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Neuroanesthesia
Anesthesia and Pain Medicine 2014;9(4):268-273.
Published online October 31, 2014.
Peripheral nerve injury caused by needle impalement: Synchrotron small-angle X-ray scattering study in ex-vivo rat sciatic nerve
Bong Il Kim, Seok Young Song, Taeha Ryu, Young Hwan Choi, Jin Yong Jung, Tae Joo Shin
1Department of Anesthesiology and Pain Medicine, School of Medicine, Catholic University of Daegu, Daegu, Korea.
2Pohang Accelator Laboratory, Pohang, Korea. stj@postech.ac.kr
Received: 17 March 2014   • Revised: 22 April 2014   • Accepted: 22 May 2014
Abstract
BACKGROUND
Direct puncture by a needle is a risk factor for nerve damage. This study was designed to demonstrate nerve damage caused by a needle using the synchrotron small-angle X-ray scattering (SAXS) technique.
METHODS
A 15 mm section of rat (Male Spargue-Dawley, about 250 grams) sciatic nerves were involved in this study. The nerve specimen for the experiment (N = 5) was punctured 5 times by a needle (25 G, 100 beveled) under general anesthesia with enflurane. The needle was placed perpendicular to the nerve and the needle bevel was placed parallel to the nerve. The SAXS patterns of the punctured nerves, extracted about 15 min prior to the experiment, were acquired after 1 week. The SAXS patterns of a normal sciatic nerve (N = 5), extracted about 15 min prior to the experiment, were measured in order to provide a comparison. Experiments were carried out at 4C1 beamline at Pohang Accelerator Laboratory in Korea. Incoming X-rays were monochromatized at 11 keV using a double multilayer (WB4C) monochromator; the beam size was around 0.5 (V) x 0.8 (H) mm2. The exposure time was 60 sec, and 8 to 12 images were acquired per sample with a 0.5 mm interval.
RESULTS
In the punctured group, the periodic peaks of myelin sheath and collagen fiber were not changed. However, the periodic peaks of interfibrillar distance of collagen were greatly changed.
CONCLUSIONS
Direct needle-nerve impalement did not cause damages in myelin sheath and collagen fibers when the needle was placed perpendicular and the needle bevel paralleled to the nerve fiber. This result can imply that the needle slipped into the interfibrillar packing of collagen fibrils.
Key Words: Needle, Scattering, Sciatic nerve, Small angle
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