Item type:Thesis, Open Access

Histologische Veränderungen an peripheren Nerven nach peri- und intraneuraler Injektion von Bupivacain versus Bupivacain & Clonidin in einem experimentellen Regionalanästhesiemodell

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Date

2020-04-06

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Philipps-Universität Marburg
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Abstract

Introduction: The intraneural as well as perineural injection of local anesthetics can produce inflammation within the nerve. This fact is a key factor for neurological sequelae after regional anesthesia. Beside local anesthetics, there are other drugs which can be added to prolong the block time and reduce the total dose requirement of local anesthetics at the same time. One of these drugs is clonidine. The effect of clonidine on bupivacaine-induced inflammation has not been investigated to any great extent. The aim of this study was to investigate the modulating effect of clonidine on bupivacaine-induced inflammation. Material and methods: In total, 13 pigs were used to performe the intraneural as well as perineural injection of the test solution of the intervention (bupivacaine, bupivacaine + clonidine) or negative control group (sodium chloride) into their axillary brachial nerves. After 48h of maintained general anethesia, 111 nerves were excised, including those of the negative and positive control group, were histologically prepared and underwent blinded histological examination. All nerves were analyzed for signs of inflammation, intraneural hematoma and myelin damage and were categorized using a score ranging from 0 (no damage) to 4 (severe damage). Results: The comparison between the intraneural injection of bupivacaine alone and the intraneural injection of bupivacaine and clonidine indicated no significant difference in histological damage (p=0,372). Also the comparison between intraneural and perineural injection showed no significant difference. The intervention groups always indicated greater damage than the negative control group (e.g. ‚bupivacaine intraneural’ compared with ‚sodium chloride intraneural’ p=0,007). Conclusion: This animal study revealed no neuroprotective effect of clonidine on bupivacaine-induced inflammation. Also there was no difference between intraneural and perineural injection. Intraneural injection does not lead to more peripheral nerve damage.

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Dates
Created: 2020Issued: 2020-04-06Updated: 2020-04-06
DOI
https://doi.org/10.17192/z2020.0172
Faculty
Medizin
Publisher
Philipps-Universität Marburg
Language
ger
Data types
DoctoralThesis
Keywords
neurological sequelaeintra- und perineurale Injektionperiphere Regionalanästhesietrauma induced inflammationregional anesthesiabupivacainehistologischer Schadenhistologischer Nervenschadenclonidine
DFG-subjects
BupivacainClonidinaseptische Inflammationsreaktion,NerventraumaRegionalanästhesie
DDC-Numbers
610
License
https://rightsstatements.org/vocab/InC-NC/1.0/
URI
https://open.uni-marburg.de/handle/10.17192/z2020.0172
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Schüppel, Sebastian: Histologische Veränderungen an peripheren Nerven nach peri- und intraneuraler Injektion von Bupivacain versus Bupivacain & Clonidin in einem experimentellen Regionalanästhesiemodell. : Philipps-Universität Marburg 2020-04-06. DOI: https://doi.org/10.17192/z2020.0172.

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