Comparação dos efeitos da infiltração com bupivacaína, lidocaína e tramadol na cicatrização de feridas em ratos

Volkan Hancı; Sedat Hakimoğ; lu; Haktan Özaçmak; Sibel Bektaş; Hale Sayan Özaçmak; Ş; ükrü Oğ; uz Özdamar; Serhan Yurtlu; Iş; ı; l Özkoçak Turan

doi:10.1590/S0034-70942012000600005

Scientific Article

Comparação dos efeitos da infiltração com bupivacaína, lidocaína e tramadol na cicatrização de feridas em ratos

Comparison of the effects of bupivacaine, lidocaine, and tramadol infiltration on wound healing in rats

Volkan Hancı; ; Sedat Hakimoğ; lu; Haktan Özaçmak; Sibel Bektaş; ; Hale Sayan Özaçmak; Ş; ükrü Oğ; uz Özdamar; Serhan Yurtlu; Iş; ı; l Özkoçak Turan

http://dx.doi.org/10.1590/S0034-70942012000600005 Braz J Anesthesiol, vol.62, n6, p.804-810, 2012

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JUSTIFICATIVA E OBJETIVOS: O objetivo deste estudo foi o de investigar os efeitos da solução salina, da bupivacaína, lidocaína e da infiltração de tramadol na cicatrização de feridas em ratos. MÉTODOS: Trinta e dois ratos Wistar machos albinos foram alocados aleatoriamente em quatro grupos, que receberam 3 mL de solução salina no grupo controle (Grupo C, n = 8); 3 mL de lidocaína a 2% (Grupo L, n = 8); 3 mL de bupivacaína a 0,5% (Grupo B, n = 8) e 3 mL de tramadol a 5% (Grupo T, n = 8). As medidas de tensão de ruptura, contagem de fibras de colágeno e avaliação histopatológica foram avaliadas nas amostras de tecido retiradas dos ratos. RESULTADOS: A comparação do grupo controle com os grupos onde bupivacaína e lidocaína foram usadas para infiltração da ferida mostrou que nestes últimos a produção de colágeno foi menor e a resistência na tensão de ruptura, enquanto se observou edema mais intenso, vascularização e escores de inflamação significantes (p < 0,0125). Entre o grupo controle e o grupo tramadol não houve diferenças significativas na produção de colágeno, tensão de ruptura e edema, vascularização, e escores de inflamação (p > 0,0125). CONCLUSÃO: Neste estudo, verificou-se que tanto bupivacaína como lidocaína reduziram a produção de colágeno, resistência à ruptura da cicatriz e causaram edema, vascularização e inflamação significantes quando comparadas com o grupo controle. Não houve diferença significativa entre os grupos controle e tramadol para estas variáveis. Os resultados deste estudo experimental preliminar em ratos indicam que o tramadol pode ser utilizado para a anestesia por infiltração em incisões sem efeitos adversos sobre o processo de cicatrização cirúrgica. Estes resultados precisam ser verificados em seres humanos.

Palavras-chave

ANESTESIA, Local, ANESTÉSICOS, Local, bupivacaína, lidocaína, DROGAS, Tramadol, Cicatrização

Abstract

BACKGROUND AND OBJECTIVES: The aim of this study was to investigate the effects of saline solution, bupivacaine, lidocaine and tramadol infiltration on wound healing in rats. METHOD: Thirty-two male Wistar Albino rats were randomly separated into four groups, receiving 3 mL saline solution in control group (Group C, n = 8), 3 mL of 2% lidocaine in lidocaine group (Group L, n = 8), 3 mL of 0.5% bupivacaine in bupivacaine group (Group B, n = 8), and 3 mL of 5% tramadol in tramadol group (Group T, n = 8). Breaking-strength measurements, collagen bundle counting, and histopathologic evaluation were evaluated in the tissue samples taken from the rats. RESULTS: Comparing the control group with the groups where bupivacaine and lidocaine were used for wound infiltration, collagen production was lower, breaking-strength measurements showed reduced resistance while significantly high edema, vascularity, inflammation scores were found (p < 0.0125). Between the control and the tramadol group there were no significant differences in collagen production, breaking-strength measurements, and edema, vascularity, inflammation scores (p > 0.0125). CONCLUSION: In our study, we found bupivacaine and lidocaine reduced the collagen production, wound breaking strength, and caused significantly high scores for edema, vascularity, and inflammation when compared to the control group. There was no significant difference between the control and the tramadol group. Results of this experimental preliminary study on rats support the idea that tramadol can be used for wound infiltration anesthesia without adverse effect on the surgical healing process. These results need to be verified in humans.

Keywords

Anesthesia, Local, Tramadol, Bupivacaine, Lidocaine, Wound Healing

Referências

Ozyilmaz K, Ayoglu H, Okyay RD. Postoperative Analgesic Effects of Wound Infiltration With Tramadol and Levobupivacaine in Lumbar Disk Surgeries. J Neurosurg Anesthesiol. 2012.

Beaussier M, Bouaziz H, Aubrun F. les membres du comité douleur: ALR de la Sfar - Wound infiltration with local anesthetics for postoperative analgesia. Results of a national survey about its practice in France. Ann Fr Anesth Reanim. 2012;31:120-125.

Dere K, Sen H, Teksoz E. The comparison of the effects of different doses of levobupivacaine infiltration on wound healing. J Invest Surg. 2009;22:112-116.

Johansson B, Glise H, Hallerback B, Dalman P, Kristoffersson A. Preoperative local infiltration with ropivacaine for postoperative pain relief after cholecystectomy. Anesth Analg. 1994;78:210-214.

Vigneau A, Salengro A, Berger J. A double blind randomized trial of wound infiltration with ropivacaine after breast cancer surgery with axillary nodes dissection. BMC Anesthesiol. 2011;11.

Bari MS, Haque N, Talukder SA. Postoperative pain relief following inguinal hernia repair in children by wound infiltration with levobupivacaine. Mymensingh Med J. 2011;20:586-590.

Bilgin TE, Bozlu M, Atici S, Cayan S, Tasdelen B. Wound Infiltration with Bupivacaine and Intramuscular Diclofenac Reduces Postoperative Tramadol Consumption in Patients Undergoing Radical Retropubic Prostatectomy: A Prospective, Double-blind, Placebo-controlled, Randomized Study.. Urology. 2011;78:1281-1285.

Hernandez Palazon J, Tortosa Serrano JA, Burguillos Lopez S, Molero Molero E. Infiltration of surgical wound with local anesthetic for postoperative analgesia in patients operated for lumbar disc herniation: comparative study of ropivacaine and bupivacaine. Rev Esp Anestesiol Reanim. 2001;48:17-20.

Cnar SO, Kum U, Cevizci N, Kayaoglu S, Oba S. Effects of levobupivacaine infiltration on postoperative analgesia and stress response in children following inguinal hernia repair. Eur J Anaesthesiol. 2009;26:430-434.

Sorbello M, Paratore A, Morello G. Wound levobupivacaine continuous infusion for postoperative analgesia in living kidney donors: case-control study. Transplant Proc. 2009;41:1128-1131.

Kocabas S, Yedicocuklu D, Yuksel E, Uysallar E, Askar F. Infiltration of the sternotomy wound and the mediastinal tube sites with 0.25% levobupivacaine as adjunctive treatment for postoperative pain after cardiac surgery. Eur J Anaesthesiol. 2008;25:842-849.

Memis D, Hekimoglu S, Kaya G, Atakan HI, Kaplan M. Efficacy of levobupivacaine wound infiltration with and without intravenous lornoxicam for post-varicocoele analgesia: a randomized, double-blind study. Clin Drug Investig. 2008;28(6):353-359.

Lewis KS, Han NH. Tramadol: a new centrally acting analgesic. Am J Health Syst Pharm. 1997;54:643-52.

Khajavi MR, Aghili SB, Moharari RS. Subcutaneous tramadol infiltration at the wound site versus intravenous administration after pyelolithotomy. Ann Pharmacother. 2009;43:430-435.

Kargi E, Babuccu O, Altunkaya H, Hosnuter M, Ozer Y, Babuccu B, Payasli C. Tramadol as a local anaesthetic in tendon repair surgery of the hand. J Int Med Res. 2008;36:971-978.

Kaki AM, Al Marakbi W. Post-herniorrhapy infiltration of tramadol versus bupivacaine for postoperative pain relief: a randomized study. Ann Saudi Med. 2008;28:165-168.

Demiraran Y, Ilce Z, Kocaman B, Bozkurt P. Does tramadol wound infiltration offer an advantage over bupivacaine for postoperative analgesia in children following herniotomy?. Paediatr Anaesth. 2006;16:1047-1050.

Altunkaya H, Ozer Y, Kargi E. The postoperative analgesic effect of tramadol when used as subcutaneous local anesthetic. Anesth Analg. 2004;99:1461-1464.

Altunkaya H, Ozer Y, Kargi E, Babuccu O. Comparison of local anaesthetic effects of tramadol with prilocaine for minor surgical procedures. Br J Anaesth. 2003;90:320-322.

Desmeules JA, Piguet V, Collart L, Dayer P. Contribution of monoaminergic modulation to the analgesic effect of tramadol. Br J Clin Pharmacol. 1996;41:7-12.

Yurtlu S, Hanci V, Kargi E. The analgesic effect of dexketoprofen when added to lidocaine for intravenous regional anaesthesia: a prospective, randomized, placebo-controlled study. J Int Med Res. 2011;39:1923-1931.

Memis D, Turan A, Karamanlioglu B, Tükenmez B, Pamukçu Z. The effect of tramadol or clonidine added to intraperitoneal bupivacaine on postoperative pain in total abdominal hysterectomy. J Opioid Manag. 2005;1:77-82.

Tsai YC, Chang PJ, Jou IM. Direct tramadol application on sciatic nerve inhibits spinal somatosensory evoked potentials in rats. Anesth Analg. 2001;92:1547-1551.

Acalovschi I, Cristea T, Margarit S, Gavrus R. Tramadol added to lidocaine for intravenous regional anesthesia. Anesth Analg. 2001;92:209-214.

Robaux S, Blunt C, Viel E. Tramadol added bupivicaine, morphine and tramadol in rats. Agri. 2004;16:53-58.

Jou IM, Chu KS, Chen HH, Chang PJ, Tsai YC. The effect of intrathecal tramadol on spinal somatosensory-evoked potentials and motor-evoked responses in rats. Anesth Analg. 2003;96:783-788.

Guven M, Mert T, Gunay I. Effects of tramadol on nerve action potentials in rats: comparisons with benzocaine and lidocaine. Int J Neurosci. 2005;115:339-349.

Vasseur PB, Paul HA, Dybdal N, Crumley L. Effects of local anesthetics on healing of abdominal wounds in rabbits. Am J Vet Res. 1984;45:2385-2388.

Waite A, Gilliver SC, Masterson GR, Hardman MJ, Ashcroft GS. Clinically relevant doses of lidocaine and bupivacaine do not impair cutaneous wound healing in mice. Br J Anaesth. 2010;104:768-773.

Drucker M, Cardenas E, Arizti P, Valenzuela A, Gamboa A. Experimental studies on the effect of lidocaine on wound healing. World J Surg. 1998;22:394-397.

Fedder C, Beck-Schimmer B, Aguirre J. In vitro exposure of human fibroblasts to local anaesthetics impairs cell growth. Clin Exp Immunol. 2010;162:280-288.

Desai SP, Kojima K, Vacanti CA, Kodama S. Lidocaine inhibits NIH-3T3 cell multiplication by increasing the expression of cyclin-dependent kinase inhibitor 1A (p21). Anesth Analg. 2008;107:1592-1597.

Scherb MB, Han SH, Courneya JP, Guyton GP, Schon LC. Effect of bupivacaine on cultured tenocytes. Orthopedics. 2009;32.

Harris KL, Bainbridge NJ, Jordan NR, Sharpe JR. The effect of topical analgesics on ex vivo skin growth and human keratinocyte and fibroblast behavior. Wound Repair Regen. 2009;17:340-346.

Sturrock JE, Nunn JF. Cytotoxic effects of procaine, lignocaine and bupivacaine. Br J Anaesth. 1979;51:273-281.

Rodrigues FV, Hochman B, Wood VT, Simões MJ, Juliano Y, Ferreira LM. Effects of lidocaine with epinephrine or with buffer on wound healing in rat skin. Wound Repair Regen. 2011;19:223-228.

Field FK, Kerstein MD. Overview of wound healing in a moist environment (review). Am J Surg. 1994;167:2S-6S.

Luostarinen V, Evers H, Lytikainen MT. Antitrombotic effects of lidocaine and related compounds on laser induced microvascular injury. Acta Anesth Scand. 1981;9:25-28.

Morris T, Appleby R. Retardation of wound healing by procaine. Br J Surg. 1980;67:391-395.

Morris T, Tracey J. Lignocaine: its effects on wound healing. Br J Surg. 1977;64:902-905.

Bisla K, Tanelian DL. Concentration-dependent effects of lidocaine on corneal epithelial wound healing. Invest Ophthalmol Vis Sci. 1992;33:3029-3033.

Rosenberg PH, Renkoven OV. Antimicrobial activity of bupivacaine and morphine. Anesthesiology. 1985;62:178-179.

Sakuragi T, Ishino H, Dan K. Bactericidal activity of 0.5 % bupivacaine with presentatives on microorganisms in the human skin flora. Reg Anesth. 1997;22:178-184.

Hodson M, Gajraj R, Scott NB. A comparison of the antibacterial activity of levobupivacaine vs. bupivacaine: an in vitro study with bacteria implicated in epidural infection. Anesthesia. 1999;54:683-702.

Sedef Gocmen J, Buyukkocak U, Caglayan O, Aksoy A. In vitro antibacterial effects of topical local anesthetics. J Dermatolog Treat. 2008;19:351-353.

Berg JO, Mössner BK, Skov MN, Lauridsen J, Gottrup F, Kolmos HJ. Antibacterial properties of EMLA and lidocaine in wound tissue biopsies for culturing. Wound Repair Regen. 2006;14:581-585.

Tamanai-Shacoori Z, Shacoori V, Jolivet-Gougeon A. The antibacterial activity of tramadol against bacteria associated with infectious complications after local or regional anesthesia. Anesth Analg. 2007;105:524-527.

Zink W, Seif C, Bohl JR. The acute myotoxic effects of bupivacaine and ropivacaine after continuous peripheral nerve blockades. Anesth Analg. 2003;97:1173-1179.

Nouette-Gaulain K, Bringuier S, Canal-Raffin M. Time course of mitochondrial metabolism alterations to repeated injections of bupivacaine in rat muscle. Can J Anaesth. 2010:57836-57842.

Foster AH, Carlson BM. Myotoxicity of local anesthetics and regeneration of the damaged muscle fibers. Anesth Analg. 1980;59:727-736.

Khooshideh M, Shahriari A. A comparison of tramadol and pethidine analgesia on the duration of labour: a randomised clinical trial. Aust N Z J Obstet Gynaecol. 2009;49:59-63.

Comparação dos efeitos da infiltração com bupivacaína, lidocaína e tramadol na cicatrização de feridas em ratos

Comparison of the effects of bupivacaine, lidocaine, and tramadol infiltration on wound healing in rats

Volkan Hancı; ; Sedat Hakimoğ; lu; Haktan Özaçmak; Sibel Bektaş; ; Hale Sayan Özaçmak; Ş; ükrü Oğ; uz Özdamar; Serhan Yurtlu; Iş; ı; l Özkoçak Turan

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