Influence of general anesthesia and surgical procedure on functional recovery following rat sciatic nerve transection and repair
DOI:
https://doi.org/10.25305/unj.354660Keywords:
peripheral neuropathy, neurorrhaphy, peripheral nerve regeneration, isoflurane, ketamine, sciatic nerve, Hargreaves test, von Frey tes, Sciatic Functional IndexAbstract
Objective. To evaluate the effects of the type of general anesthesia and surgical procedure on sensory and motor functional recovery following sciatic nerve transection with immediate neurorrhaphy in rats.
Materials and methods. The study was conducted in male Wistar rats using an experimental model of complete sciatic nerve transection followed by immediate end-to-end suture repair employing either two or four interrupted epineurial sutures. General anesthesia was induced using either inhaled isoflurane or an intraperitoneal ketamine/xylazine mixture. During the postoperative period (up to 24 weeks), thermal and mechanical sensitivity were assessed, along with motor function recovery evaluated by the Sciatic Functional Index (SFI).
Results. The type of general anesthesia significantly affected the pattern and dynamics of sensory and motor functional recovery after neurorrhaphy. Animals operated under ketamine/xylazine anesthesia demonstrated more stable and complete recovery of both sensory and motor functions, as evidenced by the absence of persistent mechanical and thermal hypoalgesia and by significant improvement in SFI values, even when the minimum number of epineurial sutures was used. In contrast, the use of inhalational isoflurane anesthesia was associated with more prolonged postoperative sensory deficits, which were largely dependent on the surgical procedure. Under isoflurane anesthesia, the application of four epineurial sutures provided more favorable conditions for sensory recovery, particularly mechanical sensitivity, compared with neurorrhaphy performed using two sutures.
Conclusions. The type of general anesthesia and the characteristics of the suture repair technique are important determinants of sciatic nerve regeneration and functional recovery following transection. Ketamine/xylazine anesthesia is associated with more favorable conditions for sensorimotor recovery. The use of inhalational isoflurane anesthesia during neurorrhaphy, particularly when a minimal number of sutures is employed, should be approached with caution, as it may adversely affect the stability and functional outcomes of sciatic nerve recovery.
References
1. Aman M, Zimmermann KS, Thielen M, Thomas B, Daeschler S, Boecker AH, Stolle A, Bigdeli AK, Kneser U, Harhaus L. An Epidemiological and Etiological Analysis of 5026 Peripheral Nerve Lesions from a European Level I Trauma Center. J Pers Med. 2022 Oct 8;12(10):1673. [CrossRef] [PubMed] [PubMed Central]
2. Murphy RNA, de Schoulepnikoff C, Chen JHC, Columb MO, Bedford J, Wong JK, Reid AJ. The incidence and management of peripheral nerve injury in England (2005-2020). J Plast Reconstr Aesthet Surg. 2023 May;80:75-85. [CrossRef] [PubMed]
3. Randall ZD, Navarro BJ, Brogan DM, Dy CJ. Insights Into the Epidemiology of Peripheral Nerve Injuries in the United States: Systematic Review. Hand (N Y). 2026 Feb;21(2):194-201. [CrossRef] [PubMed] [PubMed Central]
4. Shaprynskyi Y V, Lypkan VM. Treatment of patients with gunshot traumatic amputations of the lower limbs due to explosive injury in the conditions of today’s war in Ukraine. Reports Vinnytsia Natl Med Univ 2023;27:581–5. [CrossRef]
5. Shi S, Tang J, Lu Y, Xu S, Wang M, Wan S. A burden of nerve injury from a global perspective, 1990-2021: an analysis of incidence, prevalence, and years lived with disability. Front Neurol. 2026 Jan 6;16:1669662. [CrossRef] [PubMed] [PubMed Central]
6. Shvets A V, Horishna O V, Deputat YM, Rychka O V, Zhaldak AY, Kikh AY. Prognostic assessment of the need for medical rehabilitation among military officers of the armed forces of ukraine based on the structure of their combat trauma. Ukr Z Vijskovoi Med 2022;3:110–7. [CrossRef]
7. Vela FJ, Martínez-Chacón G, Ballestín A, Campos JL, Sánchez-Margallo FM, Abellán E. Animal models used to study direct peripheral nerve repair: a systematic review. Neural Regen Res. 2020 Mar;15(3):491-502. [CrossRef] [PubMed] [PubMed Central]
8. Zaidman M, Novak CB, Midha R, Dengler J. Epidemiology of peripheral nerve and brachial plexus injuries in a trauma population. Can J Surg. 2024 Jun 26;67(3):E261-E268. [CrossRef] [PubMed] [PubMed Central]
9. Howard IM, Sedarsky K, Gallagher M, Miller M, Puffer RC. Combat-related peripheral nerve injuries. Muscle Nerve. 2025 May;71(5):768-781. [CrossRef] [PubMed]
10. Hems TE. Nerve injury: Classification, clinical assessment, investigation, and management. Living Textb Hand Surg 2016. [CrossRef]
11. Hostiuc S, Ciobanu OM, Popa E, Căținaș R, Ionescu-Mihăiță AM, Sima A, Negoi I, Costescu M. Clinical Anatomy and Diagnostic Challenges in Peripheral Nerve Trauma for the Forensic Physician. Diagnostics (Basel). 2025 Jun 24;15(13):1597. [CrossRef] [PubMed] [PubMed Central]
12. Khan H, Perera N. Peripheral nerve injury: an update. Orthop Trauma. 2020;(34):168–73. [CrossRef]
13. Bergmeister KD, Große-Hartlage L, Daeschler SC, Rhodius P, Böcker A, Beyersdorff M, Kern AO, Kneser U, Harhaus L. Acute and long-term costs of 268 peripheral nerve injuries in the upper extremity. PLoS One. 2020 Apr 6;15(4):e0229530. [CrossRef] [PubMed] [PubMed Central]
14. Bateman EA, Pripotnev S, Larocerie-Salgado J, Ross DC, Miller TA. Assessment, management, and rehabilitation of traumatic peripheral nerve injuries for non-surgeons. Muscle Nerve. 2025 May;71(5):696-714. [CrossRef] [PubMed] [PubMed Central]
15. Lin JS, Jain SA. Challenges in Nerve Repair and Reconstruction. Hand Clin. 2023 Aug;39(3):403-415. [CrossRef] [PubMed]
16. Li A, Pereira C, Hill EE, Vukcevich O, Wang A. In Vitro, In Vivo and Ex Vivo Models for Peripheral Nerve Injury and Regeneration. Curr Neuropharmacol. 2022;20(2):344-361. [CrossRef] [PubMed] [PubMed Central]
17. Melikov ZK, Medvediev V V. The rat’s sciatic nerve functional index dynamics after its transection and recovery by means of epineural neurorrhaphy. Ukr Neurosurg J 2024;30:30–42. [CrossRef]
18. Oh SS, Narver HL. Mouse and Rat Anesthesia and Analgesia. Curr Protoc. 2024 Feb;4(2):e995. [CrossRef] [PubMed] [PubMed Central]
19. Lee WP, Constantinescu MA, Butler PE. Effect of early mobilization on healing of nerve repair: histologic observations in a canine model. Plast Reconstr Surg. 1999 Nov;104(6):1718-25. [CrossRef] [PubMed]
20. Griffin MF, Malahias M, Hindocha S, Khan WS. Peripheral nerve injury: principles for repair and regeneration. Open Orthop J. 2014 Jun 27;8:199-203. [CrossRef] [PubMed] [PubMed Central]
21. Molotkovets VY, Medvediev V V, Korsak A V, Chaikovsky YB, Marynsky GS, Tsymbaliuk VI. Restoration of the Integrity of a Transected Peripheral Nerve with the Use of an Electric Welding Technology. Neurophysiology 2020;52:31–42. [CrossRef]
22. Noldus Information Technology BV. The complete gait analysis system CatWalk. Noldus; 2026. https://noldus.com/catwalk-xt
23. Bomikhov O. Gait2SFI scripts for automated SFI calculation from rodent walking videos (sciatic nerve injury model). GitHub, Inc.; 2026. https://github.com/olbmv/Gait2SFI
24. Varejão AS, Meek MF, Ferreira AJ, Patrício JA, Cabrita AM. Functional evaluation of peripheral nerve regeneration in the rat: walking track analysis. J Neurosci Methods. 2001 Jul 15;108(1):1-9. [CrossRef] [PubMed]
25. Krotov V, Agashkov K, Romanenko S, Koroid K, Krasniakova M, Belan P, Voitenko N. Neuropathic pain changes the output of rat lamina I spino-parabrachial neurons. BBA Adv. 2023 Feb 14;3:100081. [CrossRef] [PubMed] [PubMed Central]
26. Kopach O, Krotov V, Goncharenko J, Voitenko N. Inhibition of Spinal Ca(2+)-Permeable AMPA Receptors with Dicationic Compounds Alleviates Persistent Inflammatory Pain without Adverse Effects. Front Cell Neurosci. 2016 Feb 29;10:50. [CrossRef] [PubMed] [PubMed Central]
27. Chaplan SR, Bach FW, Pogrel JW, Chung JM, Yaksh TL. Quantitative assessment of tactile allodynia in the rat paw. J Neurosci Methods. 1994 Jul;53(1):55-63. [CrossRef] [PubMed]
28. Gonzalez-Izarzugaza J.M. Von-Frey - 1.0. DTU Health Tech; 2026. https://services.healthtech.dtu.dk/services/Von-Frey/
29. Schmider E, Ziegler M, Danay E, Beyer L, Bühner M. Is It Really Robust?: Reinvestigating the robustness of ANOVA against violations of the normal distribution assumption. Methodology 2010;6:147–51. [CrossRef]
30. Gatto G, Smith KM, Ross SE, Goulding M. Neuronal diversity in the somatosensory system: bridging the gap between cell type and function. Curr Opin Neurobiol. 2019 Jun;56:167-174. [CrossRef] [PubMed] [PubMed Central]
31. Melikov ZK, Medvediev VV. Peripheral nerve injury: molecular pathophysiology and prospects for restorative treatment by means of cell transplantation: a literature review. Ukr Neurosurg J. 2023;29(4):3–12. [CrossRef]
32. Meek MF, Den Dunnen WF, Schakenraad JM, Robinson PH. Long-term evaluation of functional nerve recovery after reconstruction with a thin-walled biodegradable poly (DL-lactide-epsilon-caprolactone) nerve guide, using walking track analysis and electrostimulation tests. Microsurgery. 1999;19(5):247-53. [CrossRef] [PubMed]
33. Ganguly A, McEwen C, Troy EL, Colburn RW, Caggiano AO, Schallert TJ, Parry TJ. Recovery of sensorimotor function following sciatic nerve injury across multiple rat strains. J Neurosci Methods. 2017 Jan 1;275:25-32. [CrossRef] [PubMed]
34. Meder T, Prest T, Skillen C, Marchal L, Yupanqui VT, Soletti L, Gardner P, Cheetham J, Brown BN. Nerve-specific extracellular matrix hydrogel promotes functional regeneration following nerve gap injury. NPJ Regen Med. 2021 Oct 25;6(1):69. [CrossRef] [PubMed] [PubMed Central]
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Oleksandr V. Bomikhov, Valentyn V. Yarynka, Taras I. Petriv, Ziia K. Melikov, Nana V. Voitenko, Volodymyr V. Medvediev, Pavel V. Belan
This work is licensed under a Creative Commons Attribution 4.0 International License.
Ukrainian Neurosurgical Journal abides by the CREATIVE COMMONS copyright rights and permissions for open access journals.
Authors, who are published in this Journal, agree to the following conditions:
1. The authors reserve the right to authorship of the work and pass the first publication right of this work to the Journal under the terms of Creative Commons Attribution License, which allows others to freely distribute the published research with the obligatory reference to the authors of the original work and the first publication of the work in this Journal.
2. The authors have the right to conclude separate supplement agreements that relate to non-exclusive work distribution in the form of which it has been published by the Journal (for example, to upload the work to the online storage of the Journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this Journal is included.
