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KMID : 0438219760130010129
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Korea University Medical Journal
1976 Volume.13 No. 1 p.129 ~ p.139
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Experimental Injection Injury of the Sciatic Nerve
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Abstract
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This experimental study was conducted in order to observe the change and degree of the functional disability of the sciatic nerve following infection of various drugs such as Rheumapyrine, Chloromycetin, Penicillin and physiological normal saline solution. In clinical practice a serious sciatic nerve injury may result from an erroneous injection of commonly used antibiotics and other therapeutic or prophylactic agents into the gluteal region, which can occur at any age, especially common in infants, children and small debilitated patients.
Thirty-six normal adult-rabbits were divided into four groups depending on injected materials and also divided into two groups of simple exposure and closure of the nerve and of simple puncture of the exposed nerve with injection needle. The drugs were injected into the right sciatic nerve intraneurally and around the left sciatic nerve perineurally.
For the functional study in the nerve, needle electrode was inserted into the calf muscle which was pick-up muscle, and nerve potential was recorded on electromyography(EMG) and motor nerve conduction velocity(M. N. C. V.) was also measured in the calf muscle at intervals of 3,7, 10 and 14 days after the injection.
In normal control group, electrical activity on E M G was silent in resting state of muscle and was normal motor unit action potential (normal motor unit) in volition state by demonstrating biphasic or triphasic wave patterns. Distal latency averaged 1.1 msec and the amplitude of action potential was average 6.4 mV.
Two experimental groups of simple exposure and closure of the nerve and of simple puncture of
the exposed nerve with injection needle showed identical E M G findings with those in normal control group. In E M G findings of both normal saline and Chloromycetin injection groups, there were no significant differences in comparison with those in normal control group.
Abnormal EMG findings were observed in both Penicillin and Rheumapyrine groups, which showed fibrillation potential and positive sharp wage in resting state and decreased amplitude or reduced numbers of normal motor unit in volition state, along with delayed M. N. C. V. No abnormal EMG findings were observed in the left side where the drugs were injected around the sciatic nerve perineurally. Two of five cases with penicillin injection showed denervation potentials and delayed M. N. C. V. 10 days after the injection, while all cases with Rheumapyrine injection started to demonstrate the denervation patterns on E M G and delayed M. N. C. V. 3 days after the injection, and these abnormal findings were become more evident and severe to be partial or complete denervation as the time elapsed following the injection. It was postulated that functonal and physiolgical disabilities recorded on E M G were developed after the injection only when there was a severe degree or nerve damages on the basis of histopathological study.
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