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. 2018 Sep;5(3):176-185.
doi: 10.14744/nci.2017.28190.

Sciatic nerve injury following analgesic drug injection in rats: A histopathological examination

Habib Bostan  1 , Murat Cabalar  1 , Serdar Altinay  2 , Yildiray Kalkan  3 , Levent Tumkaya  3 , Ayhan Kanat  4 , Sabri Balik  5 , Adem Erkut  5 , Dudu Altuner  6 , Ziya Salihoglu  1 , Abdulkadir Kocer  7
Affiliations

Sciatic nerve injury following analgesic drug injection in rats: A histopathological examination

Habib Bostan et al. North Clin Istanb. 2018 Sep.

Abstract

Objective: Sciatic nerve neuropathy can be observed following intramuscular gluteal injections. The histopathological examination of sciatic nerve damage following intramuscular injection in the gluteal region for acute pain treatment is not feasible in humans due to the inability to dissect and examine the nerve tissue. To overcome this issue, we used a rat model for demonstrating damage to the sciatic nerve tissue after the application of commonly used drug injections.

Methods: We investigated possible damage following the intramuscular injection of diclofenac, lornoxicam, morphine, and pethidine in a rat model based on histopathological characteristics such as myelin degeneration, axon degeneration, epineurium degeneration, fibrosis, epineurium thickening, perineurium thickening, lymphocyte infiltration, vacuolization, and edema.

Results: All the analgesic drugs used in our study induced histopathological changes in the sciatic nerve. Anti-S100 positivity, showing nerve damage, was found to be the lowest in the group treated with diclofenac. Neurotoxic effects of diclofenac on the sciatic nerve were greater than those of the other drugs used in the study. Lornoxicam induced the least histopathological changes in the nerve.

Conclusion: Diclofenac induced severe nerve damage not only after direct injection in the sciatic nerve but also after injection in the area around the nerve. Thus, we recommend restricting the use of intramuscular gluteal injections of diclofenac. Intramuscular use of morphine and pethidine should also be overviewed.

Keywords: Acute pain treatment; diclofenac; lornoxicam; morphine; pethidine; sciatic neuropathy.

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Conflict of interest statement

Conflict of Interest: The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A, B) Histopathological changes after injection in the muscle tissue adjacent to the sciatic nerve: epi, epineurium; e, edema; v, vacuolization; l, lymphocyte infiltration; star, normal axons; arrow head, degenerated axons; s, swollen Schwann cells; thick arrow, myelin degeneration; hematoxylin–eosin staining, ×40. (C, D) Histopathological changes after injection in the sciatic nerve: epi, epineurium; e, edema; v, vacuolization; l, lymphocyte infiltration; star, normal axons; arrow head, degenerated axons; s, swollen Schwann cells; thick arrow, myelin degeneration; hematoxylin–eosin staining, ×40. Control: star, normal axons; arrow head, mildly degenerated axons; s, normal Schwann cells; hematoxylin–eosin staining, ×40.
Figure 2
Figure 2
(A, B) Histopathological changes after injection in the muscle tissue adjacent to the sciatic nerve detected using anti-S100 immunohistochemical staining: arrow head, degenerated axons; s, swollen Schwann cells; short arrow, immunopositive cells; v, vacuolization; immunoperoxidase staining. (C, D) Histopathological changes after injection in the sciatic nerve detected using anti-S100 immunohistochemical staining: arrow head, degenerated axons; s, swollen Schwann cells; short arrow, immunopositive cells; v, vacuolization; epi, epineurium; e, edema; immunoperoxidase staining. Control: star, normal axons; short arrow, moderate immunopositive cells; s, intense immunopositive Schwann cells; immunoperoxidase.
See this image and copyright information in PMC

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