Differences in Cytotoxicity of Lidocaine, Ropivacaine, and Bupivacaine on the Viability and Metabolic Activity of Human Adipose-Derived Mesenchymal Stem Cells.
Eva Kubrova, Min Su, Catalina Galeano-Garces and 6 others
PMID 32657816WHAT IT FOUND
In lab dishes, lidocaine, ropivacaine, and bupivacaine reduced stem cell survival and activity from three donors.
Ropivacaine was least harmful. This is not patient evidence.
Key findings
01At high concentrations, lidocaine and bupivacaine caused marked decreases in viable cells, while the lowest tested concentrations maintained persistent cell survival greater than 80% after 12 hours.
02Ropivacaine was less detrimental to cell viability than lidocaine and bupivacaine, with no significant continuing decline after the initial 1.5 hour time point.
03Local anesthetics reduced metabolic activity, with lidocaine and bupivacaine at the two highest concentrations falling below 25% of control, while ropivacaine showed a less significant decline.
STILL TO COME
How it was doneWhat they found
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What it does not show
This was a lab study on cells in dishes, not patients, so it cannot show what happens after an injection in a joint. The culture system kept anesthetic concentrations in contact with cells longer than would happen in tissue, because cells could not clear the drug into surrounding tissue. Cells came from only three donors, and the authors noted extensive donor dependent variation. For bupivacaine and lidocaine, gene expression data were limited because RNA yield was poor at the highest concentrations, where many cells died. The paper reports no clinical outcomes, no patient symptoms, and no treatment efficacy.
Declared interests
The supplied metadata lists research support from NIH extramural funding. The article text does not include a conflicts of interest or author declaration.
The easy way to misread this
Do not conclude that ropivacaine is the safest anesthetic for patients or that local anesthetics should be avoided in stem cell procedures. The study tested cells in lab dishes from three donors, not people undergoing treatment.