Histopathological Alterations after Single Epidural Injection of Ropivacaine, Methylprednizolone Acetate, or Contrast Material in Swine

Journal Article · Thu Dec 15 00:00:00 EST 2011 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-011-0159-1· OSTI ID:21608658

Kitsou, Maria-Chrysanthi; Kostopanagiotou, Georgia; Kalimeris, Konstantinos ^[1]; Vlachodimitropoulos, Demetrios ^[2]; Soultanis, Konstantinos ^[3]; Batistaki, Chrysanthi ^[1]; Kelekis, Alexis ^[4]

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1. University of Athens, 2nd Department of Anesthesiology-Pain Unit, School of Medicine, Attikon University Hospital (Greece)
2. University of Athens, Department of Forensic Medicine, School of Medicine (Greece)
3. University of Athens, 1st Department of Orthopaedics, School of Medicine, Attikon University Hospital (Greece)
4. University of Athens, 2nd Radiology Department, Attikon University Hospital (Greece)

Purpose: The consequences from the injection of different types of drugs in the epidural space remains unknown. Increasing evidence suggests that localized inflammation, fibrosis, and arachnoiditis can complicate sequential epidural blockades, or even epidural contrast injection. We investigate the in vivo effect of epidural injections in the epidural space in an animal model. Materials and Methods: A group of ten male adult pigs, five punctures to each at distinct vertebral interspaces under general anesthesia, were examined, testing different drugs, used regularly in the epidural space (iopamidol, methylprednisolone acetate, ropivacaine). Each site was marked with a percutaneous hook wire marker. Histological analysis of the epidural space, the meninges, and the underlying spinal cord of the punctured sites along with staining for caspase-3 followed 20 days later. Results: The epidural space did not manifest adhesions or any other pathology, and the outer surface of the dura was not impaired in any specimen. The group that had the contrast media injection showed a higher inflammation response compared to the other groups (P = 0.001). Positive staining for caspase-3 was limited to <5% of neurons with all substances used. Conclusion: No proof of arachnoiditis and/or fibrosis was noted in the epidural space with the use of the above-described drugs. A higher inflammation rate was noted with the use of contrast media.

• OSTI ID: 21608658
• Journal Information: Cardiovascular and Interventional Radiology, Vol. 34, Issue 6; Other Information: DOI: 10.1007/s00270-011-0159-1; Copyright (c) 2011 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Country of input: International Atomic Energy Agency (IAEA); ISSN 0174-1551
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ADULTS
ANESTHESIA
DRUGS
FIBROSIS
IN VIVO
INFLAMMATION
INJECTION
IOPAMIDOL
MALES
MATERIALS
NERVE CELLS
PATHOLOGY
SPINAL CORD
SWINE
AGE GROUPS
ANIMAL CELLS
ANIMALS
CENTRAL NERVOUS SYSTEM
CONTRAST MEDIA
DOMESTIC ANIMALS
INTAKE
MAMMALS
NERVOUS SYSTEM
PATHOLOGICAL CHANGES
SOMATIC CELLS
SYMPTOMS
VERTEBRATES