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Depot local anesthetic in polymethylmethacrylate bone cement: a preliminary study
David M Bond1, John Rudan, Susan M Kobus
1Department of Anesthesiology, Queen's University, Kingston General Hospital, Ontario, Canada. dmbond@hotmail.com
Clinical Orthopaedics and Related Research
|March 27, 2004
Summary
This study explored using acrylic bone cement to slowly release local anesthetics for pain management in orthopedic surgery. Different anesthetics and cement brands showed varying release rates, suggesting potential for controlled drug delivery.
Area of Science:
- Orthopedic Surgery
- Pharmacology
- Biomaterials Science
Background:
- Acrylic bone cement is a proven antibiotic delivery system in orthopedics.
- Local anesthetics could offer targeted pain relief when delivered similarly.
- This study investigates the in vitro feasibility of anesthetic elution from bone cement.
Purpose of the Study:
- To assess the elution characteristics of local anesthetics from acrylic bone cement.
- To compare the release rates of different anesthetic agents (prilocaine, bupivacaine, lidocaine).
- To evaluate the influence of acrylic cement brand on anesthetic elution.
Main Methods:
- Five brands of acrylic bone cement were prepared with local anesthetic bases (up to 2g/40g).
- Anesthetic elution into saline was measured over 72 hours.
- Elution rates were analyzed based on anesthetic type and cement brand.
Main Results:
- Prilocaine demonstrated the fastest elution, followed by lidocaine, and then bupivacaine (slowest).
- Elution rates were highest within the first hour and decreased over time.
- Significant variations in elution rates were observed between cement brands, with CMW3 showing the quickest and Surgical Simplex P the slowest release.
Conclusions:
- Acrylic bone cement can serve as a depot for local anesthetic elution.
- Optimizing drug elution requires considering cement properties and drug concentration to maintain mechanical integrity.
- Further in vivo studies are needed to validate therapeutic potential and safety before clinical application.