Improving the Safety of Pain Pumps After Knee Surgery

Posted August 28th, 2008 by Matt

Pain Management

Pain pumps are often used after joint surgery to deliver a controlled amount of anesthetic and narcotic. This device provides good pain relief. Patients use less narcotic medication. But previous animal studies have shown that some drugs (lidocaine, bupivacaine) actually cause chondrocytes (cartilage cells) to die.

In this study, the effect of bupivacaine on chondrocytes in human articular cartilage samples is tested. The chondrocytes came from the femoral condyle of patients who had a total knee replacement. The femoral condyle is the round end of the femur (thigh bone).

The cells were scraped off and taken to a lab where they were prepared in a special culture. A system of pain pump to culture was set up. Medication was pumped into the culture plates in such a way as to mimic the way a normal, human joint would be treated.

Medications used included one-per cent lidocaine, one-per cent lidocaine with epinephrine, 0.25 per cent bupivacaine, 0.25 bupivacaine with epinephrine, 0.5 per cent bupivacaine, or 0.5 per cent bupivacaine with epinephrine. The amount of each drug used was similar to the dose given after surgery for pain control. Epinephrine is a stress hormone also known as adrenaline. It has many functions such as increasing the amount of oxygen supplied to the cells.

Samples were treated for 24-, 48-, and 72-hour trials. Control groups were used for comparison. The controls had chondrocytes in a culture media (solution) but without the drugs. The number of live cells in each sample (medication groups and the control groups) were counted before and after the drug trials. Accurate cell counts were done using digitally captured images and special computer software.

After 24-hours there was a significant decrease in the number of live cartilage cells in the medications that contained epinephrine. More than half the chondrocytes in the solution with lidocaine and epinephrine were gone.

The cell death rate was similar after 48-hours for the cells infused with any drug that contained epinephrine. At this point in time, samples containing one-per cent lidocaine also showed a decreased number of live chondrocytes. After 72-hours, cultures with 0.5 per cent bupivacaine showed similar losses of chondrocytes.

Overall, it looked like the death rate of chondrocytes increased with time. The combination of lidocaine and epinephrine had the worst results. These results may help explain reports of severe chondrolysis (breakdown of cartilage cells) after using intra-articular pain pumps.

The authors advise caution when using intra-articular pain pumps for more than 48 hours. Medications that have epinephrine in them should not be used at all. Bupivacaine (0.25 per cent) and lidocaine (one-per cent) are safe and effective during the first 48-hours post-op.

There are still many things that remain unknown about this experiment. Does the pH (acidity) of the medication make a difference in cell death? Would the epinephrine affect chondrocytes of young, healthy patients the same way? The patients in this study getting a total knee replacement were older adults with arthritis. Perhaps these cells are just more susceptible to damage.

Do knee chondrocytes respond differently to these drugs than chondrocytes from the hip or shoulder? Future studies are needed to answer these questions and find the optimal way to use intra-articular pain pumps after surgery.

Jason L. Dragoo, MD, et al. The Effect of Local Anesthetics Administered Via Pain Pump on Chondrocyte Viability. In The American Journal of Sports Medicine. August 2008. Vol. 36. No. 8. Pp. 1484-1488.

Post to Del.icio.us

Email to a Friend

Comments

ucvhost is a leading web

On March 2nd, 2010 keith12 says:

ucvhost is a leading web site hosting service provider that is known to provide reliable and affordable hosting packages to customers. Cheap Hosting company believes in providing absolute and superior control to the customer as well as complete security and flexibility through its many packages. Forex Vps Moreover, the company provides technical support as well as customer service 24x7, in order to enable its customer. price. windows vps
One good linux hosting option is the package cheap vps offered by ucvhost , which not only provides the best in terms of hosting packages but also believes in truly being there for the customer, 24x7. Moreover windows hosting , they offer unlimited bandwidth as well as nearly 1GB storage along with database maintenance, email facility along with storage, availability of sub domain and many other important features for a very low . thanks ucvhost

Abercrombie Hoodies

On March 26th, 2010 CYJisCod says:

Abercrombie Hoodies Abercrombie Hoodies
Abercrombie Jeans Abercrombie Jeans
Abercrombie Pants Abercrombie Pants
Abercrombie Tees Abercrombie Tees
Abercrombie Shorts Abercrombie Shorts
Abercrombie Sweater Abercrombie Sweater
Abercrombie Outerwear Abercrombie Outerwear
Abercrombie Polo Abercrombie Polo
Abercrombie Shirts Abercrombie Shirts
abercrombie henleys crew abercrombie henleys crew
hollister hollister
hollister uk hollister uk
abercrombie mens abercrombie mens
abercrombie womens abercrombie womens
Ruehl 925 Ruehl 925

Abercrombie Hoodies Abercrombie Hoodies
Abercrombie Jeans Abercrombie Jeans
Abercrombie Pants Abercrombie Pants
Abercrombie Tees Abercrombie Tees
Abercrombie Shorts Abercrombie Shorts
Abercrombie Sweater Abercrombie Sweater
Abercrombie Outerwear Abercrombie Outerwear
Abercrombie Polo Abercrombie Polo
Abercrombie Shirts Abercrombie Shirts
abercrombie henleys crew abercrombie henleys crew
hollister hollister
hollister uk hollister uk
abercrombie mens abercrombie mens
abercrombie womens abercrombie womens
Ruehl 925 Ruehl 925
Abercrombie And Fitch Abercrombie And Fitch
Wedding Dresses Wedding Dresses

kamagra is a generic version

On May 3rd, 2010 kamagra says:

kamagra is a generic version of viagra. generic viagra is a drug that contains the same active ingredient of brand viagra, which is sildenafil citrate , but is marketed under different brand names, like buy kamagra. lovegra. is the medication that is specifically designed for the women to enhance the sexual pleasures. oral jelly
The M-1965 Field Jacket , also known as the m65 jacket is a popular field jacket designed for the U.S. military. The m65 field jacket has been around for many years. It was introduced into US military service in 1965 to replace the M-1951 field jacket, an evolution of a Second World War design, the M-1943 field jacket. The m65 field jacket was widely used by United States troops during the vietnam war clothing in which the ed hardy became useful for troops serving in the Central Highlands of South Vietnam, as well as keeping a soldier warm from the cool weather conditions that came after monsoonal rains. new york city hotel
Learn how to make money on google , Easy Step by Step on How to Start Generating an income on google . make money writing, tv tuner card copy software dog carrier acne tandem costume

Thanks for sharing nice

On June 2nd, 2010 amisha says:

Thanks for sharing nice information with us. i like your post and all you share with us is uptodate and quite informative, i would like to bookmark the page so i can come here again to read you, as you have done a wonderful job.
algae killer

replica watches

On June 12th, 2010 cheap watches says:

replica watches

On June 12th, 2010 cheap watches says:

. as well as Nike basketball shoes the way to summarize everything that has been done previously. In 2005. the company presented not Cheap PRADA just Cheap Adidas ZX Series special anniversary timepieces but also new regular production models. %AThe Vacheron Constantin Museum%A To pay a tribute to the brand's history. Fake Watches the opening of China LED Ribbon Light the Vacheron Constantin Museum was appointed on December 8. The company decided to transfer its offices to Plan-les-Ouates to centralize production and administration and to use the new available Replica watches space Men PRADA t shirts in the historical building in mild seven cigarettes Geneva. The decision was inspired by the idea to unite the museum Fakes Watches. the replica Leather shoes boutique and the custom made watch ateliers under the same roof. The museum will organize different exhibitions. so the visitors that will cl boots come more Replica Puma Watches than once during the same year will probably not see the same watches.%A%ATo visit the museum. the interested people should Replica Nike Shox Turbo Shoes approach the boutique to make an appointment. It is not possible Cheap Adidas Superstar SS2G to have the museum open all the time for organizational luxury bedding reasons. but personalized guided tours are perfectly suitable for all the visitors. %A At Prada Handbags the Cheap replica Chanel shoes leather moment the museum comprises about 650 Men ARMANI t shirts pieces that are relevant to the different periods of the brand's history. These pieces. being the part of Wholesale Leather Handbags Cheaply cigarettes Vacheron Constantin's history. feature the Replica DUNHILL cigarettes peculiarities in Nike basketball shoes their design Cheap Nike Shox O Nine color=red>Replica Omega. outstanding fake Triumph Motorcycles Watches complications or historic significance. The museum is Replica Watch still in search for exceptional pieces for its unique collection!%AThe visitors of the custom watch ateliers top Louis vuitton/LV corium shoes leather will have the opportunity to see with their own eyes the way how the work in the haute horlogerie atelier is Replica Watches organized and functions. To provide the ability to meet the needs of any client concerning custom made timepieces will take time and patience. %AVacheron Constantin Watches and Collecting%A At the Antiquorum thematic auction for Vacheron Constantin's quarter millennium the brand Discount NEWPORT introduced a few pieces developed specially for the 250th anniversary. The collectors are getting more and more interested in Vacheron Constantin watches. For many collectors the brand was well known but davidoff menthol cigarettes now they are getting really attracted Replica Hermes Strap by its timepieces. The 250th anniversary also designer leather ballet flat shoes captured the attention of a lot of watch Replica 555 cigarettes connoisseurs.%AAuthentic Vacheron Constantin watches that are not striving Whimsical Rplica Watches for fashion will cheap 555 cigarettes continue to enjoy MP3,MP4 player the appreciation of collectors. Although the brand launches excellent contemporary pieces produced in limited editions or models no longer in production. its vintage models are still in great demand.%ANaturally. the time factorsoccer jersey supplier has always significantly influenced the choice of he collectors. It is proved again and again that the weight of history should not be ignored. If a 1940s chronographs and a contemporary chronograph are presented China LED Ribbon Light for sale the collector will most probably get Omega Watches for sale interested in the vintage model. At one of the actions pocket watch was purchased for over a million Swiss francs by some Replica Adidas trainers Shoes passionate collector.%AThe clients. who acquire a branded item. stop their choice at an accumulation of Replica Nike Shox Deliver Shoes historical values that add to the item's overall value. The buyers are very Fake Cheap Chanel Handbags often guided by an emotional aspect linked to the item's past giving Replica Gucci Wallets it adidas shoes a particular credibility in the eyes of the customers.%AThe Vacheron Constantin producers do not try to be image makers. They trust their collectors are able Fake Watches to decide themselves what is worth Discount Prada Bags nike air max 360 their attention. If the watch amateurs think that vintage Vacheron Replica Louis Vuitton Handbags Constantin timepieces are worth hunting for at auctions then it discount mild seven will provide a powerful image accelerator for the company and Cheap Nike Air Max 360 its Replica Marni Handbags further Cheap replica Chanel shoes leather credibility.%A%9%9%9%9%9%9%A

birkenstock

On June 25th, 2010 EmilieJuan says:

Birkenstock is a German brand of sandals and other shoes, notable for birkenstocks contoured cork and rubber footbeds, which conform somewhat to the shape of their wearers' feet. Representative products include the Birkenstock sandals and birkenstock gizeh. Birkenstock shoes are worn with or without socks, the choice generally based on outside temperature.

i like your post and all you

On June 30th, 2010 amisha says:

i like your post and all you share with us is uptodate and quite informative, i would like to bookmark the page so i can come here again to read you, as you have done a wonderful job
grow taller blog

What a Great Article it its

On July 1st, 2010 nishant says:

What a Great Article it its really informative and innovative keep us posted with new updates. its was really valuable. thanks a lot.
knee surgery

sdf

On July 5th, 2010 meixiang says:

singing musicmbt chapa rock, mbt chapa rock
air jordan 15, air jordan 15
mbt sport 2 grey, mbt sport 2 grey
Louis Vuitton Epi Alma, Louis Vuitton Epi Alma
dunk sb, dunk sb
discount ugg boots ultra short, discount ugg boots ultra short

UGG Boots on sale

On July 6th, 2010 fang says:

I was very pleased to find

On July 6th, 2010 mark456 says:

I was very pleased to find this site.I wanted to thank you for this great read!!
windows vps | ucvhost | vps | hosting

ugg boots on sale

On July 9th, 2010 shely77 says:

uggs on sale

On July 12th, 2010 uggs on sale says:

ugg boots sale

On July 16th, 2010 uggs on sale says:

UGG Boots on sale

On July 20th, 2010 fang says:

The quality of content is

On July 29th, 2010 kusum says:

The quality of content is good. Thanks for taking the time to discuss this,would you mind updating your blog with more information?
french country kitchen cabinets
bunn coffee maker parts
hotels near sea world orlando
best home coffee maker
bunn coffee maker parts

Audemars Piguet watches

On July 30th, 2010 gwy says:

The time that we should save and cherish it, but what is the time, do you know and what is the best replica Ferrari to your taste.
christian Dior replica are delighted to tell you the story about one of the brightest events that marked the history of watch-making.
The connoisseurs of A. Lange Sohne timepieces witnessed a unique event that took place in the world of alain Silberstein for sale-making. The prominent company brought the world's time zones together, having linked the major cities to its replica Rolex-making house in Saxony through a live link moderated in Germany on July 8 2005.
A Lange Sohne made sure that the Middle East was included in the regions with originating capacities, which gave them the possibility to transmit live back to the town of Glashutte.
A. Lange Sohne organized sending out its iWC replica with 36 of its croum replica into the most well-known cities around the world to mark the creation of its recent masterpiece, the Lange 1 Time Zone. Linked via satellite, each of the selected 36 cities such as Brussels, Berlin, Chicago, Milan, New York, Rome Paris, Tokyo and Zurich welcomed one A Lange & Sohne envoy who delivered an exceptional set of three Lange 1 Time Zone watches- in pink gold, yellow gold and platinum.
The Lange 1 Time Zone timepieces were entrusted into the hands of the craftsmen who departed from Glashutte at the same time and started on their separate journeys to the respective A. Lange Sohne dealers around the world. Celebrities omega replica，replica christian Dior，replica Hublot，oris replica，Glashutte replica，a.Lange & Sohne for sale，Breitling for sale，Patek Philippe watches，Burberry watches，Franck Muller for sale，Panerai watches，Graham watches， lovers and official representatives were waiting at the symbolic place to witness the watchmakers' arrival on their screens.
Every time zone and its invited guests enjoyed the provided possibility to interact with other time zones via presenters in the cities who were leading live discussions moderated through the town of Glashutte, the centre of the occasion.
The event was attended by such prominent guests as Jackie Chan in Hong Kong. Everyone was charmed to discover the elegant sets of three Lange 1 Time Zone Bell & Ross watches. In Beirut, Mr. Abou Adal, the official agent of the Breitling for sale brand in Lebanon accompanied by Nadine Njeim, who became Miss Lebanon 2004, were joined by an audience of 100 watch enthusiasts in the neighborhood of the Cadrans boutique, the luxury U-boat for sale and jewelry shop offering fine A. Lange Shone timepieces.
From the one side, the creators of the Lange 1 Time Zone watch simply made their contribution into the global celebration linking the world's time zones. On the other side, the company took the timely opportunity to highlight its deep interest in replica chopard-making history, craftsmanship and originality.
The time zones linked by A. Lange Sohne from Saxony in such an unprecedented way stirred all the watch-making industry. The successful realization of the idea proved that the company is not only in a league of its own if to consider its craftsmanship and perfection but its priority is the novel approach to enhancing its noble reputation.
Any model of replica Baume & Mercier will add into your life more precision, adventure and beauty.

http://www.msoftkey.net/

On August 16th, 2010 windows7key says:

The web Discount Windows Product Key has cheap Windows Key changed wholesale Office Product KeyAnd DiscountWindows Activation there's a cheap wholesale Windows Activation Key new way wholesale DiscountOffice Activation Key of Discount thinking cheapWindows Generator about wholesaleWindows Key Generator your DiscountOffice Key Generator applications.cheapWindows Keygen You wholesaleWindows Key can't DiscountOffice Keygenjust write cheapWindows Upgradesome wholesaleOffice UpgradeHTML and DiscountMicrosoft UpgradesCSS cheapWindows 7 Product Keyanymore wholesaleWindows 7 Key 2009and DiscountWindows 7 Keyexpect cheapWindows 7 Ultimate Keyto be wholesaleWindows 7 Home Premium Keythe next DiscountWindows 7 Professional Key Twitter. Hear cheapWindows 7 Product Keyhow to wholesaleMicrosoft Office 2010 Product Keymake your site wholesaleMicrosoft Office 2007 Product Keysocially

Login or register to post comments

*Disclaimer:*The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

All content provided by eORTHOPOD® is a registered trademark of Medical Multimedia Group, L.L.C.. Content is the sole property of Medical Multimedia Group, LLC and used herein by permission.

Back to top

User login

Username: *

Password: *

Create new account
Request new password

Helpful Links

All-Time Popular Content

Recent Popular Content

Terms Of Service

About Spine University

Spine Care Basics

Spine Wizard

Spine News

Spine Q & A

Neck Pain

Low Back Pain

Chronic Pain

Nutrition and the Spine

Mind Body Medicine

Journal Watch

Navigation

Pain Management

Patient Guides

News

FAQs

Spine Cervical

Patient Guides

News

FAQs

Spine General

Patient Guides

News

FAQs

Spine Lumbar

Patient Guides

News

FAQs

Spine Thoracic

Patient Guides

News

FAQs

*Disclaimer:*The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
	All content provided by eORTHOPOD® is a registered trademark of Medical Multimedia Group, L.L.C.. Content is the sole property of Medical Multimedia Group, LLC and used herein by permission.

Search

Improving the Safety of Pain Pumps After Knee Surgery

Comments

Comment viewing options

User login

Helpful Links

Spine Care Basics

Navigation