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By contrast, ropivacaine and lidocaine were similar to saline in most assays, except for a low degree of mitochondrial stress as evidenced by increased ROS production. Ultimately, bupivacaine 0.75% was harmful to platelets as evidenced by reduced platelet viability, adhesion, and increased apoptosis, whereas lidocaine 1% and ropivacaine 0.5% were relatively safe at the 11 and 13 dilutions. Clinical significance Lidocaine 1% and ropivacaine 0.5% can be used at up to a 11 ratio with platelet preparations to reduce the pain and discomfort