• Irfan Gungor, Akin Yilmaz, Akif Muhtar Ozturk, Mehmet Ali Ergun, Sevda Menevse, and Kadir Kaya.
• Department of Anesthesiology and Reanimation, Faculty of Medicine, Gazi University, Ankara, Turkey.
• Eur J Orthop Surg Tr. 2014 Apr 1; 24 (3): 291-5.

PurposeOsteoarthritis (OA) is characterized by chondrocyte apoptosis and necrosis which play a key role during the progression of OA. Intra-articular administration of bupivacaine is a practical and effective way of postoperative pain control following various joint surgeries. 0.25 % bupivacaine showed to be safe in terms of chondrocyte toxicity. Around 200 nM of bupivacaine was shown to be effective for peripheral nerve block. This study aims to observe the possible cytotoxic effects of bupivacaine and its enantiomer levobupivacaine on chondrocyte cell culture at 7.69, 76.9, and 384.5 μM or at 0.0125, 0.0025, and 0.00025 % concentrations, respectively.MethodsChondrocytes were isolated from rat articular cartilage after incubating with collagenase in RPMI-1640 medium. Cells were treated with bupivacaine and levobupivacaine at 7.69, 76.9, and 384.5 μM concentrations for 6, 24, and 48 h. Treated chondrocytes were stained with acridine orange and ethidium bromide and examined under a fluorescence microscope at a 490 nm excitation wavelength for apoptotic changes.ResultsStudy results suggest that both bupivacaine and levobupivacaine have dose-dependent chondrocyte toxicity, and this is significantly lesser at 7.69 μM dose. There was no significant difference in terms of chondrocyte apoptosis, (p > 0.05).ConclusionsClinicians should be skeptic for the serious long-term side effects of bupivacaine and its analogs, even at ultra-low doses.

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