Wang P-H, Tsai C-L, Lee J-S, Wu K-C, Cheng K-I, Jou I-M
Department of Orthopedics, Chi-Mei Medical Center, Tainan, Taiwan.
J Hand Surg Eur Vol. 2011 Mar;36(3):236-43. doi: 10.1177/1753193410390760. Epub 2011 Jan 31.
Despite known detrimental effects on the blood flow and histology of nerves after intraneural corticosteroid injection, the neurotoxic effect of corticosteroids remains unclear. We investigated the effect of topical dexamethasone on nerve function. Two sponge strips soaked with dexamethasone at doses of 0.8, 1.6, and 3.2 mg were placed under and over the left sciatic nerve of adult Wistar rats for 30 minutes. Mixed-nerve-elicited somatosensory evoked potentials and dermatomal somatosensory evoked potentials were evaluated immediately and repeated together with functional tests and histology 2 weeks later. Evoked potential amplitude was dose-dependently lower and latency was prolonged in dexamethasone-treated sciatic nerves compared to controls. The suppression persisted with incomplete recovery for at least 4 hours, but differences between treated and control nerves were not significant after 2 weeks. Topical dexamethasone adversely affected neural conduction in a dose-dependent manner. Our results suggest that caution is required when using large doses of corticosteroid for injection of the carpal tunnel.
尽管已知神经内注射皮质类固醇后对神经血流和组织学有有害影响，但皮质类固醇的神经毒性作用仍不清楚。我们研究了局部应用地塞米松对神经功能的影响。将两条浸泡有0.8、1.6和3.2毫克地塞米松的海绵条分别置于成年Wistar大鼠左侧坐骨神经的下方和上方30分钟。立即评估混合神经诱发的体感诱发电位和皮节体感诱发电位，并在2周后与功能测试和组织学检查一起重复评估。与对照组相比，地塞米松处理的坐骨神经诱发电位幅度呈剂量依赖性降低，潜伏期延长。这种抑制持续至少4小时且恢复不完全，但2周后处理组和对照组神经之间的差异不显著。局部应用地塞米松以剂量依赖性方式对神经传导产生不利影响。我们的结果表明，在使用大剂量皮质类固醇注射腕管时需要谨慎。
