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Absence of neurotoxicity with perineural injection of ultrasound gels: assessment using an animal model
BACKGROUND: Ultrasound gels may contain propylene glycol and glycerol, which are neurotoxic in high concentrations. If the needle passes through gel during regional anesthesia, gel may be injected near the nerve. It is unknown if this practice poses a risk for neurotoxicity. Using an animal model, w...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3846145/ https://www.ncbi.nlm.nih.gov/pubmed/24004500 http://dx.doi.org/10.1186/1471-2253-13-18 |
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author | Belavy, David Sunn, Nana Lau, Queenie Robertson, Thomas |
author_facet | Belavy, David Sunn, Nana Lau, Queenie Robertson, Thomas |
author_sort | Belavy, David |
collection | PubMed |
description | BACKGROUND: Ultrasound gels may contain propylene glycol and glycerol, which are neurotoxic in high concentrations. If the needle passes through gel during regional anesthesia, gel may be injected near the nerve. It is unknown if this practice poses a risk for neurotoxicity. Using an animal model, we assessed the histological changes of perineural propylene glycol on nerves. We then assessed three commonly used sterile gels for evidence of neurotoxicity. METHODS: Micro-ultrasound guided perineural sciatic nerve injections were performed in mice. Propylene glycol (PG) 2.5%, 10%, 35%, 70% (v/v) or saline was injected. Nerves were assessed after three days for evidence of neurotoxicity. Aquasonic® 100 Ultrasound Gel, K-Y® Lubricating Jelly, and PDI® Lubricating Jelly were also studied against saline controls. RESULTS: Confluent areas of axonal degeneration and intraneural inflammation occurred in 5 of 9 specimens injected with 70% PG. At 35%, 2 of 8 specimens showed patchy changes not present at lower concentrations. No degeneration occurred with Aquasonic® 100 or PDI® Lubricating Jelly. In the K-Y® group, one gel and one saline specimen demonstrated confluent degenerative changes. CONCLUSIONS: Similar to glycerol, 70% PG may cause confluent areas of axon and myelin degeneration with associated intraneural inflammation. The concentration of PG present in ultrasound gels is unlikely to cause neurotoxicity. Aquasonic® 100 and PDI® Lubricating Jelly did not cause neurotoxicity. The results for K-Y® Lubricating Jelly are inconclusive. There is no evidence that passing the needle through the studied gels during regional anesthesia procedures is harmful. |
format | Online Article Text |
id | pubmed-3846145 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-38461452013-12-03 Absence of neurotoxicity with perineural injection of ultrasound gels: assessment using an animal model Belavy, David Sunn, Nana Lau, Queenie Robertson, Thomas BMC Anesthesiol Research Article BACKGROUND: Ultrasound gels may contain propylene glycol and glycerol, which are neurotoxic in high concentrations. If the needle passes through gel during regional anesthesia, gel may be injected near the nerve. It is unknown if this practice poses a risk for neurotoxicity. Using an animal model, we assessed the histological changes of perineural propylene glycol on nerves. We then assessed three commonly used sterile gels for evidence of neurotoxicity. METHODS: Micro-ultrasound guided perineural sciatic nerve injections were performed in mice. Propylene glycol (PG) 2.5%, 10%, 35%, 70% (v/v) or saline was injected. Nerves were assessed after three days for evidence of neurotoxicity. Aquasonic® 100 Ultrasound Gel, K-Y® Lubricating Jelly, and PDI® Lubricating Jelly were also studied against saline controls. RESULTS: Confluent areas of axonal degeneration and intraneural inflammation occurred in 5 of 9 specimens injected with 70% PG. At 35%, 2 of 8 specimens showed patchy changes not present at lower concentrations. No degeneration occurred with Aquasonic® 100 or PDI® Lubricating Jelly. In the K-Y® group, one gel and one saline specimen demonstrated confluent degenerative changes. CONCLUSIONS: Similar to glycerol, 70% PG may cause confluent areas of axon and myelin degeneration with associated intraneural inflammation. The concentration of PG present in ultrasound gels is unlikely to cause neurotoxicity. Aquasonic® 100 and PDI® Lubricating Jelly did not cause neurotoxicity. The results for K-Y® Lubricating Jelly are inconclusive. There is no evidence that passing the needle through the studied gels during regional anesthesia procedures is harmful. BioMed Central 2013-09-03 /pmc/articles/PMC3846145/ /pubmed/24004500 http://dx.doi.org/10.1186/1471-2253-13-18 Text en Copyright © 2013 Belavy et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Belavy, David Sunn, Nana Lau, Queenie Robertson, Thomas Absence of neurotoxicity with perineural injection of ultrasound gels: assessment using an animal model |
title | Absence of neurotoxicity with perineural injection of ultrasound gels: assessment using an animal model |
title_full | Absence of neurotoxicity with perineural injection of ultrasound gels: assessment using an animal model |
title_fullStr | Absence of neurotoxicity with perineural injection of ultrasound gels: assessment using an animal model |
title_full_unstemmed | Absence of neurotoxicity with perineural injection of ultrasound gels: assessment using an animal model |
title_short | Absence of neurotoxicity with perineural injection of ultrasound gels: assessment using an animal model |
title_sort | absence of neurotoxicity with perineural injection of ultrasound gels: assessment using an animal model |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3846145/ https://www.ncbi.nlm.nih.gov/pubmed/24004500 http://dx.doi.org/10.1186/1471-2253-13-18 |
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