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. 2021 Aug 20;2:723883. doi: 10.3389/fpain.2021.723883

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Copyright © 2021 Steverink, Piluso, Malda and Verlaan.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Light microscopy images of LA-induced myotoxicity. (A) Skeletal muscle 2 days after 0.9% saline injection, showing connective tissue (CT) between normal muscle fibers (MC) (20× magnification, insert 40×). (B) Skeletal muscle 2 days after 0.5% bupivacaine injection, showing degenerative (DA) and inflammatory areas (IA) alternated with MC (20× magnification). (C) Skeletal muscle 2 days after 0.5% ropivacaine injection, also displaying DA and IA (20× magnification). (D) Skeletal muscle 2 days after 0.5% levobupivacaine injection, showing incidental IA and blood vessels (BV) between MC (20× magnification). Öz Gergin et al. Comparison of the Myotoxic Effects of Levobupivacaine, Bupivacaine, and Ropivacaine: An Electron Microscopic Study. Ultrastructural Pathology, May 2015. Reprinted by permission of the publisher (Taylor & Francis Ltd.) (34).