P Lirk1, C Verhamme2, R Boeckh3, M F Stevens1, W ten Hoope1, P Gerner4, S Blumenthal5, U de Girolami6, I N van Schaik2, M W Hollmann7, S Picardi8. 1. Department of Anaesthesiology and Laboratory of Experimental Anaesthesiology and Intensive Care (LEICA), University of Amsterdam, Amsterdam, The Netherlands. 2. Department of Neurology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. 3. Department of Anesthesiology, University of Heidelberg, Heidelberg, Germany. 4. Department of Anesthesiology, Perioperative and Critical Care Medicine, Paracelsus Medical University, Salzburg, Austria. 5. Department of Anaesthesiology and Intensive Care Medicine, Triemli Hospital, Zurich, Switzerland. 6. Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. 7. Department of Anaesthesiology and Laboratory of Experimental Anaesthesiology and Intensive Care (LEICA), University of Amsterdam, Amsterdam, The Netherlands m.w.hollmann@amc.uva.nl. 8. Department of Anaesthesiology and Laboratory of Experimental Anaesthesiology and Intensive Care (LEICA), University of Amsterdam, Amsterdam, The Netherlands Department of Anesthesiology, University of Heidelberg, Heidelberg, Germany.
Abstract
BACKGROUND: The neuropathy of type II diabetes mellitus (DM) is increasing in prevalence worldwide. We aimed to test the hypothesis that in a rodent model of type II DM, neuropathy would lead to increased neurotoxicity and block duration after lidocaine-induced sciatic nerve block when compared with control animals. METHODS: Experiments were carried out in Zucker diabetic fatty rats aged 10 weeks (early diabetic) or 18 weeks (late diabetic, with or without insulin 3 units per day), and age-matched healthy controls. Left sciatic nerve block was performed using 0.2 ml lidocaine 2%. Nerve conduction velocity (NCV) and F-wave latency were used to quantify nerve function before, and 1 week after nerve block, after which sciatic nerves were used for neurohistopathology. RESULTS: Early diabetic animals did not show increased signs of nerve dysfunction after nerve block. In late diabetic animals without insulin vs control animals, NCV was 34.8 (5.0) vs 41.1 (4.1) ms s(-1) (P<0.01), and F-wave latency was 7.7 (0.5) vs 7.0 (0.2) ms (P<0.01), respectively. Motor nerve block duration was prolonged in late diabetic animals, but neurotoxicity was not. Late diabetic animals receiving insulin showed intermediate results. CONCLUSIONS: In a rodent type II DM model, nerves have increased sensitivity for short-acting local anaesthetics without adjuvants in vivo, as evidenced by prolonged block duration. This sensitivity appears to increase with the progression of neuropathy. Our results do not support the hypothesis that neuropathy due to type II DM increases the risk of nerve injury after nerve block.
BACKGROUND: The neuropathy of type II diabetes mellitus (DM) is increasing in prevalence worldwide. We aimed to test the hypothesis that in a rodent model of type II DM, neuropathy would lead to increased neurotoxicity and block duration after lidocaine-induced sciatic nerve block when compared with control animals. METHODS: Experiments were carried out in Zucker diabetic fatty rats aged 10 weeks (early diabetic) or 18 weeks (late diabetic, with or without insulin 3 units per day), and age-matched healthy controls. Left sciatic nerve block was performed using 0.2 ml lidocaine 2%. Nerve conduction velocity (NCV) and F-wave latency were used to quantify nerve function before, and 1 week after nerve block, after which sciatic nerves were used for neurohistopathology. RESULTS: Early diabetic animals did not show increased signs of nerve dysfunction after nerve block. In late diabetic animals without insulin vs control animals, NCV was 34.8 (5.0) vs 41.1 (4.1) ms s(-1) (P<0.01), and F-wave latency was 7.7 (0.5) vs 7.0 (0.2) ms (P<0.01), respectively. Motor nerve block duration was prolonged in late diabetic animals, but neurotoxicity was not. Late diabetic animals receiving insulin showed intermediate results. CONCLUSIONS: In a rodent type II DM model, nerves have increased sensitivity for short-acting local anaesthetics without adjuvants in vivo, as evidenced by prolonged block duration. This sensitivity appears to increase with the progression of neuropathy. Our results do not support the hypothesis that neuropathy due to type II DM increases the risk of nerve injury after nerve block.
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