Peripheral nerve injection injury: an experimental pilot study of treatment modalities

The accidental injection of various drugs into peripheral nerves has serious medical complications and medicolegal implications. The most neurotoxic substances of II agents tested in a previous study were penicillin G, diazepam, and chlorpromazine. The appropriate management of such an injury has not been well-established. In an attempt to define the proper treatment in accidental peripheral nerve injection, an experimental study was carried out, in which 70 sciatic nerves of rats were injected intrafascicularly with penicillin G and treated by neurolysis, neurolysis and Celestone irrigation (betamethasone, a synthetic glucocorticoid), and neurolysis and saline irrigation. The degree of damage was evaluated histologically after two weeks. Statistical analysis of the results showed that neurolysis performed at 24 hours after the injury lessened the damage to the peripheral nerve. No additional improvement was found when, in addition to neurolysis, the nerves were irrigated with Celestone or saline solutions.