Hesperidin alleviates bupivacaine anesthesia‐induced neurotoxicity in SH‐SY5Y cells by regulating apoptosis and oxidative damage

Abstract Local anesthetic with bupivacaine (BV) administration may cause severe neurotoxicity and neurological complications in developing neurons. Any substances that can mitigate the toxic effects of BV are of great importance in surgical procedures and pain management. The present study attempted to investigate if hesperidin (HN) could inhibit or prevent BV‐induced neurotoxicity in SH‐SY5Y cells. Exposure of BV at 5 mM resulted in a significant decrease of cell viability and a remarkable increase of lactate dehydrogenase release via the induction of apoptosis and production of reactive oxygen species. Moreover, a loss of mitochondrial membrane potential, decreased Bcl‐2 protein expression, as well as increased expression of cytoplasmic cytochrome c , Bax, and cleaved caspase‐3 protein was also observed in BV‐stimulated SH‐SY5Y cells. In addition, BV stimulation impaired the balance of oxidation–reduction and inflammation system, as evidenced by the increased malondialdehyde content, decreased superoxide dismutase and catalase activity, and reduced level of reduced glutathione, interleukin‐6 (IL‐6), IL‐1β, and tumor necrosis factor‐α. However, these iatrogenic changes were all reversed by the HN (5, 10, and 20 μM) supplement for 48 h in a concentration‐dependent manner. In conclusion, HN can protect SH‐SY5Y cells against BV‐stimulated neurotoxicity via the inhibition of apoptosis, oxidative stress, and inflammation response. The present findings suggested that HN may be an effective alternative agent to inhibit or prevent BV‐induced neurotoxicity in human patients.