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Sodalaymlı ve sodalaymsız tekrarlanan sevofluran anestezisinin yetişkin rat karaciğer ve böbreği üzerine etkileri

The renal and hepatic effects of repeated sevoflurane anaesthesia with or without sodalime

Journal Name:

  • Selçuk Tıp Dergisi

Publication Year:

  • 2003

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Abstract (2. Language): 
Experimental studies showed that recurrent exposure to sevofıurane can be toxic. İt may be either related with direct effects of this anaesthetb agent or with the degradation of sevoflurane by soda lime which is also known to produce toxic products. The aim of this study was to investigate the effect of repeated sevoflurane anaesthesia on kidney and liver in rats with or without soda lime. After local ethlcal comitte aproval thirty adult VVistar rats were divided into three groups. The tats were placed İn a specially prepared transparant plastic box. Group C was the controt group. Theyreceived 100 % 02. İn the anaesthesia circie without soda-lime sevoflurane in 2.5 -2.7 % concentration with 02 (100 %) were administered directly in group S, while the same gas mixture was applied through the soda lime in group SS. Repeated anesthesia (five fimes) was applied to the rats for sixty nainutes mth two days intervais. Biodd ürea nitrogene, creatinin, SGOT, SGPT and ALP levels were assessed from the blood sample. Following sacrifice, kidneys and livers were obtained from the rats for examinatıön using light microscopy for histopathological evaluatbn and mean damage scores (MDS) of the specimens were calculated. SGPT values were higher in group S and SS when compared with group C (p<0.05). There were only minimal changes in histopathological evaluation of liver which was not statistbally signifıcant. The changes İn BUN and creatinin levels were not signiücant among the groups. The MDS's in renal tissues were significantly higher in group S and SS when compared with group C, vvhile there werenodif-ferences behveen group S and SS. İt was concluded that repeated exposure to sevoflurane has minimal effects in liver accord-ing to mean damage score and in the presence of soda lime, sevoflurane anaesthesia with 100 % oxygene did not signifi¬cantly increased histopathological damage to liver. The toxic effects of sevoflurane on renal tissue were greater in ratsespe-cially when sevoflurane was administered through the sodalime
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Abstract (Original Language): 
Deneysel çalışmalar sevofluranın tekrarlanan uygulamalarının toksik olabileceğini belirtmektedir. Bu anestezik ajanın direk etkisinden olabileceği gibi, sevofluranın sodalaym tarafından parçalanması sonucu oluşan toksik ürün¬lere bağlı da gelişebilir. Bu çalışmanın amacı, erişkin raflarda sodalaymlı ve sodalaymsız devrelerde tekrarlanan sevofluran anestezisinin, karaciğer ve böbrek üzerine etkilerini araştırmaktır. Lokal hayvan etik kurul kararı alındıktan sonra 30 adet erişkin VVistar rat 3 gruba ayrıldı. Raflar özel olarak yaptırılmış transparan plastik kutuya alındılar. Kontrol grubu olan Grup K'ya %100 02 verildi Sodalaymsız anestezi devresinde sevofluran uygulanan gruba Grup S % 100 ö2 içinde % 2.5- 2.7 konsantrasyonda sevofluran uygulanırken, aynı gaz karışımı sodalaymlı anestezi devresinde Grup SS'e uygulandı. Ratlara, gün aşırı toplam 5 kez olmak üzere 60 dakika sevofluran anestezisi uygulandı. Kan örneklerinden Üre, kreatinin, SGOT, SGPT ve alkalen fosfataz değerleri elde edildi. 10. günde raflar sakrifiye edildikten sonra, karaciğer ve böbrek doku örnekleri ışık mikroskobisi ile histopatolojik olarak değerlendirildi ve preparatların ortalama hasar skorları (OHS) hesaplandı. Grup S ve Grup SS'de SGPT değerleri grup C'ye göre yüksek bulundu (p<0.05). Karaciğer histopatolojisinde ise istatistiksel olarak anlamlı olmayan mi¬nimal değişiklikler mevcuttu. BUN ve kreatinin düzeylerindeki değişiklikler açısından gruplar arasında istatistiksel olarak fark yoktu. Grup S ve grup SS'in böbrek OHS'ları, grup C den yüksekken (p<0.05), grup S ve grup SS arasında fark yoktu. Tekrarlanan sevofluran anestezisinin OHS'na göre karaciğer üzerine minimal etkisi olduğu, %100 02 ile sodalaymlı devrede uygulanan sevofluranın histopatolojik olarak karaciğer hasarını artırmadığı gözlendi. Sodalaymın ek karaciğer hasarına sebep olmadığı kanaatine varıldı. Tekrarlanan sevofluran anestezisinin, erişkin rat böbrek dokularına toksik etkisi olduğu ve bu toksisiteyi sodalaymın artırdığı saptandı.
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