{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:42:45Z","timestamp":1787013765430,"version":"build-2736575974"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,10,25]],"date-time":"2016-10-25T00:00:00Z","timestamp":1477353600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Institutional resources"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background &amp; Objectives<\/jats:title>\n                    <jats:p>Most anesthesiologists use the injection of a test dose of local anesthetic in order to evaluate the final needle tip position. Thus, the intraneural injection of a full dose can be avoided. The aim of this study was to analyze whether an intraneural injection of a test dose of bupivacaine could trigger histological changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Intraneural injections under direct vision were performed in 40 brachial plexus nerves in seven anesthetized pigs. Tibial nerves served as positive and negative controls. Two milliliter of bupivacaine 0.5% was injected in three nerves on the left brachial plexus. For control of local anesthetic's toxicity Ringer's solution was applied intraneurally on the right side. After maintaining 48 h of general anesthesia, the nerves were resected. The specimens were processed for histological examination and assessed for inflammation (hematoxylin and eosin stain,\n                      <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>\n                      68\u2010immunohistochemistry) and myelin damage (Kluver\u2013Barrera stain). The degree of nerve injury was rated on a scale from 0 (no injury) to 4 (severe injury).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Statistical analysis showed no significant differences between the bupivacaine group [median (interquartile range) 1 (1\u20131.5)] and the Ringer's solution group [1 (0.5\u20132)\n                      <jats:italic>P<\/jats:italic>\n                      = 0.772]. Mild myelin alteration was found in 12.5% of all specimens following intraneural injection, irrespective of the applied substance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\"In our experimental study, intraneural injection of 2 ml of bupivacaine or Ringer's solution showed comparable mild inflammation. Nevertheless, inflammation can only be prevented by strictly avoiding nerve perforation followed by intraneural injection, as mechanical nerve perforation is a key factor for evolving inflammation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aas.12825","type":"journal-article","created":{"date-parts":[[2016,10,25]],"date-time":"2016-10-25T04:26:52Z","timestamp":1477369612000},"page":"91-98","source":"Crossref","is-referenced-by-count":14,"title":["Intraneural injection of a test dose of local anesthetic in peripheral nerves \u2013 does it induce histological changes in nerve tissue?"],"prefix":"10.1111","volume":"61","author":[{"given":"T.","family":"Wiesmann","sequence":"first","affiliation":[{"name":"Department of Anesthesia and Intensive Care University Hospital Marburg Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Steinfeldt","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care University Hospital Marburg Marburg Germany"},{"name":"Department of Anesthesia and Intensive Care Medicine Diakonie\u2010Klinikum Schwaebisch Hall Schwaebisch Hall Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Exner","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care University Hospital Marburg Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.","family":"Nimphius","sequence":"additional","affiliation":[{"name":"Department of Pathology University Hospital Marburg Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"De Andres","sequence":"additional","affiliation":[{"name":"Anesthesia Division Department of Surgery Valencia School of Medicine Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Wulf","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care University Hospital Marburg Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U.","family":"Schwemmer","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology &amp; Critical Care Klinikum Neumarkt Neumarkt i.d.OPf. Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,10,25]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000124"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0b013e31819a7225"},{"key":"e_1_2_8_4_1","volume-title":"Hadzic's peripheral nerve blocks and anatomy for ultrasound\u2010guided regional anesthesia","author":"Hadzic A","year":"2011"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aep366"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1155\/2011\/591851"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/71.2.323-a"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00115550-200809000-00006"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0b013e31819624eb"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0b013e318228c835"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3940(01)02143-7"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(99)00102-5"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200610000-00024"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1213\/ane.0b013e3181aa2d73"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/AIA.0b013e31821bbb47"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e318202cb9c"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000170"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3181de574e"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e31821b2227"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2010.02279.x"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.1977.tb01208.x"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/aas.12680"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.1978.tb01346.x"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/00115550-200409000-00005"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0b013e3181d25cfe"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2006.01169.x"}],"container-title":["Acta Anaesthesiologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Faas.12825","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Faas.12825","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aas.12825","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T12:30:19Z","timestamp":1695558619000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aas.12825"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,10,25]]},"references-count":25,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2017,1]]}},"alternative-id":["10.1111\/aas.12825"],"URL":"https:\/\/doi.org\/10.1111\/aas.12825","archive":["Portico"],"relation":{},"ISSN":["0001-5172","1399-6576"],"issn-type":[{"value":"0001-5172","type":"print"},{"value":"1399-6576","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,10,25]]}}}