Cartilage Damage Reported After Anesthetic Infusions

December 2009

The Food and Drug Administration (FDA) has issued a notification on continuously infused local anesthetics. The anesthetics – bupivacaine, chlorprocaine, lidocaine, mepivacaine, procaine, and ropivacaine – can cause chondrolysis, which is necrosis and destruction of cartilage.

The FDA has received 35 reports of chondrolysis in patients who were given continuous infusions of local anesthetics with infusion devices to manage post-surgical pain. The anesthetics were infused for 48 to 72 hours. The drug labels for local anesthetics don't include an approval for continuous postoperative infusions or for the use of infusion devices.

Chondrolysis was diagnosed, on average, 8.5 months after the infusion. Loss of motion, joint pain, and stiffness were reported as soon as two months after. In more than half of the reported cases, patients needed additional surgery. Local anesthetics are only approved as injections for local or regional anesthesia.