[Translated article] In vitro elution of local anaesthetics from PMMA bone cement.

BACKGROUND AND AIM: Currently, we do not have a gold standard for pain management after total knee arthroplasty. We may use one of more drug delivery systems, none of which are ideal. An ideal depot delivery system would provide therapeutic, nontoxic, doses of drug at the surgical side, especially during 72h postoperatively. The bone cement used in arthroplasties has been used as a drug delivery system, especially antibiotics, since 1970. Based on this principle, we developed this study with the aim to characterize the elution profile of two local anaesthetics (lidocaine hydrochloride and bupivacaine hydrochloride) from PMMA (polymethilmethacrylate) bone cement. MATERIAL AND METHODS: Palacos® R+G bone cement and lidocaine hydrochloride or bupivacaine hydrochloride specimens were obtained depending on the study group. These specimens were immersed in PBS (phosphate buffered saline) and removed from the solution at different set times. Subsequently, the concentration of local anaesthetic in the liquid was analyzed by liquid chromatography. RESULTS: The percentage of lidocaine eluted from PMMA bone cement in this study was 9.74% of the total lidocaine content per specimen at 72h and 18.73% at 336h (14 days). In case of bupivacaine, the elution percentage was 2.71% of the total bupivacaine content per specimen at 72h and 2.70% at 336h (14 days). CONCLUSIONS: Local anaesthetics elute in vitro from PMMA bone cement, reaching doses at 72h close to the doses used in anaesthetic blocks.

Estudio in vitro de elución de anestésicos locales en cemento óseo de PMMA / In vitro elution of local anesthetics from PMMA bone cement

Antecedentes y objetivo:Actualmente, no disponemos de un gold standard para el manejo del dolor postoperatorio tras una artroplastia total de rodilla, dado que se pueden administrar analgésicos a través de diferentes vías y ninguna de estas está exenta de riesgos. El sistema ideal de administración de analgésicos debería proporcionar dosis terapéuticas, no tóxicas, en el sitio quirúrgico, especialmente durante las primeras 72h. El cemento óseo utilizado en las artroplastias se ha usado como un medio de liberación de fármacos, especialmente antibióticos, desde 1970. Basado en este principio, se desarrolló este estudio con el objetivo de conocer el perfil de elución de dos anestésicos locales (hidrocloruro de lidocaína e hidrocloruro de bupivacaína) desde el cemento óseo de polimetilmetacrilato (PMMA). Material y métodos: Se obtuvieron especímenes de cemento óseo Palacos® R+G e hidrocloruro de lidocaína o hidrocloruro de bupivacaína según el grupo de estudio. Estos especímenes se sumergieron en PBS (por sus siglas en inglés de phosphate buffered saline) y se retiraron de la solución en diferentes cortes temporales establecidos. Posteriormente, se analizó la concentración de anestésico local en el líquido mediante cromatografía líquida. Resultados: El porcentaje de lidocaína eludida del cemento óseo PMMA de este estudio ha sido del 9,74% del contenido total de lidocaína por espécimen a las 72h y del 18,73% a las 336h (14 días). En el caso de la bupivacaína, el porcentaje de elución ha sido del 2,71% del contenido total de bupivacaína por espécimen a las 72h y del 2,70% a las 336h (14 días). Conclusiones: Los anestésicos locales eluyen in vitro desde el cemento óseo, alcanzando a las 72h dosis cercanas a las dosis utilizadas en bloqueos anestésicos.(AU)

Background and aim: Currently, we do not have a gold standard for pain management after total knee arthroplasty. We may use one of more drug delivery systems, none of which are ideal. An ideal depot delivery system would provide therapeutic, nontoxic, doses of drug at the surgical side, especially during 72h postoperatively. The bone cement used in arthroplasties has been used as a drug delivery system, especially antibiotics, since 1970. Based on this principle, we developed this study with the aim to characterize the elution profile of two local anesthetics (lidocaine hydrochloride and bupivacaine hydrochloride) from PMMA (polymethilmethacrylate) bone cement. Material and methods: Palacos® R+G bone cement and lidocaine hydrochloride or bupivacaine hydrochloride specimens were obtained depending on the study group. These specimens were immersed in PBS (phosphate buffered saline) and removed from the solution at different set times. Subsequently, the concentration of local anesthetic in the liquid was analyzed by liquid chromatography. Results: The percentage of lidocaine eluted from PMMA bone cement in this study was 9.74% of the total lidocaine content per specimen at 72h and 18.73% at 336h (14 days). In case of bupivacaine, the elution percentage was 2.71% of the total bupivacaine content per specimen at 72h and 2.70% at 336h (14 days). Conclusions: Local anesthetics elute in vitro from PMMA bone cement, reaching doses at 72h close to the doses used in anesthetic blocks.(AU)

[Translated article] In vitro elution of local anaesthetics from PMMA bone cement / Estudio in vitro de elución de anestésicos locales en cemento óseo de PMMA

Antecedentes y objetivo:Actualmente, no disponemos de un gold standard para el manejo del dolor postoperatorio tras una artroplastia total de rodilla, dado que se pueden administrar analgésicos a través de diferentes vías y ninguna de estas está exenta de riesgos. El sistema ideal de administración de analgésicos debería proporcionar dosis terapéuticas, no tóxicas, en el sitio quirúrgico, especialmente durante las primeras 72h. El cemento óseo utilizado en las artroplastias se ha usado como un medio de liberación de fármacos, especialmente antibióticos, desde 1970. Basado en este principio, se desarrolló este estudio con el objetivo de conocer el perfil de elución de dos anestésicos locales (hidrocloruro de lidocaína e hidrocloruro de bupivacaína) desde el cemento óseo de polimetilmetacrilato (PMMA). Material y métodos: Se obtuvieron especímenes de cemento óseo Palacos® R+G e hidrocloruro de lidocaína o hidrocloruro de bupivacaína según el grupo de estudio. Estos especímenes se sumergieron en PBS (por sus siglas en inglés de phosphate buffered saline) y se retiraron de la solución en diferentes cortes temporales establecidos. Posteriormente, se analizó la concentración de anestésico local en el líquido mediante cromatografía líquida. Resultados: El porcentaje de lidocaína eludida del cemento óseo PMMA de este estudio ha sido del 9,74% del contenido total de lidocaína por espécimen a las 72h y del 18,73% a las 336h (14 días). En el caso de la bupivacaína, el porcentaje de elución ha sido del 2,71% del contenido total de bupivacaína por espécimen a las 72h y del 2,70% a las 336h (14 días). Conclusiones: Los anestésicos locales eluyen in vitro desde el cemento óseo, alcanzando a las 72h dosis cercanas a las dosis utilizadas en bloqueos anestésicos.(AU)

Background and aim: Currently, we do not have a gold standard for pain management after total knee arthroplasty. We may use one of more drug delivery systems, none of which are ideal. An ideal depot delivery system would provide therapeutic, nontoxic, doses of drug at the surgical side, especially during 72h postoperatively. The bone cement used in arthroplasties has been used as a drug delivery system, especially antibiotics, since 1970. Based on this principle, we developed this study with the aim to characterize the elution profile of two local anesthetics (lidocaine hydrochloride and bupivacaine hydrochloride) from PMMA (polymethilmethacrylate) bone cement. Material and methods: Palacos® R+G bone cement and lidocaine hydrochloride or bupivacaine hydrochloride specimens were obtained depending on the study group. These specimens were immersed in PBS (phosphate buffered saline) and removed from the solution at different set times. Subsequently, the concentration of local anesthetic in the liquid was analyzed by liquid chromatography. Results: The percentage of lidocaine eluted from PMMA bone cement in this study was 9.74% of the total lidocaine content per specimen at 72h and 18.73% at 336h (14 days). In case of bupivacaine, the elution percentage was 2.71% of the total bupivacaine content per specimen at 72h and 2.70% at 336h (14 days). Conclusions: Local anesthetics elute in vitro from PMMA bone cement, reaching doses at 72h close to the doses used in anesthetic blocks.(AU)

[Translated article] In vitro elution of local anaesthetics from PMMA bone cement.

BACKGROUND AND AIM: Currently, we do not have a gold standard for pain management after total knee arthroplasty. We may use one of more drug delivery systems, none of which are ideal. An ideal depot delivery system would provide therapeutic, nontoxic, doses of drug at the surgical side, especially during 72h postoperatively. The bone cement used in arthroplasties has been used as a drug delivery system, especially antibiotics, since 1970. Based on this principle, we developed this study with the aim to characterise the elution profile of two local anaesthetics (lidocaine hydrochloride and bupivacaine hydrochloride) from PMMA (polymethilmethacrylate) bone cement. MATERIAL AND METHODS: Palacos® R+G bone cement and lidocaine hydrochloride or bupivacaine hydrochloride specimens were obtained depending on the study group. These specimens were immersed in PBS (phosphate buffered saline) and removed from the solution at different set times. Subsequently, the concentration of local anaesthetic in the liquid was analysed by liquid chromatography. RESULTS: The percentage of lidocaine eluted from PMMA bone cement in this study was 9.74% of the total lidocaine content per specimen at 72h and 18.73% at 336h (14 days). In case of bupivacaine, the elution percentage was 2.71% of the total bupivacaine content per specimen at 72h and 2.70% at 336h (14 days). CONCLUSIONS: Local anaesthetics elute in vitro from PMMA bone cement, reaching doses at 72h close to the doses used in anaesthetic blocks.

In vitro elution of local anesthetics from PMMA bone cement. / Estudio in vitro de elución de anestésicos locales en cemento óseo de PMMA.

BACKGROUND AND AIM: Currently, we do not have a gold standard for pain management after total knee arthroplasty. We may use one of more drug delivery systems, none of which are ideal. An ideal depot delivery system would provide therapeutic, nontoxic, doses of drug at the surgical side, especially during 72h postoperatively. The bone cement used in arthroplasties has been used as a drug delivery system, especially antibiotics, since 1970. Based on this principle, we developed this study with the aim to characterize the elution profile of two local anesthetics (lidocaine hydrochloride and bupivacaine hydrochloride) from PMMA (polymethilmethacrylate) bone cement. MATERIAL AND METHODS: Palacos® R+G bone cement and lidocaine hydrochloride or bupivacaine hydrochloride specimens were obtained depending on the study group. These specimens were immersed in PBS (phosphate buffered saline) and removed from the solution at different set times. Subsequently, the concentration of local anesthetic in the liquid was analyzed by liquid chromatography. RESULTS: The percentage of lidocaine eluted from PMMA bone cement in this study was 9.74% of the total lidocaine content per specimen at 72h and 18.73% at 336h (14 days). In case of bupivacaine, the elution percentage was 2.71% of the total bupivacaine content per specimen at 72h and 2.70% at 336h (14 days). CONCLUSIONS: Local anesthetics elute in vitro from PMMA bone cement, reaching doses at 72h close to the doses used in anesthetic blocks.

Prótesis fémoro-patelar / Femoropatellar prosthesis

Las prótesis de rótula ofrece buenas probabilidades de proporcionar a los enfermos resultados que eliminen el dolor y satisfactorios de la movilidad y de la capacidad de marcha, siguiendo una indicación rigurosa en la artrosis fémoro-patelar aislada grave. Constituye una alternativa ventajosa frente a la patelectomía

Patellar prostheses offer patients good probabilities of pain relief and satisfactory mobility and walking capacity, following strict indication in severe isolated femoropatellar arthrosis. Such management constitutes an advantageous alternative to patellectomy

Un paciente con dolor de cadera

No disponible