Effects of Levobupivacaine on Wound Healing

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. Sixty Wistar a...

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Published in:	Anesthesia and analgesia Vol. 116; no. 2; pp. 495 - 499
Main Authors:	Zeren, Sezgin, Kesici, Sevgi, Kesici, Ugur, Isbilir, Salim, Turkmen, Ulku Aygen, Ulusoy, Hulya, Karpuz, Vildan, Ozcan, Omer, Polat, Erdal, Ipcioglu, Osman Metin, Sari, Musa Kazim
Format:	Journal Article
Language:	English
Published:	United States International Anesthesia Research Society 01-02-2013
Subjects:	Anesthetics, Local - adverse effects Anesthetics, Local - therapeutic use Animals Biopsy Bupivacaine - adverse effects Bupivacaine - analogs & derivatives Bupivacaine - therapeutic use Cell Proliferation Female Fibrosis Hydroxyproline - analysis Hydroxyproline - metabolism Postoperative Period Rats Rats, Wistar Skin - chemistry Sutures Tensile Strength Wound Healing - drug effects Wounds and Injuries - metabolism Wounds and Injuries - pathology
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Summary:	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. 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. 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. 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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0003-2999 1526-7598
DOI:	10.1213/ANE.0b013e318273f48e