肌腱注射局部麻醉劑會怎樣?

 

 

 

答: 跟類固醇一樣,會讓肌腱組織弱化!

 

 

 

 

 

從之前的文章中,我們知道,肌腱一旦被類固醇注射後,會阻礙肌腱細胞的

 

 

再生修補作用。而本篇研究,更進一步呼應了這種現象。

 

 

在主流的臨床診治上,當醫師要為患者注射局部類固醇時,通常多少會加一些

 

 

局部麻醉劑;所以當您聽到醫師囑咐護理師備藥,說出 [1+1] 這類的術語時,

 

 

就是指 [1單位的類固醇 + 1cc 的局部麻醉劑] 。

 

 

這種每天都在你我身邊發生的治療方式,到底會對身體造成甚麼樣的影響呢?

 

 

 以下這篇美國康乃迪克醫學中心發表的研究,應該能提供醫界與病患再一次

 

 

反思的依據。

 

 

 

研究發現,受損肌腱組織接受自體PRP促進再生的作用,會明顯被同時加入的

 

 

類固醇與局麻劑所削弱 (類固醇=methylprednisolone;局麻劑=lidocaine/bupivacaine)。

 

 

 

而且,無論上述兩者單獨或合併加入試劑,都會造成修補抑制的現象。尤有甚者,

 

 

 

局部麻醉劑對肌腱修補的抑制作用,比類固醇更嚴重!

 

 

 

下回,當親朋好友要打針時,當您要為患者選擇注射藥劑時,請想一想這篇研究。

 

 

 

[原文摘要]

 

Arthroscopy. 2012 May;28(5):711-9. Epub 2012 Jan 21.

 

Corticosteroids and local anesthetics decrease positive effects of platelet-rich plasma: an in vitro study on human tendon cells.

 

Carofino B, Chowaniec DM, McCarthy MB, Bradley JP, Delaronde S, Beitzel K, Cote MP, Arciero RA, Mazzocca AD.

Source

Department of Orthopaedic Surgery, University of Connecticut Health Center, Farmington, Connecticut 06030, USA.

 

[Abstract]

PURPOSE:

To determine the effects of mixing anesthetics or corticosteroids with platelet-rich plasma (PRP) on human tenocytes in vitro.

 

METHODS:

Two separate protocols (double spin and single spin) were used to obtain homologous PRP from the blood of 8 healthy volunteers. Discarded tendon acquired during biceps tenodesis served as tendon specimens for all experiments. After cell isolation, tenocytes were treated in culture with PRP alone or in combination with corticosteroids and/or anesthetics. Fetal bovine serum in concentrations of 2% and 10% served as controls. Cell exposure times of 5, 10, and 30 minutes were used. Radioactive thymidine and luminescence assays were obtained to examine cell proliferation and viability.

 

RESULTS:

The presence of lidocaine, bupivacaine, or methylprednisolone resulted in significantly less proliferation than the negative 2% fetal bovine serum control (P < .05). When we compared groups, both lidocaine and bupivacaine had a greater inhibitory effect than methylprednisolone (P < .05). At all time points, viability was significantly decreased in the presence of lidocaine, bupivacaine, or methylprednisolone compared with the negative control (P < .05).

 

CONCLUSIONS:

The addition of either anesthetics or corticosteroids to PRP resulted in statistically significant decreases in tenocyte proliferation and cell viability. These results suggest that incorporation of anesthetics or corticosteroids, either alone or in combination, with PRP injection may compromise the potentially beneficial in vitro effects of isolated PRP on tendon cells and compromise cell viability at the site of tendon injury.

 

CLINICAL RELEVANCE:

Anesthetics or corticosteroids either alone or in combination should be used carefully to preserve the proposed positive effects of PRP in the treatment of tendon injury.

 

Copyright © 2012 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

 

PMID: 22264830

 

 

P.S.

 

1.資料來源:疼痛書房

 

2.我打了10年(不得不),這2年並不是好了,而是自己想辦法

 

, , , , , , , , , , , , , , ,
創作者介紹

獨飲食

歪婦wife 發表在 痞客邦 PIXNET 留言(0) 人氣()