile strength and on collagen ultrastructure. METHODS This study was conducted on male Sprague Dawley rats. On days 0, 8th, 15th, and 21st, all animals were weighed and received a preincisional subcutaneous infiltration of 3mL of a solution according the group. Control saline (C), lidocaine (L) 7mg.kg-1, prilocaine (P) 2mg.kg-1, bupivacaine (B) 2mg.kg-1 and levobupivacaine (LVB) 2.5mg.kg-1. The infiltrations were done at the back region 1.5cm where incision would be performed at the upper, middle and lower part along the midline, under general anesthesia. Wound tensile strengths were measured after 0.7cm×2cm of cutaneous and subcutaneous tissue samples were obtained vertical to incision from infiltrated regions. Tissue samples were also obtained for electron microscopic examination. Evaluations were on the 8th, 15th and 21st days after infiltration. RESULTS There was no difference between groups in the weights of the rats at the 0th, 8th, 15th and 21st days. The collagen maturation was no statistically different between groups at the 8th and 15th days. The maturation scores of the B and L groups at the 21st day was significantly lower than the Group C (1.40, 1.64 and 3.56; respectively). The wound tensile strength was no statistically different between groups at the 8th and 15th days but at the 21st day the Groups B and LVB had significantly lower value than Group C (5.42, 5.54 and 6.75; respectively). CONCLUSION Lidocaine and prilocaine do not affect wound healing and, bupivacaine and levobupivacaine affect negatively especially at the late period.
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Affiliation(s)
- Sevgi Kesici
- Istanbul Aydın University, Vocational School of Health Services, Department of Anesthesiology, Istambul, Turquia.
| | - Ugur Kesici
- University of Beykent, School of Medicine, Department of General Surgery, Istambul, Turquia
| | - Hulya Ulusoy
- Karadeniz Technical University, Faculty of Medicine, Department of Anesthesiology and Reanimation, Trebizonda, Turquia
| | - Pelin Erturkuner
- Istanbul University, Cerrahpasa Medical Faculty, Department of Histology and Embryology, Istambul, Turquia
| | - Aygen Turkmen
- University of Giresun, School of Medicine, Department of Anesthesiology and Reanimation, Giresun, Turquia
| | - Oktay Arda
- Altınbas University, Medical Faculty, Department of Histology and Embryology, Istambul, Turquia
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Korat PS, Kapupara PP. Local infiltration of the surgical wound with levobupivacaine, ibuprofen, and epinephrine in postoperative pain: An experimental study. Biomed Pharmacother 2017; 96:104-111. [DOI: 10.1016/j.biopha.2017.09.131] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Revised: 09/25/2017] [Accepted: 09/25/2017] [Indexed: 11/27/2022] Open
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Biçer C, Yontar Y, Gökahmetoğlu G, Eskitaşçıoğlu T. Comparison of Effects of Levobupivacaine and Ropivacaine Infiltration on Cutaneous Wound Healing in a Rat Model. J INVEST SURG 2017; 31:515-520. [PMID: 28925761 DOI: 10.1080/08941939.2017.1363325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Cihangir Biçer
- a Department of Anesthesiology and Reanimation, Medical Faculty , Erciyes University , Kayseri , Turkey
| | - Yalcin Yontar
- b Department of Plastic, Reconstructive, and Aesthetic Surgery , Kayseri Training and Research Hospital , Kayseri , Turkey
| | - Günhan Gökahmetoğlu
- c Department of Anesthesiology and Reanimation , Kayseri Training and Research Hospital , Kayseri , Turkey
| | - Teoman Eskitaşçıoğlu
- d Department of Plastic, Reconstructive, and Aesthetic Surgery, Medical Faculty , Erciyes University , Kayseri , Turkey
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Gao Z, Cui F, Cao X, Wang D, Li X, Li T. Local infiltration of the surgical wounds with levobupivacaine, dexibuprofen, and norepinephrine to reduce postoperative pain: A randomized, vehicle–controlled, and preclinical study. Biomed Pharmacother 2017; 92:459-467. [DOI: 10.1016/j.biopha.2017.05.038] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 05/06/2017] [Accepted: 05/08/2017] [Indexed: 12/24/2022] Open
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Gomez-Brouchet A, Blaes N, Mouledous L, Fourcade O, Tack I, Francès B, Girolami JP, Minville V. Beneficial effects of levobupivacaine regional anaesthesia on postoperative opioid induced hyperalgesia in diabetic mice. J Transl Med 2015; 13:208. [PMID: 26136113 PMCID: PMC4488045 DOI: 10.1186/s12967-015-0575-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 06/16/2015] [Indexed: 12/26/2022] Open
Abstract
Background Diabetic neuropathy is one of the most common complications of diabetes and causes various problems in daily life. The aim of this study was to assess the effect of regional anaesthesia on post surgery opioid induced hyperalgesia in diabetic and non-diabetic mice. Methods Diabetic and non-diabetic mice underwent plantar surgery. Levobupivacaine and sufentanil were used before surgery, for sciatic nerve block (regional anaesthesia) and analgesia, respectively. Diabetic and non-diabetic groups were each randomly assigned to three subgroups: control, no sufentanil and no levobupivacaine; sufentanil and no levobupivacaine; sufentanil and levobupivacaine. Three tests were used to assess pain behaviour: mechanical nociception; thermal nociception and guarding behaviours using a pain scale. Results Sufentanil, alone or in combination with levobupivacaine, produced antinociceptive effects shortly after administration. Subsequently, sufentanil induced hyperalgesia in diabetic and non-diabetic mice. Opioid-induced hyperalgesia was enhanced in diabetic mice. Levobupivacaine associated to sufentanil completely prevented hyperalgesia in both groups of mice. Conclusion The results suggest that regional anaesthesia can decrease opioid-induced hyperalgesia in diabetic as well as in non-diabetic mice. These observations may be clinically relevant for the management of diabetic patients.
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Affiliation(s)
- Anne Gomez-Brouchet
- Service d'Anatomie Pathologique et Histologie-Cytologie, IUCT Oncopôle, 1 Avenue du Juliot Curie, 31059, Toulouse Cedex 9, France.
| | - Nelly Blaes
- Institute of Metabolic and Cardiovascular Diseases, I2MC, INSERM, U1048, Université Paul Sabatier, 31432, Toulouse, France.
| | - Lionel Mouledous
- CNRS, IPBS, Institut de Pharmacologie et de Biologie Structurale, 205 Route de Narbonne, 31077, Toulouse, France.
| | - Olivier Fourcade
- Department of Anaesthesiology and Intensive Care, Toulouse University Hospital, 31432, Toulouse, France.
| | - Ivan Tack
- Institute of Metabolic and Cardiovascular Diseases, I2MC, INSERM, U1048, Université Paul Sabatier, 31432, Toulouse, France.
| | - Bernard Francès
- Université de Toulouse, Centre de Recherches sur la Cognition Animale, CNRS, UMR 5169, Université Paul Sabatier, 118 Route de Narbonne, 31062, Toulouse, France.
| | - Jean-Pierre Girolami
- Institute of Metabolic and Cardiovascular Diseases, I2MC, INSERM, U1048, Université Paul Sabatier, 31432, Toulouse, France.
| | - Vincent Minville
- Department of Anaesthesiology and Intensive Care, Toulouse University Hospital, 31432, Toulouse, France. .,Institute of Metabolic and Cardiovascular Diseases, I2MC, INSERM, U1048, Université Paul Sabatier, 31432, Toulouse, France.
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Korkmaz M, Saritas TB, Sevimli A, Saritas ZK, Elitok B. The effect of gabapentin and pregabalin on intestinal incision wound healing in rabbits. Vet World 2015; 8:279-83. [PMID: 27047085 PMCID: PMC4774831 DOI: 10.14202/vetworld.2015.279-283] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 01/15/2015] [Accepted: 01/25/2015] [Indexed: 11/17/2022] Open
Abstract
AIM To evaluate the macroscopic and histologic effects of pregabalin (PG) gabapentin (GB) on longitudinal intestinal wound healing in New Zealand rabbits. MATERIALS AND METHODS The animals were divided into three groups randomly; the control group (n=6), PG group (n=6) and GB group (n=6). All animals were premedicated with xylazine HCI, 5 mg/kg i.m. and general anaesthesia was performed by ketamine HCI 50 mg/kg i.m injection. A 4 cm incision in the caecum through median laparotomy was achieved under aseptic surgery. Intestinal wound was closed with double-sutured. All animals were received parenteral antibiotic treatment for 5 days. PG and GB groups were treated by PG (30 mg/kg, oral, daily) and GB (30 mg/kg, oral, daily) for 10 days respectively. Control group did not receive any treatment. The animals were euthanized on day 10 and the caecum was examined by laparotomy. Adhesion formation was observed, and tissue samples were taken from suture lines for histologic examination. Cellular infiltration (polymorphonuclear white blood cells and mononuclear cells), accumulation of connective tissue, vascularization and extent of necrosis were evaluated and scored separately for each of mucosal, submucosal, muscular and serosal layers of caecum. RESULTS Adhesions were more severe in the GB group compared to other groups. No statistically significant differences were detected among the three groups about the wound healing. CONCLUSION It was suggested that the use of gabapentinoids had no significant effect on wound healing in patients undergoing gastrointestinal surgery and further studies with treatment periods longer than 10 days are needed.
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Affiliation(s)
- M. Korkmaz
- Department of Surgery, Faculty of Veterinary Medicine, Afyon Kocatepe University, 03200, Afyonkarahisar, Turkey
| | - T. B. Saritas
- Department of Anaesthesiology and Reanimation, Meram Medical School, Necmettin Erbakan University, 42080, Konya, Turkey
| | - A. Sevimli
- Department of Pathology, Faculty of Veterinary Medicine, Afyon Kocatepe University, 03200, Afyonkarahisar, Turkey
| | - Z. K. Saritas
- Department of Surgery, Faculty of Veterinary Medicine, Afyon Kocatepe University, 03200, Afyonkarahisar, Turkey
| | - B. Elitok
- Department of Internal Medicine, Faculty of Veterinary Medicine, Afyon Kocatepe University, 03200, Afyonkarahisar, Turkey
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Comparison of the effects of bupivacaine, lidocaine, and tramadol infiltration on wound healing in rats. Rev Bras Anestesiol 2014. [PMID: 23176988 DOI: 10.1016/s0034-7094(12)70180-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The aim of this study was to investigate the effects of saline solution, bupivacaine, lidocaine and tramadol infiltration on wound healing in rats. METHOD Thirty-two male Wistar Albino rats were randomly separated into four groups, receiving 3 mL saline solution in control group (Group C, n=8), 3 mL of 2% lidocaine in lidocaine group (Group L, n=8), 3 mL of 0.5% bupivacaine in bupivacaine group (Group B, n=8), and 3 mL of 5% tramadol in tramadol group (Group T, n=8). Breaking-strength measurements, collagen bundle counting, and histopathologic evaluation were evaluated in the tissue samples taken from the rats. RESULTS Comparing the control group with the groups where bupivacaine and lidocaine were used for wound infiltration, collagen production was lower, breaking-strength measurements showed reduced resistance while significantly high edema, vascularity, inflammation scores were found (p<0.0125). Between the control and the tramadol group there were no significant differences in collagen production, breaking-strength measurements, and edema, vascularity, inflammation scores (p>0.0125). CONCLUSION In our study, we found bupivacaine and lidocaine reduced the collagen production, wound breaking strength, and caused significantly high scores for edema, vascularity, and inflammation when compared to the control group. There was no significant difference between the control and the tramadol group. Results of this experimental preliminary study on rats support the idea that tramadol can be used for wound infiltration anesthesia without adverse effect on the surgical healing process. These results need to be verified in humans.
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Xiang K, Cai H, Song Z. Comparison of Analgesic Effects of Remifentanil and Fentanyl NCA after Pediatric Cardiac Surgery. J INVEST SURG 2014; 27:214-8. [DOI: 10.3109/08941939.2013.879968] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Baxter R, Bramlett K, Onel E, Daniels S. Impact of Local Administration of Liposome Bupivacaine for Postsurgical Analgesia on Wound Healing: A Review of Data From Ten Prospective, Controlled Clinical Studies. Clin Ther 2013; 35:312-320.e5. [DOI: 10.1016/j.clinthera.2013.02.005] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 02/05/2013] [Accepted: 02/08/2013] [Indexed: 12/20/2022]
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Zeren S, Kesici S, Kesici U, Isbilir S, Turkmen UA, Ulusoy H, Karpuz V, Ozcan O, Polat E, Ipcioglu OM, Sari MK. Effects of levobupivacaine on wound healing. Anesth Analg 2013; 116:495-9. [PMID: 23302982 DOI: 10.1213/ane.0b013e318273f48e] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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.
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Affiliation(s)
- Sezgin Zeren
- Department of General Surgery, Okmeydani Training and Research Hospital, and Department of Pathology, University of Science, Istanbul, Turkey
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Beaussier M, Bouaziz H, Aubrun F, Belbachir A, Binhas M, Bloc S, Fuzier R, Jochum D, Nouette-Gaulain K, Paqueron X. [Wound infiltration with local anesthetics for postoperative analgesia. Results of a national survey about its practice in France]. ACTA ACUST UNITED AC 2011; 31:120-5. [PMID: 22209702 DOI: 10.1016/j.annfar.2011.10.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Accepted: 10/04/2011] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVE Local wound infiltration is a component of multimodal postoperative (p.o.) analgesia. Its implementation in current clinical practice remains unknown. Pain and Regional Anesthesia Committee of the French Anaesthesia and Intensive Care Society (Sfar) aimed to appraise its practice. METHOD Postal sample survey based on representative sample of national activity were sent to heads of anaesthesiology departments. The questionnaires included 36 items on single-shot and continuous wound infiltrations (CWI) with considerations about modality of administration, drugs and development limitations. Results in mean [CI95 %]. RESULTS Response rate was 32 % (n=120). Sample was in accordance with national representation of health institutions. Local infiltration was included in 85 % [79-91] of the p.o. analgesia protocols. Regardless of the surgery, single-shot wound infiltration and CWI were used in more than 50 % of the patients by respectively 58 % [49-67] and 18 % [11-25] of the responders. However, a significant part of the surgeons remained reluctant to CWI. Lack of information and fear of septic complications were the most reported barriers. Peritoneal instillation after laparoscopy was rarely performed, in contrast with intra-articular infiltration after knee arthroscopy, performed systematically or very frequently by 60 % [50-70] of the responders. CONCLUSION The practice of local wound infiltration for p.o. analgesia seems presently well established, especially for single-shot injections. CWI is less commonly performed. Several surgical reluctances remain to be overcome. Better information about effectiveness and safety are likely to still improve their practices.
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Affiliation(s)
- M Beaussier
- Département d'anesthésie-réanimation chirurgicale, hôpital Saint-Antoine, université Pierre-et-Marie-Curie, Paris-6, AP-HP, 184, rue du Faubourg-Saint-Antoine, 75571 Paris cedex 12, France.
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Waite A, Gilliver SC, Masterson GR, Hardman MJ, Ashcroft GS. Clinically relevant doses of lidocaine and bupivacaine do not impair cutaneous wound healing in mice. Br J Anaesth 2010; 104:768-73. [PMID: 20418532 DOI: 10.1093/bja/aeq093] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Lidocaine and bupivacaine are commonly infiltrated into surgical cutaneous wounds to provide local anaesthesia after surgical procedures. However, very little is known about their effects on cutaneous wound healing. If an inhibitory effect is demonstrated, then the balance between the benefits of postoperative local anaesthesia and the negatives of impaired cutaneous wound healing may affect the decision to use local anaesthesia or not. Furthermore, if a difference in the rate of healing of lidocaine- and bupivacaine-treated cutaneous wounds is revealed, or if an inhibitory effect is found to be dose-dependent, then this may well influence the choice of agent and its concentration for clinical use. METHODS Immediately before incisional wounding, we administered lidocaine and bupivacaine intradermally to adult female mice, some of which had been ovariectomized to act as a model of post-menopausal women (like post-menopausal women, ovariectomized mice heal wounds poorly, with increased proteolysis and inflammation). Day 3 wound tissue was analysed histologically and tested for expression of inflammatory and proteolytic factors. RESULTS On day 3 post-wounding, wound areas and extent of re-epithelialization were comparable between the control and local anaesthetic-treated animals, in both intact and ovariectomized groups. Both tested drugs significantly increased wound activity of the degradative enzyme matrix metalloproteinase-2 relative to controls, while lidocaine also increased wound neutrophil numbers. CONCLUSIONS Although lidocaine and bupivacaine influenced local inflammatory and proteolytic factors, they did not impair the rate of healing in either of two well-established models (mimicking normal human wound healing and impaired age-related healing).
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Affiliation(s)
- A Waite
- Faculty of Life Sciences, University of Manchester, AV Hill Building, Oxford Road, Manchester, UK
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