Local Anesthetics as Antimicrobial Agents: A Review

Abstract

Local anesthetics not only serve as agents for pain control, but possess antimicrobial activity as well. In such a capacity, local anesthetics can be considered as an adjunct to traditional antimicrobial use in the clinical or laboratory setting. Additionally, caution should be exercised when administering local anesthetics prior to diagnostic procedures in which culture specimens are to be obtained, as the antimicrobial activity of the local anesthetic could lead to false-negative results or suboptimal culture yields.

Postoperative Analgesia in TKA: Ropivacaine Continuous Intraarticular Infusion

“…It is possible, with pain control, there is an inhibition of inflammatory mediators, less edema, and, therefore, better tissue oxygenation. In addition, it is known that local anesthetics have a bactericidal and/or bacteriostatic effect, as well as a fungistatic effect [15]. Therefore, it seems local anesthetic infusion could reduce the risk of infection [23].…”

Antimicrobial Activity of Lidocaine, Bupivacaine, Mepivacaine and Ropivacaine on Staphylococcus epidermidis, Staphylococcus aureus and Bacillus subtilis

“…Considering the literature [1], antimicrobial activity of local anaesthetics could lead to false-negative results in microbial assessment of biopsies. Potential mechanisms of these antimicrobial effects are lysis, increased cell wall permeability and dehydrogenase activity [2].…”

“…Potential mechanisms of these antimicrobial effects are lysis, increased cell wall permeability and dehydrogenase activity [2]. Various studies conclude that prior to diagnostic biopsies the lowest concentration of local agents should be used or a ring block with additive-free local anaesthetics should be performed [1,3]. In 2010, Kose and colleagues [4] showed that under in vivo conditions different local anaesthetics did not have any antimicrobial effects.…”

Continuous wound infusion of ropivacaine for the control of pain after thoracolumbar spinal surgery: a randomized clinical trial

“…It was also reported that the incidence of catheter or pump failure was 1.1 %. Although it has been reported that the local anesthetic ropivacaine displays antimicrobial activity [15], a study of continuous ropivacaine infusion in the median sternotomy incision following cardiac surgery showed high infection rates (9 %, n = 44) and this rate of infection was not statistically different in the saline group (0 %, n = 41) (P [ 0.05) [16]. However, a larger sample size must be evaluated before a definitive conclusion can be drawn about the safety of this technique.…”