bupivacaine toxic to cartilage

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Interesting info on what you thought you knew was ok...high concentration doses, but still

http://www.aaos.org/news/aaosnow/jun08/clinical4.asp

More doom and gloom. Have a nice day.

this has been known to occur from continuous infusion catheters using bupivicaine in glenohumeral joints post scope/labral repair/capsulorrhaphy. the dosages were high but some rat models have even shown damage to muscle and tendons with lower dosages.
That being said, corticosteroids kill articular cartilage with frequent administration as well.

this coudl explain why my Diagnostic MBB that I use 0.5% Bupi with last for more than 4 hours. Sometimes weeks and months!! I used to thnk it was psychogenic, but perhaps it is because it's a neurolytic.....lol I'm not advocating billing this as a neurolysis!!! But it is interesting.

Also, I wonder if this doc has stock in Naropin/Ropi ....

Article was in 2008 but I heard some new studies were done. It kills mesenchymal stem cells too.

Originally Posted by PinchandBurn

this coudl explain why my Diagnostic MBB that I use 0.5% Bupi with last for more than 4 hours. Sometimes weeks and months!! I used to thnk it was psychogenic, but perhaps it is because it's a neurolytic.....lol I'm not advocating billing this as a neurolysis!!! But it is interesting.

Also, I wonder if this doc has stock in Naropin/Ropi ....

the article was about effects on cartilage, not on nerves.


ps from the article, the lead researcher stated "Given that 0.125 percent bupivacaine had similar effects as saline, I believe the potential for clinically significant cartilage damage is quite low with the occasional single injection of a small amount of bupivacaine into a large joint."

Originally Posted by Ducttape

ps from the article, the lead researcher stated "Given that 0.125 percent bupivacaine had similar effects as saline, I believe the potential for clinically significant cartilage damage is quite low with the occasional single injection of a small amount of bupivacaine into a large joint."

Exactly. I think there's a HUGE difference between bathing a piece of cartilage outside the human body in concentrated bupivacaine versus giving a single injection with bupivacaine the will be both diluted in synovial fluid and also absorbed systemically.

Thanks for sharing though. I like having this information brought to my attention and then debated.

I've been using ropi for joints for a couple of years after asking the orthos about it when the switched their post-scope solution.

Originally Posted by drf

I've been using ropi for joints for a couple of years after asking the orthos about it when the switched their post-scope solution.

Has anyone actually repeated the same study with ropi so we know it's safer than bupi, or do we just think that because no one has studied ropi?

Hell, you bathe human cells in any high concentration liquid and I bet you can demonstrate increased cell death. I"m not convinced that really means anything in vivo.

Somebody once showed that peanut butter causes cancer after they force fed rats it their body weight in peanut butter twice a week.
Doesn't mean I'm worried about my occasional PB & J...................

so i take it you dont suffer from arachibutyrophobia....