Peripheral nerve injection injury with antiemetic agents

Jessica E. Strasberg, Arthur Atchabahian, Suzanne R. Strasberg, Osamu Watanabe, Daniel A. Hunter, Susan E. Mackinnon

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Antiemetics are widely used drugs, frequently administered to alleviate postoperative and postchemotherapeutic nausea and vomiting. While antiemetics do not induce peripheral neurotoxicity when administered systemically, it is not known whether peripheral nerve injury can occur as a result of inadvertent intraneural injection during intramuscular administration. The purpose of this study was to characterize the neurotoxic effect of three commonly used antiemetic agents (promethazine, dimenhydrinate, and prochlorperazine) as compared to saline in the rat sciatic nerve model. Intrafascicular and extrafascicular injection as well as direct application of the antiemetic drugs were performed. Nerves were harvested at 2 weeks postoperatively for histology and morphometry, with an additional sacrifice point at 8 weeks for the intrafascicular injection group. Injection injuries caused by antiemetic drugs differed depending on the agent injected and the location of injection. Extrafascicular injection and direct application caused no damage. Intrafascicular injection caused diffuse axonal injury in the promethazine and dimenhydrinate groups, while prochlorperazine caused only focal injury. Regeneration was prominent at 8 weeks in all intrafascicular injection groups in this rat model. Prochlorperazine thus appears to be less neurotoxic when injected intraneurally and should preferentially be used for intramuscular injections.

Original languageEnglish
Pages (from-to)99-107
Number of pages9
JournalJournal of neurotrauma
Volume16
Issue number1
DOIs
StatePublished - Jan 1999
Externally publishedYes

Keywords

  • Antiemetic agents
  • Dimenhydrinate
  • Injection injury
  • Lewis rats
  • Prochlorperazine
  • Promethazine
  • Sciatic nerve

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  • Cite this

    Strasberg, J. E., Atchabahian, A., Strasberg, S. R., Watanabe, O., Hunter, D. A., & Mackinnon, S. E. (1999). Peripheral nerve injection injury with antiemetic agents. Journal of neurotrauma, 16(1), 99-107. https://doi.org/10.1089/neu.1999.16.99