Cicala R S, Turner R, Moran E, Henley R, Wong R, Evans J
Department of Anesthesiology, University of Tennessee, Memphis 38163.
Anesthesiology. 1990 Mar;72(3):556-8. doi: 10.1097/00000542-199003000-00026.
Few studies have examined the possible adverse effects that epidural injection of depot corticosteroid preparations may have on meningeal membranes and nervous tissue. Thirty-six healthy adult white rabbits received 0.3 ml/kg epidural injections of either lactated Ringer's solution (negative control group), 1% lidocaine containing methylprednisolone acetate (study group), or normal saline containing talc (positive control group). Animals were killed either 4 or 10 days after injection and stained sections of the spinal cord and meningeal membranes were examined by light microscopy. In all animals that received either lactated Ringer's solution or lidocaine with methylprednisolone acetate, microscopic examination of specimens taken from the L5-L6 interspace revealed no white cell infiltrates and no fibroblastic activity. All animals that received epidural injections of normal saline containing talc had marked infiltration of tissue macrophages in the epidural space. There was no thickening of the meningeal membranes or nerve roots in any animal. The complete lack of inflammatory changes and meningeal thickening demonstrated in this pilot study helps to confirm the safety of methylprednisolone acetate when injected into the epidural space.
很少有研究探讨硬膜外注射长效皮质类固醇制剂可能对脑膜和神经组织产生的不良影响。36只健康成年白兔接受了0.3毫升/千克的硬膜外注射，注射的分别是乳酸林格氏液（阴性对照组）、含醋酸甲基泼尼松龙的1%利多卡因（研究组）或含滑石粉的生理盐水（阳性对照组）。在注射后4天或10天处死动物，通过光学显微镜检查脊髓和脑膜的染色切片。在所有接受乳酸林格氏液或含醋酸甲基泼尼松龙的利多卡因注射的动物中，对取自L5-L6间隙的标本进行显微镜检查，未发现白细胞浸润和成纤维细胞活性。所有接受含滑石粉生理盐水硬膜外注射的动物，硬膜外间隙均有明显的组织巨噬细胞浸润。所有动物的脑膜和神经根均未增厚。这项初步研究中完全没有炎症变化和脑膜增厚现象，这有助于证实醋酸甲基泼尼松龙注入硬膜外间隙时的安全性。
