title: Effects of early and late diabetic neuropathy on sciatic nerve block duration and neurotoxicity in Zucker diabetic fatty rats.
abstract: BACKGROUND
  The neuropathy of type II diabetes mellitus (DM) is increasing in prevalence worldwide. We aimed to test the hypothesis that in a rodent model of type II DM, neuropathy would lead to increased neurotoxicity and block duration after lidocaine-induced sciatic nerve block when compared with control animals.
  
  
  METHODS
  Experiments were carried out in Zucker diabetic fatty rats aged 10 weeks (early diabetic) or 18 weeks (late diabetic, with or without insulin 3 units per day), and age-matched healthy controls. Left sciatic nerve block was performed using 0.2 ml lidocaine 2%. Nerve conduction velocity (NCV) and F-wave latency were used to quantify nerve function before, and 1 week after nerve block, after which sciatic nerves were used for neurohistopathology.
  
  
  RESULTS
  Early diabetic animals did not show increased signs of nerve dysfunction after nerve block. In late diabetic animals without insulin vs control animals, NCV was 34.8 (5.0) vs 41.1 (4.1) ms s(-1) (P<0.01), and F-wave latency was 7.7 (0.5) vs 7.0 (0.2) ms (P<0.01), respectively. Motor nerve block duration was prolonged in late diabetic animals, but neurotoxicity was not. Late diabetic animals receiving insulin showed intermediate results.
  
  
  CONCLUSIONS
  In a rodent type II DM model, nerves have increased sensitivity for short-acting local anaesthetics without adjuvants in vivo, as evidenced by prolonged block duration. This sensitivity appears to increase with the progression of neuropathy. Our results do not support the hypothesis that neuropathy due to type II DM increases the risk of nerve injury after nerve block.
authors.affiliation: Department of Anaesthesiology and Laboratory of Experimental Anaesthesiology and Intensive Care (LEICA), University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: P
authors.initials: P
authors.lastname: Lirk
authors.affiliation: Department of Neurology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: C
authors.initials: C
authors.lastname: Verhamme
authors.affiliation: Department of Anesthesiology, University of Heidelberg, Heidelberg, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Boeckh
authors.affiliation: Department of Anaesthesiology and Laboratory of Experimental Anaesthesiology and Intensive Care (LEICA), University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: M F
authors.initials: MF
authors.lastname: Stevens
authors.affiliation: Department of Anaesthesiology and Laboratory of Experimental Anaesthesiology and Intensive Care (LEICA), University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: W
authors.initials: W
authors.lastname: ten Hoope
authors.affiliation: Department of Anesthesiology, Perioperative and Critical Care Medicine, Paracelsus Medical University, Salzburg, Austria.
authors.forename: P
authors.initials: P
authors.lastname: Gerner
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Triemli Hospital, Zurich, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: Blumenthal
authors.affiliation: Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: U
authors.initials: U
authors.lastname: de Girolami
authors.affiliation: Department of Neurology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: I N
authors.initials: IN
authors.lastname: van Schaik
authors.affiliation: Department of Anaesthesiology and Laboratory of Experimental Anaesthesiology and Intensive Care (LEICA), University of Amsterdam, Amsterdam, The Netherlands m.w.hollmann@amc.uva.nl.
authors.forename: M W
authors.initials: MW
authors.lastname: Hollmann
authors.affiliation: Department of Anaesthesiology and Laboratory of Experimental Anaesthesiology and Intensive Care (LEICA), University of Amsterdam, Amsterdam, The Netherlands Department of Anesthesiology, University of Heidelberg, Heidelberg, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Picardi
mesh_terms: D000375:Aging / Q000502:physiology; D000818:Animals; D001786:Blood Glucose / Q000378:metabolism; D001835:Body Weight / Q000187:drug effects; D003929:Diabetic Neuropathies / Q000150:complications*; D055724:Electrophysiological Phenomena / Q000187:drug effects; D009407:Nerve Block / Q000379:methods*; D020258:Neurotoxicity Syndromes / Q000473:pathology / Q000503:physiopathology*; D051381:Rats; D011924:Rats, Zucker; D012584:Sciatic Nerve / Q000473:pathology
chemical_list: D001786:Blood Glucose
keywords: local anaesthetics; nerve block; neuropathy, diabetic; neurotoxicity