Absence of neurotoxicity with perineural injection of ultrasound gels: assessment using an animal model

Belavy, David; Sunn, Nana; Lau, Queenie; Robertson, Thomas

doi:10.1186/1471-2253-13-18

Cited by 16 publications

(6 citation statements)

References 14 publications

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“…However, application to the peripheral nerve is limited, although ultrasonography-guided nerve stimulation is frequently used for regional anesthesia (Wadhwa et al 2011). Recently, ultrasonography-guided injection has facilitated the safe delivery into the perineural region (Belavy et al 2013), demonstrating the safety of ultrasonography gels and needle injection. There was a minimal inflammatory response and no damage to the nerve.…”

Section: Discussionmentioning

confidence: 99%

Ultrasonography-guided transplantation facilitates perineural delivery of stem cells

Kim

Joo

Hong

et al. 2015

Animal Cells and Systems

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Treatment options for peripheral neuropathy are very limited. In order to develop a therapeutic strategy using stem cell therapy for the peripheral nervous system, we explored the feasibility of a new delivery method. Using ultrasonographyguided transplantation, human mesenchymal stem cells (hMSCs) were delivered into the perineural region of small rodent models. An optical imaging system revealed that hMSCs stained with CFSE or PKH26 reside for a week posttransplantation in both the mouse and rat. Immunofluorescence analysis of tissues revealed the presence of transplanted hMSCs in the perineural region of mice. At the end of the experiments, no behavioral or phenotypic abnormalities were observed. In addition, H&E and toluidine blue staining showed the integrity of the sciatic nerve after transplantation. This is the first study, to the best of our knowledge, to deliver cells into the perineural region under ultrasonography guidance. Since hMSCs can reside for a considerable time at a transplanted site, an anti-inflammatory efficacy of the transplanted hMSCs can be expected in the perineural region. In conclusion, we established a new administration route for inflammatory peripheral neuropathy without complications, and this may be used for delivery of chemical drugs or stem cells.

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Section: Discussionmentioning

confidence: 99%

Ultrasonography-guided transplantation facilitates perineural delivery of stem cells

Kim

Joo

Hong

et al. 2015

Animal Cells and Systems

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“…Therefore, mixed gel was suitable for pleural marking. A sterilized echogenic jelly is said not to cause tissue degeneration during subcutaneous insertion (14) and is guaranteed to be safe as a material used for marking. Additionally, shielding by the surgical tape may make it safer.…”

Section: Discussionmentioning

confidence: 99%

Virtual thoracoscopic imaging-assisted pleural marking of pulmonary nodules

et al. 2020

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Background: Computed tomography (CT) is now able to detect small pulmonary nodules. Surgical resection for diagnosis of these nodules is widely performed with video-assisted thoracoscopic surgery (VATS). However, it is very difficult to localize a small tumor by palpation via a small access port. In this study, we aimed to describe a novel intraoperative method for marking the location of the pulmonary nodule. Methods: In 46 cases, a virtual thoracoscopic image was reconstructed using the CT images of the chest using volume rendering software before surgery. During thoracoscopic surgery, a pleural marker was affixed to the parietal pleura, just above the tumor, by referring to the virtual thoracoscopic image. The pleural marker dye was then transferred to the point on the visceral pleura just above the nodule. The distance between the center of the marking and the visceral pleura closest to the tumor was measured to evaluate the accuracy of the marking. Results: The mean distance between the center of the marking and the visceral pleura closest to the tumor was 10.2 mm. In 42 cases (92%), the tumor was within 30 mm of the marked point. All tumors were fully resected. No morbidity occurred intra-or postoperatively. Conclusions: Our pleural marking, using a virtual thoracoscopic image, identified the tumor location with high accuracy, may help surgeon to confirm whether the palpated nodule is the target one. This new procedure can assist in the localization of the pulmonary nodule with ease of application, safety, and accuracy.

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“…Studies have reported signs of chronic inflammation, such as adhesions, fascia thickening, vascular changes, and scar tissue formation that cause compression neuropathy in PNB [156]. Such inflammation can also be caused by accidental injection of ultrasound gel [157][158][159] or alcohol-based disinfectant (used for surface disinfection) around the nerve during PNB. Neuropathy caused due to inflammation following surgery is called postsurgical inflammatory neuropathy (PSIN).…”

Section: Inflammatory Mechanismmentioning

confidence: 99%

“Knowing It Before Blocking It,” the ABCD of the Peripheral Nerves: Part B (Nerve Injury Types, Mechanisms, and Pathogenesis)

Sonawane¹,

Dixit²,

Thota³

et al. 2023

Cureus

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Selander emphatically said, “ Handle these nerves with care ,” and those words still echo, conveying a loud and clear message that, however rare, peripheral nerve injury (PNI) remains a perturbing possibility that cannot be ignored. The unprecedented nerve injuries associated with peripheral nerve blocks (PNBs) can be most tormenting for the unfortunate patient and a nightmare for the anesthetist. Possible justifications for the seemingly infrequent occurrences of PNB-related PNIs include a lack of documentation/reporting, improper aftercare, or associated legal implications. Although they make up only a small portion of medicolegal claims, they are sometimes difficult to defend. The most common allegations are attributed to insufficient informed consent; preventable damage to a nerve(s); delay in diagnosis, referral, or treatment; misdiagnosis, and inappropriate treatment and follow-up care. Also, sufficient prospective studies or randomized trials have not been conducted, as exploring such nerve injuries (PNB-related) in living patients or volunteers may be impractical or unethical. Understanding the pathophysiology of various types of nerve injury is vital to dealing with them further. Processes like degeneration, regeneration, remyelination, and reinnervation can influence the findings of electrophysiological studies. Events occurring in such a process and their impact during the assessment determine the prognosis and the need for further interventions. This educational review describes various types of PNB-related nerve injuries and their associated pathophysiology.

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Absence of neurotoxicity with perineural injection of ultrasound gels: assessment using an animal model

Cited by 16 publications

References 14 publications

Ultrasonography-guided transplantation facilitates perineural delivery of stem cells

Ultrasonography-guided transplantation facilitates perineural delivery of stem cells

Virtual thoracoscopic imaging-assisted pleural marking of pulmonary nodules

“Knowing It Before Blocking It,” the ABCD of the Peripheral Nerves: Part B (Nerve Injury Types, Mechanisms, and Pathogenesis)

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