title: Neurotoxicity of intrathecal 6% hydroxyethyl starch 130/0.4 injection in a rat model.
abstract: Epidural blood patch is the gold standard treatment for post-dural puncture headache, although hydroxyethyl starch may be a useful alternative to blood if the latter is contraindicated. The aim of this experimental study was to assess whether hydroxyethyl starch given via an indwelling intrathecal catheter resulted in clinical or histopathological changes suggestive of neurotoxicity. The study was conducted in rats that were randomly allocated to receive three 10-μl injections on consecutive days of either saline or hydroxyethyl starch administered via the intrathecal catheter. Eight rats were given injections of saline 0.9% and 11 were given 6% hydroxyethyl starch 130/0.4 derived from thin boiling waxy corn starch in 0.9% sodium chloride (Voluven). Daily clinical evaluation, activity measured by actimetry and neuropathological analysis of the spinal cord were subsequently performed to assess for signs of neurotoxicity. No clinical or actimetric changes were observed in either group following intrathecal saline or hydroxyethyl starch administration. Histopathological examination showed non-specific changes with no differences between the two groups. This experimental study in the rat suggests that repeated intrathecal injection of hydroxyethyl starch is not associated with neurotoxicity.
authors.affiliation: Department of Paediatric Anaesthesia, Hôpital Femme Mère Enfant, Centre Hospitalier Universitaire Lyon, Lyon, France.
authors.forename: O
authors.initials: O
authors.lastname: Vassal
authors.affiliation: Aniphy, Claude Bernard University, University of Lyon, Lyon, France.
authors.forename: P
authors.initials: P
authors.lastname: Del Carmine
authors.affiliation: Department of Neurosurgery, Hôpital Pierre Wertheimer, Centre Hospitalier Universitaire Lyon, Lyon, France.
authors.forename: P-A
authors.initials: PA
authors.lastname: Beuriat
authors.affiliation: Department of Paediatric Anaesthesia, Hôpital Femme Mère Enfant, Centre Hospitalier Universitaire Lyon, Lyon, France.
authors.forename: F-P
authors.initials: FP
authors.lastname: Desgranges
authors.affiliation: Department of Histology, ANIPath, Laennec University, University of Lyon, Lyon, France.
authors.forename: N
authors.initials: N
authors.lastname: Gadot
authors.affiliation: Department of Paediatric Anaesthesia, Hôpital Femme Mère Enfant, Centre Hospitalier Universitaire Lyon, Lyon, France.
authors.forename: B
authors.initials: B
authors.lastname: Allaouchiche
authors.affiliation: Aniphy, Claude Bernard University, University of Lyon, Lyon, France.
authors.forename: Q
authors.initials: Q
authors.lastname: Timour-Chah
authors.affiliation: Department of Anaesthesia, University College Hospital NHS Foundation Trust, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Stewart
authors.affiliation: Department of Paediatric Anaesthesia, Hôpital Femme Mère Enfant, Centre Hospitalier Universitaire Lyon, Lyon, France.
authors.forename: D
authors.initials: D
authors.lastname: Chassard
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D006895:Hydroxyethyl Starch Derivatives / Q000633:toxicity*; D007278:Injections, Spinal; D008297:Male; D020258:Neurotoxicity Syndromes / Q000209:etiology*; D010952:Plasma Substitutes / Q000633:toxicity*; D051381:Rats; D017207:Rats, Sprague-Dawley; D012965:Sodium Chloride / Q000008:administration & dosage
chemical_list: C485123:HES 130-0.4; D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes; D012965:Sodium Chloride