TY - JOUR
TI - Histopathological alterations after single epidural injection of ropivacaine, methylprednizolone acetate, or contrast material in Swine
AU - Kitsou, M.-C.
AU - Kostopanagiotou, G.
AU - Kalimeris, K.
AU - Vlachodimitropoulos, D.
AU - Soultanis, K.
AU - Batistaki, C.
AU - Kelekis, A.
JO - CardioVascular and Interventional Radiology
PY - 2011
VL - 34
TODO - 6
SP - 1288-1295
PB - 
SN - 0174-1551, 1432-086X
TODO - 10.1007/s00270-011-0159-1
TODO - caspase 3;  contrast medium;  iopamidol;  iopamiro 300;  methylprednisolone acetate;  ropivacaine;  unclassified drug, animal experiment;  animal tissue;  apoptosis;  article;  controlled study;  epidural anesthesia;  epidural space;  histopathology;  in vivo study;  lymphocytic infiltration;  male;  meninx;  nonhuman;  parameningeal disorder;  priority journal;  protein expression;  spinal cord;  staining;  subarachnoid edema;  swine, Amides;  Animals;  Chi-Square Distribution;  Contrast Media;  Dura Mater;  Epidural Space;  Fluoroscopy;  Immunohistochemistry;  Injections, Epidural;  Iopamidol;  Male;  Methylprednisolone;  Swine
TODO - 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 abovedescribed drugs. A higher inflammation rate was noted with the use of contrast media. © Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2011.
ER -