PMID- 25812024
OWN - NLM
STAT- MEDLINE
DCOM- 20160617
LR  - 20181113
IS  - 1360-046X (Electronic)
IS  - 0268-8697 (Print)
IS  - 0268-8697 (Linking)
VI  - 29
IP  - 4
DP  - 2015
TI  - Acute and subacute effects of the ultrasonic blade and electrosurgery on nerve 
      physiology.
PG  - 569-73
LID - 10.3109/02688697.2015.1023772 [doi]
AB  - Ultrasonic blades have been shown to cause less acute electrophysiological damage 
      when applied near nerves than monopolar electrosurgery (ES). This study was 
      performed to determine whether the acute nerve damage observed for ES, as well as 
      the relative lack of damage observed for ultrasonic dissection, extends through a 
      subacute timeframe. Muscle incisions were made in rat with the Harmonic((R)) Blade 
      (HB) and ES at a distance of 2 mm from the sciatic nerve. Sham surgery was also 
      performed which consisted of similar exposure of the sciatic nerve without use of 
      an energized device. Electrophysiological function was assessed acutely over a 
      3-h period, and subacutely after a 7-day survival, by monitoring the sciatic 
      nerve compound action potential (CAP), conduction velocity (CV), von Frey hair 
      (VFH) stimulation force, leukocyte infiltration, and impaired axonal transport 
      via beta-amyloid precursor protein (beta-APP) immunocytochemistry. During the acute 
      period, ES produced significantly lower CAP and CV, and higher levels of 
      leukocytes and beta-APP than sham, whereas the ultrasonic blade was not 
      significantly different from sham, and had significantly lower VFH force than ES. 
      After the subacute survival, ES continued to display significantly lower CAP and 
      CV, and higher levels of leukocytes and beta-APP than sham, whereas ultrasonic blade 
      had higher CAP and CV than sham, and lower VFH than ES. This study confirms that 
      incisions made with an ultrasonic blade cause less acute nerve damage than 
      monopolar ES, and are comparable to sham surgery at a distance of 2 mm from the 
      sciatic nerve. The negative effects of electrosurgery extend through at least a 
      7-day survival period, whereas subacute recovery after application of the 
      ultrasonic blade was comparable to that of sham surgery. For surgical procedures 
      in the vicinity of vital nerves, use of the ultrasonic blade represents a lower 
      risk than ES for both acute and subacute neural trauma.
FAU - Chen, Chaoyang
AU  - Chen C
AD  - a Department of Biomedical Engineering , Wayne State University , Detroit MI , 
      USA.
FAU - Kallakuri, Srinivasu
AU  - Kallakuri S
FAU - Cavanaugh, John M
AU  - Cavanaugh JM
FAU - Broughton, Duan
AU  - Broughton D
FAU - Clymer, Jeffrey W
AU  - Clymer JW
LA  - eng
PT  - Journal Article
DEP - 20150326
PL  - England
TA  - Br J Neurosurg
JT  - British journal of neurosurgery
JID - 8800054
SB  - IM
MH  - Animals
MH  - Electrosurgery/*adverse effects
MH  - Male
MH  - Models, Animal
MH  - Neurosurgical Procedures/*adverse effects/*instrumentation
MH  - Rats
MH  - Rats, Sprague-Dawley
MH  - *Sciatic Nerve/injuries/physiology/surgery
MH  - Surgical Instruments/*adverse effects
MH  - *Ultrasonic Waves
PMC - PMC4673549
OTO - NOTNLM
OT  - electrosurgery
OT  - harmonic
OT  - nerve injury
OT  - ultrasonic surgical devices
EDAT- 2015/03/27 06:00
MHDA- 2016/06/18 06:00
PMCR- 2015/12/09
CRDT- 2015/03/27 06:00
PHST- 2015/03/27 06:00 [entrez]
PHST- 2015/03/27 06:00 [pubmed]
PHST- 2016/06/18 06:00 [medline]
PHST- 2015/12/09 00:00 [pmc-release]
AID - 1023772 [pii]
AID - 10.3109/02688697.2015.1023772 [doi]
PST - ppublish
SO  - Br J Neurosurg. 2015;29(4):569-73. doi: 10.3109/02688697.2015.1023772. Epub 2015 
      Mar 26.