BJA Advance Access originally published online on September 23, 2005
British Journal of Anaesthesia 2005 95(5):696-700; doi:10.1093/bja/aei242
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Effects of levobupivacaine and ropivacaine on rat sciatic nerve blood flow
1 Department of Anaesthesia and Intensive Care Medicine, Nancy University Hospitals, Nancy, France. 2 Departments of Anesthesiology and Pathology, VA Medical Center, San Diego, and University of California, San Diego, CA, USA
* Corresponding author: Service d'anesthésie-réanimation chirurgicale, Hôpitaux de ville, CHU de Nancy, 29 Avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy cedex, France. E-mail: h.bouaziz{at}chu-nancy.fr
Background. Ischaemia is one of the causative mechanisms of peripheral nerve injury, a documented complication of regional anaesthesia. Local anaesthetics per se and/or vasopressor adjuvants may account for changes in peripheral nerve blood flow. The aim of this study was to test the effects of levobupivacaine and ropivacaine in a rat sciatic nerve model with respect to local blood flow and histopathological changes.
Methods. Forty-eight female SpragueDawley rats were anaesthetized for left sciatic nerve exposure. After baseline nerve blood flow measurement with a laser Doppler flowmeter, 0.2 ml of one of the following solutions was applied topically to the nerve in a random fashion: saline 0.9%; lidocaine 10 mg ml1; levobupivacaine 2.5 mg ml1; levobupivacaine 5 mg ml1; levobupivacaine 7.5 mg ml1; ropivacaine 2 mg ml1; ropivacaine 7.5 mg ml1; and ropivacaine 7.5 mg ml1 plus epinephrine 5 µg ml1; all in saline 0.9%. Nerve blood flow was evaluated at 5-min intervals up to 30 min after local application of anaesthetic solution. Three animals per group were killed for histological evaluation 48 h later. Multiple one-way analyses of variance followed by Scheffé's post hoc test was used for statistical analysis. P<0.05 was considered significant.
Results. Local anaesthetics at all concentrations tested caused significant reduction in nerve blood flow. The combination of ropivacaine 7.5 mg ml1 plus epinephrine did not reduce nerve blood flow to a greater extent than ropivacaine 7.5 mg ml1 alone. Low concentrations of levobupivacaine (2.5 and 5 mg ml1) reduced nerve blood flow to the same extent as lidocaine 10 mg ml1. No significant histological changes were observed at 48 h.
Conclusion. Despite acute reductions in peripheral nerve blood flow, significant histopathological changes were not observed in this rat sciatic nerve model after topical application of levobupivacaine and ropivacaine at concentrations relevant to clinical practice.
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