Neuroprotection due to irrigation during bipolar cautery

被引:36
作者
Donzelli, J
Leonetti, JP
Wurster, RD
Lee, JM
Young, MRI
机构
[1] Edward Hines Vet Adm Hosp, Res Serv 151 Z2, Hines, IL 60141 USA
[2] Loyola Univ, Stritch Sch Med, Dept Otolaryngol, Maywood, IL 60153 USA
[3] Loyola Univ, Stritch Sch Med, Dept Physiol, Maywood, IL 60153 USA
[4] Loyola Univ, Stritch Sch Med, Dept Pathol, Maywood, IL 60153 USA
关键词
D O I
10.1001/archotol.126.2.149
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Objective: To test whether irrigation during bipolar cautery confers thermoprotection from neuronal injury. Design: A rat animal model (15 rats for each treatment group) was used to test the thermoprotective effects of irrigation during bipolar cautery. In this model, the sciatic nerve was exposed, and a 1-second stimulus was applied using bipolar cautery forceps at 40 or 20 W placed directly on the nerve in the presence or absence of simultaneous irrigation. The effects of cautery were determined on the basis of clinical gait analysis by means of the Sciatic Functional Index, temperature response, and neuropathological findings. Results: The degree of paresis was reduced with irrigation. Neuropathological examination of the sciatic nerve after cautery showed significant axonal loss (more small than large fibers) with concomitant demyelination, which was partially inhibited by irrigation (chi(2); P = .04). The mechanism of thermoprotection by irrigation was not the result of a reduction in the temperature spike that followed cautery, but resulted from a reduced temperature response during the 15 seconds that followed 40- or 20-W stimulation with bipolar cautery. Conclusions: Simultaneous irrigation and bipolar cautery enhance temperature recovery to basal levels and protect the peripheral nerve from the effects of cautery.
引用
收藏
页码:149 / 153
页数:5
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