Author/Editor		Damjanovska, Marija; Cvetko, Erika; Hadžić, Admir; Seliškar, Alenka; Plavec, Tanja; Miš, Katarina; Vuckovic Hasanbegovic, I.; Stopar Pintarič, Tatjana
Title		Neurotoxicity of perineural vs intraneural-extrafascicular injection of liposomal bupivacaine in the porcine model of sciatic nerve block
Type		članek
Publication year		2015
ISSN		0003-2409 - Anaesthesia
Language		eng
Abstract		Liposomal bupivacaine is a prolonged-release local anaesthetic, the neurotoxicity of which has not yet been determined. We used quantitative histomorphometric and immunohistochemical analyses to evaluate the neurotoxic effect of liposomal bupivacaine after perineural and intraneural (extrafascicular) injection of the sciatic nerve in pigs. In this double-blind prospective randomised trial, 4 ml liposomal bupivacaine 1.3% was injected either perineurally (n = 5) or intraneurally extrafascicularly (n = 5). Intraneural%extrafascicular injection of saline (n = 5) was used as a control. After emergence from anaesthesia, neurological examinations were conducted over two weeks. After harvesting the sciatic nerves, no changes in nerve fibre density or myelin width indicative of nerve injury were observed in any of the groups. Intraneural injections resulted in longer sensory blockade than perineural (p < 0.003) without persistent motor or sensory deficit. Sciatic nerve block with liposomal bupivacaine in pigs did not result in histological evidence of nerve injury.
Keywords		bupivacaine sciatic nerve block neurotoxicity bupivakain blok ishiadičnega živca nevrotoksičnost