European Journal of Anaesthesiology:
Abstracts and Programme: EUROANAESTHESIA 2011: The European Anaesthesiology Congress: Intensive Care Medicine
Istanbul Education & Research Hospital, Department of Anaesthesiology, Istanbul, Turkey
Background and Goal of Study: Intraarticular drug injection is consider to be a new therapeutic approach for the treatment of pain. Dexketoprofen trometamol is a water‐soluble salt of the dextrorotatory enantiomer of nonselective nonsteroidal anti‐inflamatory drug ketoprofen The principal effects of NSAIDs are peripheral and local application to the site of injury should produce analgesia while minimizing systemic side effects.. In this study we evaluate and compare the short and long term histopathological changes after direct injection of dexketoprotofen trometamol in the rat joint
Materials and Methods: Dexketoprofen 0.25 ml was injected into the right knee joint and 0.25 ml saline solution into the left knee joint as a control group of total 45 rats. Five rats were sham operated, groups of 8 rats were killed 1., 2., 7., 14., and 21. days after intraarticular injection. All joints were prepared and sectioned for histopathological examination according to the inflammation of articular cartilage, inflamatory cell infiltration, hyperplasia of synovial membrane, erosion of joint surface. Inflammatory changes in the joints were graded according to a five‐point scale, histologically.
Results and Discussion: There were no statistically significant histopathologic differences between the saline and dexketoprofen applied joints on the 1., 2., 7., 14., and 21.days (p< 0.05). Grade 3 inflammatory changes occurred only in 2 rat joints, in dexketoprofen group at 2. and 14. day after injection. Dexketoprofen has no inflammatory effect on synovia and cartiladge in the rat joint. Altough it is approved for intravenous and oral use, no toxicological
data exist regarding intraarticular administration. Further studies need to be intraarticular usage in humans with safety.
Conclusion(s): We conclude that absence of inflammatory effects after dexketoprofen injection can lead its clinical usage possible for chronic pain management.