title: Structural injury to the human sciatic nerve after intraneural needle insertion.
abstract: BACKGROUND
  Recent clinical reports suggest that intraneural needle placement may not always lead to neurologic injury. To explain the absence of neurologic complications in these reports, we studied the risk and extent of nerve injury after intentional needle-nerve placement in a cryopreserved human sciatic nerve.
  
  
  METHODS
  The sciatic nerve was dissected from a cryopreserved cadaver through partial exposure. Needles were inserted through the nerve, using blunt-tip (30 degrees beveled) (group A) and sharp-tip (15 degrees beveled) (group D) needles. Five needle insertions were made for each needle type. Subsequently, transverse nerve sections at 10 needle trajectories were processed. Nerve samples were stained with hematoxylin-eosin, Masson trichromic, and immunohistochemical stains. In each section, the following variables were quantified: total number of fascicles and vessels in the immediate vicinity of the needle trajectories and the number of injured fascicles and vessels.
  
  
  RESULTS
  A total of 520 fascicles were quantified, of which 134 were in contact with the needle trajectories. The numbers of fascicles and vessels per section were 65 +/- 8 and 14 +/- 7, respectively. A mean of 16 +/- 5 fascicles were found in contact with the needle trajectory (group A: 17+/- 3, group D: 15 +/- 6). Of these, 4 fascicles (3.2%) and 1 intraneural vessel were found damaged in group D. No fascicular or vascular injuries were found in group A.
  
  
  CONCLUSIONS
  Our findings suggest that intraneural needle insertion may more commonly result in interfascicular rather than intrafascicular needle placement.
authors: Departments of Anesthesiology, Hospital Clínic of Barcelona, Spain.
authors: Xavier
authors: X
authors: Sala-Blanch
authors: Teresa
authors: T
authors: Ribalta
authors: Eva
authors: E
authors: Rivas
authors: Ana
authors: A
authors: Carrera
authors: Albert
authors: A
authors: Gaspa
authors: Miguel A
authors: MA
authors: Reina
authors: Admir
authors: A
authors: Hadzic
mesh_terms: D000368:Aged; D002102:Cadaver; D015925:Cryopreservation; D004867:Equipment Design; D006801:Humans; D007267:Injections / Q000009:adverse effects / Q000295:instrumentation; D009339:Needles; D016602:Needlestick Injuries / Q000473:pathology*; D012584:Sciatic Nerve / Q000293:injuries* / Q000473:pathology*