Peripheral Nerve Injury After Local Anesthetic Injection

• DOI: 10.1213/ane.0b013e3182a00767
• Publication Date: 2013-08-06T19:49:36Z
• Authors: Scott J. Farber; Maryam Saheb-Al-Z...; Lawrence Zieske; Osvaldo Laurido-Soto; Amit Bery; Daniel Hunter; Philip Johnson; Susan E. Mackinnon
• Keywords: Ropivacaine; Nerve Injury; Epineurium; Peripheral nerve injury

In Brief BACKGROUND: A well-known complication of peripheral nerve block is injury, whether from the needle or toxicity medication used. this study, we sought to determine extent damage that results intrafascicular injection various commonly used local anesthetics (LAs). METHODS: Sixteen Lewis rats received an saline (control) 1 3 LAs (bupivacaine, lidocaine, ropivacaine) into sciatic (n = 4). At a 2-week end point, nerves were harvested for histomorphometric and electron microscopic analysis. RESULTS: Animals LA injections showed increased severity injury as compared with control. particular, there was significant loss large-diameter fibers indicated by decreased counts (P < 0.01 all LAs) area remaining in severely injured versus noninjured areas nerve. There layering most closest furthest site. Bupivacaine caused more large than other 2 LAs. groups, fascicular transection observed. Electron microscopy confirmed injury. CONCLUSIONS: Frequently at traditional concentrations are toxic can injure Any combination motor and/or sensory sequelae may result due varying topography Published ahead print August 6, 2013