The use of orthobiologics, such as human mesenchymal stem cells (hMSCs), is a promising approach for tissue repair and regeneration in orthopedic medicine. However, the potential toxicity of local anesthetics (LAs) used during these procedures raises concerns about the effectiveness of hMSC-based treatments.
Studies have shown that certain amide-type LAs, including bupivacaine, lidocaine, and mepivacaine, can significantly reduce hMSC viability and adhesion when used at clinically relevant doses. This is particularly true with prolonged exposure to these anesthetics. Moreover, these LAs can induce apoptosis, a form of programmed cell death, in hMSCs even after short exposure times.
Among the LAs tested, ropivacaine stands out as the exception, showing no significant negative effects on hMSC viability or adhesion. This makes it a safer choice for use in orthobiologic procedures where hMSCs are involved.
Choosing the Right Anesthetic for Orthobiologic Procedures
The choice of LA in orthopedic procedures involving hMSCs is crucial for the success of the procedure. The findings from these studies highlight the importance of careful consideration of LA selection and dosage to minimize the risks of toxicity and ensure optimal clinical outcomes.
When considering LAs for orthobiologic procedures, we recommend to prioritize ropivacaine due to its lower toxicity profile compared to other amide-type LAs.
As regenerative medicine continues to advance, it is essential to address the potential risks associated with using LAs in combination with orthobiologics. By selecting the appropriate anesthetic and optimizing its dosage, Regenexx at NROFL enhances the safety and efficacy of their orthobiologic procedures. If you or a loved one are considering an orthobiologic procedure, be sure to choose someone who uses Ropivicaine vs. any other LA.
Sources
- Dregalla RC, Lyons NF, Reischling PD, Centeno CJ. Amide-type local anesthetics and human mesenchymal stem cells: clinical implications for stem cell therapy. Stem Cells Transl Med. 2014;3(3):365-374. doi:10.5966/sctm.2013-0058
