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.
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.
Chanimov
M
M
Department of Anesthesiology, Assaf Harofeh Medical Center, Zerifin, affiliated to Sackler Faculty of Medicine, Tel-Aviv University, Israel.
Berman
S
S
Cohen
M L
ML
Friedland
M
M
Weissgarten
J
J
Averbukh
Z
Z
Herbert
M
M
Sandbank
J
J
Haitov
Z
Z
Bahar
M
M
D000818:Animals; D017217:Blood Patch, Epidural; D002470:Cell Survival; D003911:Dextrans / Q000494:pharmacology*; D007278:Injections, Spinal; D008297:Male; D020258:Neurotoxicity Syndromes / Q000196:embryology; D010952:Plasma Substitutes / Q000494:pharmacology*; D011097:Polygeline / Q000494:pharmacology*; D051299:Post-Dural Puncture Headache / Q000188:drug therapy*; D051381:Rats; D017208:Rats, Wistar; D013116:Spinal Cord / Q000473:pathology
D003911:Dextrans; D010952:Plasma Substitutes; D011097:Polygeline