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Dextran 40 (Rheomacrodex) or Polygeline (Haemaccel) as an epidural patch for post dural puncture headache: a neurotoxicity study in a rat model of Dextran 40 and Polygeline injected intrathecally

Published online by Cambridge University Press:  12 July 2006

M. Chanimov ,
S. Berman ,
M. L. Cohen ,
M. Friedland ,
J. Weissgarten ,
Z. Averbukh ,
M. Herbert ,
J. Sandbank ,
Z. Haitov  and
M. Bahar
M. Chanimov
Affiliation:
Department of Anesthesiology, Assaf Harofeh Medical Center, Zerifin, affiliated to Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
S. Berman
Affiliation:
Department of Nephrology, Assaf Harofeh Medical Center, Zerifin, affiliated to Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
M. L. Cohen
Affiliation:
Department of Anesthesiology, Assaf Harofeh Medical Center, Zerifin, affiliated to Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
M. Friedland
Affiliation:
Department of Anesthesiology, Assaf Harofeh Medical Center, Zerifin, affiliated to Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
J. Weissgarten
Affiliation:
Department of Nephrology, Assaf Harofeh Medical Center, Zerifin, affiliated to Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
Z. Averbukh
Affiliation:
Department of Nephrology, Assaf Harofeh Medical Center, Zerifin, affiliated to Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
M. Herbert
Affiliation:
Department of Pathology, Assaf Harofeh Medical Center, Zerifin, affiliated to Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
J. Sandbank
Affiliation:
Department of Pathology, Assaf Harofeh Medical Center, Zerifin, affiliated to Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
Z. Haitov
Affiliation:
Department of Anesthesiology, Assaf Harofeh Medical Center, Zerifin, affiliated to Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
M. Bahar
Affiliation:
Department of Anesthesiology, Assaf Harofeh Medical Center, Zerifin, affiliated to Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
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Abstract

Summary

Background and objective: Although an epidural autologous blood patch is considered the most effective treatment for post dural puncture headache, which sometimes occurs following spinal or inadvertent spinal anaesthesia, there remains a need for alternative materials for epidural patches. We investigated the potential neurotoxicity of Dextran 40 (Rheomacrodex) and Polygeline (Haemaccel) used for this purpose in a rat model. Methods: Repeated boluses of 10% Dextran 40, 3.5% Polygeline or 0.9% saline were injected intrathecally over a period of 1 month in three groups of rats. Results: No behavioural or clinical derangements were observed in any of the three groups during this period. After sacrifice of the animals at the end of the experiment, no significant differences in the histopathological appearances of the spinal cords in the three groups were observed. No toxic effects diminishing viability of spinal cord cells were evident. Similarly, viability of renal, hepatic and peripheral blood mononuclear cells remained unaffected (98% ± 2%). Conclusions: No deleterious effects, clinical or cellular, were evident in this rat model when Dextran 40 or Polygeline were injected intrathecally. Thus, both substances can be considered as possible alternative materials for epidural patches.

Keywords

POST DURAL PUNCTURE HEADACHEANAESTHESIA EPIDURAL, complications, dural tapBLOOD PATCH, EPIDURAL, dextran, polygelineNEUROTOXICITY SYNDROMESRAT
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 23 , Issue 9 , September 2006 , pp. 776 - 780
Copyright
2006 European Society of Anaesthesiology

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