title: The effects of ultrasonic and electrosurgery devices on nerve physiology.
abstract: BACKGROUND
  While the risks associated with the use of electrosurgery near nerves are well known, few studies have examined the neurophysiologic effects of application of the Harmonic Blade, an ultrasonic scalpel, in the vicinity of nerve fibres. This study sought to compare the sub-acute neurophysiologic effects of the Harmonic Blade and electrosurgery after incisions close to the sciatic nerve.
  
  
  METHODS
  Incisions were made in rats with the Harmonic Blade and electrosurgery at distances of 1, 2, 3 and 4 mm from the sciatic nerve. Sham surgery was also performed. The compound action potential, conduction velocity and calibrated nylon filament (von Frey hair, VFH) stimulating force were monitored for up to 3 hours after surgery. The sciatic nerve was assessed for inflammation via H&E staining and impaired axonal transport by β-APP immunohistochemistry.
  
  
  RESULTS
  Electrosurgery incisions produced a significantly greater decrease in compound action potential and conduction velocity, and increase in the VFH force than the Harmonic Blade over all time points and distances from the sciatic nerve. The Harmonic Blade was similar to sham surgery for the compound action potential and VFH force. Electrosurgery yielded significantly greater leukocyte infiltration than the Harmonic Blade and produced the highest levels of β-APP immunoreactive swellings.
  
  
  CONCLUSIONS
  Incisions with electrosurgery in the range of 1-4 mm of the sciatic nerve caused substantial changes in neurophysiologic functioning and inflammation. In contrast, the Harmonic Blade was similar to sham surgery in the vicinity of the nerve, producing little observable acute trauma.
authors: Spine Research Laboratory, Department of Biomedical Engineering, Wayne State University, Detroit, MI, USA.
authors: Chaoyang
authors: C
authors: Chen
authors: Srinivasu
authors: S
authors: Kallakuri
authors: Anuja
authors: A
authors: Vedpathak
authors: Chandrasekhar
authors: C
authors: Chimakurthy
authors: John M
authors: JM
authors: Cavanaugh
authors: Jeffrey W
authors: JW
authors: Clymer
authors: Prasanna
authors: P
authors: Malaviya
mesh_terms: D000818:Animals; D004598:Electrosurgery / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D008297:Male; D051381:Rats; D017207:Rats, Sprague-Dawley; D012584:Sciatic Nerve / Q000601:surgery*; D059708:Ultrasonic Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods