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ORIGINAL RESEARCH Table of Contents   
Year : 2019  |  Volume : 30  |  Issue : 5  |  Page : 692-696
Late hyaluronidase injection in local anesthesia: Morphofunctional evaluation in rat sciatic nerve block


1 Biophotonics Program, School of Dentistry, University Nove De Julho, São Paulo, Brazil
2 Department of Morphological Sciences, Federal University of Rio Grande Do Sul, Institute of Health Science, Porto Alegre, Brazil
3 Department of Clinical and Toxicological Analysis, Faculty of Pharmaceutics Sciences, University of São Paulo, Cidade Universitária, São Paulo, Brazil
4 Department of Stomatology, School of Dentistry, University of São Paulo, Cidade Universitária, São Paulo, Brazil
5 Department of Cell and Developmental Biology, University of São Paulo, Institute of Biomedical Sciences, Cidade Universitária, São Paulo, Brazil

Correspondence Address:
Dr. Maria Aparecida Borsatti
Av. Prof. Lineu Prestes 2227, Cidade Universitaria, Sao Paulo
Brazil
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijdr.IJDR_745_16

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Introduction: Despite the enhancing effects of hyaluronidase (HYAL) over duration of anesthesia, this enzyme could cause adverse effects when injected concomitantly with local anesthetics in dental blocks. Objective: This study aimed to assess the tissue alterations caused by a local anesthetic protocol consisting of a late HYAL injection and confirm its functional effectiveness. Materials and Methods: The protocol efficacy was proved by evaluating sensory and motor functions in rats. The sciatic nerve was blocked with 2% lidocaine (LID) with epinephrine (n = 25). Thirty minutes later, 75 TRU/ml HYAL was injected into the same site (experimental group, LID/HYAL). One week later, this protocol was repeated in the contralateral hindlimb, injecting only HYAL's vehicle (control group, LID/vehicle [LID/V]). To observe the integrity of the local tissues, histological specimens were obtained 1, 24, 48, and 72 h after treatment with LID/HYAL or LID/V (n = 16 each) and stained with hematoxylin/eosin and picrosirius red. Results: Local inflammation was similar in both groups. The integrity of the nerve fibers was preserved, in spite of some inflammation-associated injuries in the surrounding tissues. The reversible tissue disorganization caused by HYAL, probably facilitated the diffusion of the residual anesthetic to the nerve, resulting in a prolonged anesthetic effect (P < 0.05). Conclusions: No irreversible morphological alterations are caused by the administration of HYAL prior the end of the LID-induced block. Moreover, this protocol prolongs LID's anesthetic effect.


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