Error: undefined is not a constructor (evaluating 't.fotoGenislikim.includes("%")') https://service-cms.istanbulc.edu.tr/api/webclient/js?site=725BC10E5823449D9E6838B65D568312:1:1083 invoke@https://cjm.istanbulc.edu.tr/js/vendor-a003fac506.min.js:20619:24 $controllerInit@https://cjm.istanbulc.edu.tr/js/vendor-a003fac506.min.js:26021:40 nodeLinkFn@https://cjm.istanbulc.edu.tr/js/vendor-a003fac506.min.js:24959:44 compositeLinkFn@https://cjm.istanbulc.edu.tr/js/vendor-a003fac506.min.js:24327:23 publicLinkFn@https://cjm.istanbulc.edu.tr/js/vendor-a003fac506.min.js:24207:45 https://cjm.istanbulc.edu.tr/js/disabled-app-b74bf00075.min.js:1:30039 processQueue@https://cjm.istanbulc.edu.tr/js/vendor-a003fac506.min.js:31751:30 https://cjm.istanbulc.edu.tr/js/vendor-a003fac506.min.js:31767:39 $eval@https://cjm.istanbulc.edu.tr/js/vendor-a003fac506.min.js:33019:28 $digest@https://cjm.istanbulc.edu.tr/js/vendor-a003fac506.min.js:32835:36 $apply@https://cjm.istanbulc.edu.tr/js/vendor-a003fac506.min.js:33127:31 done@https://cjm.istanbulc.edu.tr/js/vendor-a003fac506.min.js:27448:53 completeRequest@https://cjm.istanbulc.edu.tr/js/vendor-a003fac506.min.js:27646:15 requestLoaded@https://cjm.istanbulc.edu.tr/js/vendor-a003fac506.min.js:27587:24 undefined https://cjm.istanbulc.edu.tr/js/vendor-a003fac506.min.js:29418 İstanbul Üniversitesi - Cerrahpaşa| Cerrahpaşa Tıp Dergisi

Yıl : 2019 Cilt : 43 Sayı : 2

Tam Metin (PDF)

Levobupivakain’in Perinöral Sürekli Infüzyonunun Infant ve Erişkin Ratlarda Periferik Sinir ve Kas Dokusuna Etkilerinin Işık ve Elektron Mikroskopisi ile Değerlendirilmesi

Open Access

Öz

Amaç: Periferik sinir ve kas hasarı, sürekli periferik sinir bloğu tekniğinin risklerinden birisidir. Bu çalışmada levobupivakainin histopatolojik etkilerini infant ve erişkin ratlarda değerlendirmeyi amaçladık. Yöntemler: Bu çalışmada ketamine anestezisi altında 10 infant ve 10 erişkin olmak üzere 20 adet rat ile çalışıldı. Ratların sağ siyatik bölgelerine levobupivakain, sol siyatik sinir bölgelerine ise 0,9% sodium klorid bolus doz sonrası üç saat süreyle infüzyon ile uygulandı. Birinci gün ve birinci hafta her gruptan üçer ratın, dördüncü haftada her gruptan dörder ratın siyatik sinirleri ve kas dokuları çıkarıldı. Periferik sinir ve kas dokusu ışık ve elektron mikroskobunda incelendi. Bulgular: Işık mikroskopisi değerlendirmesi sonucunda, sinir dokusunda çeşitli düzeylerde akson dejenerasyonu, sinirde mast hücresi ve epinöral hücre infiltrasyonu saptandı, gruplararası hasar benzerdi. Kas dokusunda miyonekroz ve iltihabi hücre infiltrasyonu levobupivakain grubunda daha belirgindi. Kas dokusunda dördüncü haftada infant ratlarda oluşan granülasyon dokusu erişkinden daha fazlaydı. Elektron mikroskobunda, miyelin dejenerasyon, miyofibril ve mitokondride ödem ve kristalarda silinme saptandı. İnfant ratların kas dokularında apopitoz gözlendi. Sonuç: Levobupivakain ve 0,9% sodium chloride solüsyonunun, infant ve erişkin ratlarda nörotoksik etkileri benzerdir. Levobupivakainin neden olduğu miyonekroz daha geç iyileşmekte ve infant ratlarda kaslarda kalıcı hasara neden olmaktadır. Cite this article as: Tunalı G, Tunalı Y, Kaya Gök A, Korkmaz Dilmen Ö, Akçıl EF, Kaya G. Light and Electron Microscopic Evaluation of Continuous Perineural Levobupivacaine Infusion Effects on Peripheral Nerve and Muscle Tissues in Infant and Adult Rats. Cerrahpasa Med J 2019; 43(2): 50-57.

Anahtar Kelimeler

Periferik-sinir-bloğu   levobupivakain   nörotoksisite   miyotoksisite   ışık-mikroskopisi   elektron-mikroskopisi  

Sorumlu Yazar

Eren Fatma Akçıl

Kaynakça

  • 1. Tucker GT, Mather LE. Properties, absorption and disposition of local anesthetics. In: Neural Blockade, 3rd edn. eds. Philadelphia: Lippincott: Cousins M.J. & Bridenbaugh, 1998: 55-95.
  • 2. Markham A, Faulds, D. Ropivacaine. A review of its pharmacology and therapeutic use in regional anaesthesia. Drugs; 1996; 52: 429-49.
  • 3. Zink W, Bernhard MG. Local anesthetic myotoxicity. Reg Anesth Pain Med 2004; 29: 333-40.
  • 4. Kitagawa N, Oda M, Totoki T. Possible mechanism of irreversible nerve injury caused by local anesthetics detergent properties of local anesthetics and membrane disruption. Anesthesiology 2004; 100: 962-67.
  • 5. Bouaziz H, Iohom G, Este’be JP, Campana WM, Myers RR. Effects of levobupivacaine and ropivacaine on rat sciatic nerve blood flow. Br J Anaesth 2005; 95: 696-700.
  • 6. Selander D, Brattsand R, Lundborg G, Nordborg C, Olsson Y. Local anesthetics: Importance of mode of application, concentration and adrenaline for the appe
Daha Fazla Göster

Detaylar

DOI 10.5152/cjm.2019.19004

Tam Metin (PDF)

Light and Electron Microscopic Evaluation of Continuous Perineural Levobupivacaine Infusion Effects on Peripheral Nerve and Muscle Tissues in Infant and Adult Rats

Open Access

Öz

Objective: Peripheral nerve and muscle damage is one of the risks of continuous peripheral nerve blockade. The aim of this study was to evaluate the tissue histopathological effects of levobupivacaine in infant and adult rats. Methods: This study was performed in 10 infant and 10 adult rats under ketamine anesthesia. A first bolus dose of levobupivacaine followed by 3 h of infusion was applied to the right sciatic nerve area and 0.9% sodium chloride solution was administered to the left sciatic nerve area to both groups. Removal of the sciatic nerve and the muscle tissues was done on the first hour and first week in three rats, respectively, while in the fourth week in the four other rats in both groups. The nerve and muscle tissues were analyzed by light and electron microscopy separately. Results: Light microscopy revealed in all periods various degrees of axonal degeneration and mast cell and epineural cell infiltration in the nerve tissues. Damage was the same between groups. The myonecrosis and inflammatory cell infiltration on muscle tissue were more profound in the levobupivacaine group. More granulation tissue was produced on the fourth week in infant than adult rats. Electron microscopy showed myelin degeneration, edema of myofibrils and mitochondrions, and effacement of cristae in mitochondria. Apoptosis was observed in the muscle tissue of infant rats. Conclusion: There were no differences between the neurotoxic effects of 0.9% sodium chloride and levobupivacaine infusions on either infant or adult rats. In adult rats, myotoxicity caused by levobupivacaine was later healed compared to that by 0.9% sodium chloride infusion and in infant rats, muscle damage was permanent with levobupivacaine. Cite this article as: Tunalı G, Tunalı Y, Kaya Gök A, Korkmaz Dilmen Ö, Akçıl EF, Kaya G. Light and Electron Microscopic Evaluation of Continuous Perineural Levobupivacaine Infusion Effects on Peripheral Nerve and Muscle Tissues in Infant and Adult Rats. Cerrahpasa Med J 2019; 43(2): 50-57.

Anahtar Kelimeler

Peripheral-nerve-block   levobupivacaine   neurotoxicity   myotoxicity   light-microscopy   electron-microscopy  

Sorumlu Yazar

Eren Fatma Akçıl

Kaynakça

  • 1. Tucker GT, Mather LE. Properties, absorption and disposition of local anesthetics. In: Neural Blockade, 3rd edn. eds. Philadelphia: Lippincott: Cousins M.J. & Bridenbaugh, 1998: 55-95.
  • 2. Markham A, Faulds, D. Ropivacaine. A review of its pharmacology and therapeutic use in regional anaesthesia. Drugs; 1996; 52: 429-49.
  • 3. Zink W, Bernhard MG. Local anesthetic myotoxicity. Reg Anesth Pain Med 2004; 29: 333-40.
  • 4. Kitagawa N, Oda M, Totoki T. Possible mechanism of irreversible nerve injury caused by local anesthetics detergent properties of local anesthetics and membrane disruption. Anesthesiology 2004; 100: 962-67.
  • 5. Bouaziz H, Iohom G, Este’be JP, Campana WM, Myers RR. Effects of levobupivacaine and ropivacaine on rat sciatic nerve blood flow. Br J Anaesth 2005; 95: 696-700.
  • 6. Selander D, Brattsand R, Lundborg G, Nordborg C, Olsson Y. Local anesthetics: Importance of mode of application, concentration and adrenaline for the appe
Daha Fazla Göster

Detaylar

DOI 10.5152/cjm.2019.19004

Tam Metin (PDF)