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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Does Spinal Block Through Tattooed Skin Cause Histological Changes in Nervous Tissue and Meninges? An Experimental Model in Rabbits

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Ferraz, Isabela Leite [1] ; Moreira de Barros, Guilherme Antonio [1] ; Ferreira Neto, Patricia Gomes [1] ; Solanki, Daneshivari [1] ; Marques, Mariangela Alencar [1] ; de Vasconcelos Machado, Vania Maria [1] ; Cabral, Lucas Wynne [1] ; Moreira e Lima, Rodrigo [1] ; Galvao Vianna, Pedro Thadeu [1] ; Camacho Navarro, Lais Helena [1] ; Ganen, Eliana Marisa [1]
Total Authors: 11
[1] Univ Sao Paulo State, Botucatu Med Sch, UNESP, BR-18618970 Botucatu, SP - Brazil
Total Affiliations: 1
Document type: Journal article
Source: REGIONAL ANESTHESIA AND PAIN MEDICINE; v. 40, n. 5, p. 533-538, SEP-OCT 2015.
Web of Science Citations: 6

Background and Objectives: Although there is no documented evidence that tattoo pigments can cause neurological complications, the implications of performing neuraxial anesthesia through tattooed skin are unknown. In this study, we aimed to assess whether spinal puncture performed through tattooed skin of rabbits determines changes over the spinal cord and meninges. In addition, we sought to evaluate the presence of ink fragments entrapped in spinal needles. Methods: Thirty-six young male adult rabbits, each weighing between 3400 and 3900 g and having a spine length between 38.5 and 39 cm, were divided by lot into 3 groups as follows: GI, spinal puncture through tattooed skin; GII, spinal puncture through tattooed skin and saline injection; and GIII, spinal puncture through skin free of tattoo and saline injection. After intravenous anesthesia with ketamine and xylazine, the subarachnoid space was punctured at S1-S2 under ultrasound guidance with a 22-gauge 21/2 Quincke needle. Animals in GII and GIII received 5 mu L/cm of spinal length (0.2 mL) of saline intrathecally. In GI, the needle tip was placed into the yellow ligament, and no solution was injected into the intrathecal space; after tattooed skin puncture, 1 mL of saline was injected through the needle over a histological slide to prepare a smear that was dyed by the Giemsa method to enable tissue identification if present. All animals remained in captivity for 21 days under medical observation and were killed by decapitation. The lumbosacral spinal cord portion was removed for histological analysis using hematoxylin-eosin stain. Results: None of the animals had impaired motor function or decreased nociception during the period of clinical observation. None of the animals from the control group (GIII) showed signs of injuries to meninges. In GII, however, 4 animals presented with signs of meningeal injury. The main histological changes observed were focal areas of perivascular lymphoplasmacyte infiltration in the pia mater and arachnoid. There was no signal of injury in neural tissue in any animal of both groups. Tissue coring containing ink pigments was noted in all GI smears from the spinal needles used to puncture the tattooed skin. Conclusions: On the basis of the present results, intrathecal injection of saline through a needle inserted through tattooed skin is capable of producing histological changes over the meninges of rabbits. Ink fragments were entrapped inside the spinal needles, despite the presence of a stylet. (AU)

FAPESP's process: 11/08906-3 - Dural puncture tattooing determine histological changes on the spinal nervous tissue and meninges?
Grantee:Eliana Marisa Ganem
Support Opportunities: Regular Research Grants