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[Translated article] In vitro elution of local anaesthetics from PMMA bone cement
M Monfort-Mira1, M Jornet-Gibert1, C Yela-Verdú2
1Departamento de Cirugía Ortopédica y Traumatología, Hospital Clínic, Barcelona, Spain.
Revista Espanola De Cirugia Ortopedica Y Traumatologia
|March 14, 2024
Summary
Local anesthetics like lidocaine and bupivacaine can be released from polymethylmethacrylate (PMMA) bone cement. This study characterized their elution profiles for potential use in post-surgical pain management.
Area of Science:
- Orthopedic Surgery
- Pharmacology
- Biomaterials Science
Background:
- Effective pain management after total knee arthroplasty remains a challenge, with no current gold standard.
- Drug delivery systems are utilized, but ideal postoperative solutions are lacking.
- Polymethylmethacrylate (PMMA) bone cement has a history of use as a drug delivery system since the 1970s.
Purpose of the Study:
- To characterize the elution profile of lidocaine hydrochloride and bupivacaine hydrochloride from PMMA bone cement.
- To evaluate the potential of PMMA bone cement as a local anesthetic depot for pain management after total knee arthroplasty.
Main Methods:
- Specimens of Palacos® R+G bone cement loaded with either lidocaine hydrochloride or bupivacaine hydrochloride were prepared.
- Specimens were immersed in phosphate-buffered saline (PBS) and sampled at various time points.
- Local anesthetic concentrations in the PBS were quantified using liquid chromatography.
Main Results:
- Lidocaine elution reached 9.74% at 72 hours and 18.73% at 336 hours.
- Bupivacaine elution was 2.71% at 72 hours and 2.70% at 336 hours.
- Eluted doses at 72 hours approached those used in clinical anesthetic blocks.
Conclusions:
- Local anesthetics demonstrate in vitro elution from PMMA bone cement.
- PMMA bone cement shows potential as a localized drug delivery system for postoperative pain control.
- Further research may optimize anesthetic elution for enhanced surgical recovery.
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