The clinical and histopathological effects of perineural dexmedetomidine and in combination with sodium bicarbonate in sciatic nerve block in rabbits after sevoflurane anesthesia: A placebo controlled, randomized experimental study

Yıl: 2019 Cilt: 26 Sayı: 2 Sayfa Aralığı: 169 - 176 Metin Dili: İngilizce DOI: 10.5455/annalsmedres.2018.10.229 İndeks Tarihi: 19-12-2019

The clinical and histopathological effects of perineural dexmedetomidine and in combination with sodium bicarbonate in sciatic nerve block in rabbits after sevoflurane anesthesia: A placebo controlled, randomized experimental study

Öz:
Aim: Peripheral nerve blockade is a common regional anesthetic technique in surgical procedures in daily clinical practice. The aim of this experimental study was to compare perineural dexmedetomidine alone with perineural sodium bicarbonate added to dexmedetomidine for measurement of analgesia, sensorial and motor blockade and histopathologic evaluation.Material and Methods: Twenty-four rabbits were randomly allocated to 3 groups; Group S: sham, Group D: perineural dexmedetomidine (20 mcg/kg) and Group D+SB: perineural dexmedetomidine (20 mcg/kg) plus sodium bicarbonate. (8.4%, 0.125 mL). Analgesia measurement was evaluated by hotplate test, the paw withdrawal response was performed for sensorial and motor blockades, also were recorded at baseline, 30, 60, 90 and 120 min after drug administration. Dissected nerve tissue was also examined for histopathologic evaluation.Results: Latency times of Group D or Group D+SB were significantly longer when compared with Group S at 30, 60, 90 and 120 min. There was no significant difference between Group D and Group D+SB for the all scheduled times. Sensorial and motor blockade scores were similar in all groups. Group D or Group D+SB caused edema, inflammation with neutrophil leukocytes, and degeneration of myelin fibers, increased in vacuolization, granulation tissue and fibrosis.Conclusion: Perineural dexmedetomidine alone or in combination with sodium bicarbonate prolonged the duration of analgesia, but did not enhance the sensorial and motor blockade, when compared with placebo. Perineural dexmedetomidine combined with sodium bicarbonate didn’t enhance the blockage. Dexmedetomidine caused edema, inflammation and degeneration of myelin fibers, increased in granulation tissue and fibrosis.
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  • 1. Keplinger M, Marhofer P, Kettner SC, et al. A pharmacodynamic evaluation of dexmedetomidine as an additive drug to ropivacaine for peripheral nerve blockade: A randomised, triple-blind, controlled study in volunteers. Eur J Anaesthesiol 2015;32:790-6.
  • 2. Memiş D, Turan A, Karamanlioğlu B, et al. Adding dexmedetomidine to lidocaine for intravenous regional anesthesia. Anesth Analg 2004;98:835-40.
  • 3. Brummett CM, Norat MA, Palmisano JM, et al. Perineural administration of dexmedetomidine in combination with bupivacaine enhances sensory and motor blockade in sciatic nerve block without inducing neurotoxicity in rat. Anesthesiol 2008;109:502-11.
  • 4. Kirksey MA, Haskins SC, Cheng J, et al. Local Anesthetic peripheral nerve block adjuvants for prolongation of analgesia: a systematic qualitative review. PLoS One 2015;10:e0137312.
  • 5. Marhofer P, Brummett CM. Safety and efficiency of dexmedetomidine as adjuvant to local anesthetics. Curr Opin Anaesthesiol 2016;29:632-7.
  • 6. Yektaş A, Çabalar M, Sar M, et al. Perineural dexmedetomidine effects on sciatic nerve in rat. Braz J Anesthesiol 2017;67:57-66.
  • 7. Hu X1, Li J, Zhou R, et al. Dexmedetomidine added to local anesthetic mixture of lidocaine and ropivacaine enhances onset and prolongs duration of a popliteal approach to sciatic nerve blockade. Clin Ther 2017;39:89-97.
  • 8. Gurajala I, Thipparampall AK, Durga P, et al. Effect of perineural dexmedetomidine on the quality of supraclavicular brachial plexus block with 0.5% ropivacaine and its interaction with general anaesthesia. Indian J Anaesth 2015;59:89-95
  • 9. Trein TA, Floriano BP, Wagatsuma JT, et al. Effects of dexmedetomidine combined with ropivacaine on sciatic and femoral nerve blockade in dogs. Vet Anaesth Analg 2017; 2987:31396-4.
  • 10. Helal SM, Eskandr AM, Gaballah KM, et al. Effects of perineural administration of dexmedetomidine in combination with bupivacaine in a femoral-sciatic nerve block. Saudi J Anaesth 2016;10:18-24.
  • 11. Ali Erdogan M, Polat A, Yucel A, et al. Effects of perineural administration of dexmedetomidine in combination with levobupivacaine in a rat sciatic nerve block. Curr Ther Res Clin Exp 2013;74:74-8.
  • 12. Zhang Y, Wang CS, Shi JH, et al. Perineural administration of dexmedetomidine in combination with ropivacaine prolongs axillary brachial plexus block. Int J Clin Exp Med 2014;7:680-5.
  • 13. Marhofer D, Kettner SC, Marhofer P, et al. Dexmedetomidine as an adjuvant to ropivacaine prolongs peripheral nerve block: a volunteer study. Br J Anaesth 2013;110:438-42.
  • 14. Dolu N, Şahin L, Kaplan DS, et al. The effects of bupivacaine combined with different adjuvants on block onset and duration and on ion channel expressions (SCN9A, TRPM) in sciatic nerve block in rats. Turk J Med Sci 2016;46:926-35.
  • 15. Capogna G, Celleno D, Laudano D, et al. Alkalinization of local anesthetics. Which block, which local anesthetic? Reg Anesth 1995;20:369-77.
  • 16. Ririe DG, Walker FO, James RL, et al. Effect of alkalinization of lidocaine on median nerve block. Br J Anaesth 2000;84:163-8.
  • 17. Huang Y, Lu Y, Zhang L, et al. Perineural dexmedetomidine attenuates inflammation in rat sciatic nerve via the NF-κB pathway. Int J Mol Sci 2014;15:4049-59.
  • 18. Kim BS, Choi JH, Baek SH, et al. Effects of intraneural injection of dexmedetomidine in combination with ropivacaine in rat sciatic nerve block. Reg Anesth Pain Med 2018;43:378-84.
  • 19. Memari E, Hosseinian MA, Mirkheshti A, et al. Comparison of histopathological effects of perineural administration of bupivacaine and bupivacaine-dexmedetomidine in rat sciatic nerve. Exp Toxicol Pathol 2016;68:559-64.
APA Akbas S, ÖZKAN A, SEVİMLİ R, ALAN S (2019). The clinical and histopathological effects of perineural dexmedetomidine and in combination with sodium bicarbonate in sciatic nerve block in rabbits after sevoflurane anesthesia: A placebo controlled, randomized experimental study. , 169 - 176. 10.5455/annalsmedres.2018.10.229
Chicago Akbas Sedat,ÖZKAN Ahmet Selim,SEVİMLİ REŞİT,ALAN Saadet The clinical and histopathological effects of perineural dexmedetomidine and in combination with sodium bicarbonate in sciatic nerve block in rabbits after sevoflurane anesthesia: A placebo controlled, randomized experimental study. (2019): 169 - 176. 10.5455/annalsmedres.2018.10.229
MLA Akbas Sedat,ÖZKAN Ahmet Selim,SEVİMLİ REŞİT,ALAN Saadet The clinical and histopathological effects of perineural dexmedetomidine and in combination with sodium bicarbonate in sciatic nerve block in rabbits after sevoflurane anesthesia: A placebo controlled, randomized experimental study. , 2019, ss.169 - 176. 10.5455/annalsmedres.2018.10.229
AMA Akbas S,ÖZKAN A,SEVİMLİ R,ALAN S The clinical and histopathological effects of perineural dexmedetomidine and in combination with sodium bicarbonate in sciatic nerve block in rabbits after sevoflurane anesthesia: A placebo controlled, randomized experimental study. . 2019; 169 - 176. 10.5455/annalsmedres.2018.10.229
Vancouver Akbas S,ÖZKAN A,SEVİMLİ R,ALAN S The clinical and histopathological effects of perineural dexmedetomidine and in combination with sodium bicarbonate in sciatic nerve block in rabbits after sevoflurane anesthesia: A placebo controlled, randomized experimental study. . 2019; 169 - 176. 10.5455/annalsmedres.2018.10.229
IEEE Akbas S,ÖZKAN A,SEVİMLİ R,ALAN S "The clinical and histopathological effects of perineural dexmedetomidine and in combination with sodium bicarbonate in sciatic nerve block in rabbits after sevoflurane anesthesia: A placebo controlled, randomized experimental study." , ss.169 - 176, 2019. 10.5455/annalsmedres.2018.10.229
ISNAD Akbas, Sedat vd. "The clinical and histopathological effects of perineural dexmedetomidine and in combination with sodium bicarbonate in sciatic nerve block in rabbits after sevoflurane anesthesia: A placebo controlled, randomized experimental study". (2019), 169-176. https://doi.org/10.5455/annalsmedres.2018.10.229
APA Akbas S, ÖZKAN A, SEVİMLİ R, ALAN S (2019). The clinical and histopathological effects of perineural dexmedetomidine and in combination with sodium bicarbonate in sciatic nerve block in rabbits after sevoflurane anesthesia: A placebo controlled, randomized experimental study. Annals of Medical Research, 26(2), 169 - 176. 10.5455/annalsmedres.2018.10.229
Chicago Akbas Sedat,ÖZKAN Ahmet Selim,SEVİMLİ REŞİT,ALAN Saadet The clinical and histopathological effects of perineural dexmedetomidine and in combination with sodium bicarbonate in sciatic nerve block in rabbits after sevoflurane anesthesia: A placebo controlled, randomized experimental study. Annals of Medical Research 26, no.2 (2019): 169 - 176. 10.5455/annalsmedres.2018.10.229
MLA Akbas Sedat,ÖZKAN Ahmet Selim,SEVİMLİ REŞİT,ALAN Saadet The clinical and histopathological effects of perineural dexmedetomidine and in combination with sodium bicarbonate in sciatic nerve block in rabbits after sevoflurane anesthesia: A placebo controlled, randomized experimental study. Annals of Medical Research, vol.26, no.2, 2019, ss.169 - 176. 10.5455/annalsmedres.2018.10.229
AMA Akbas S,ÖZKAN A,SEVİMLİ R,ALAN S The clinical and histopathological effects of perineural dexmedetomidine and in combination with sodium bicarbonate in sciatic nerve block in rabbits after sevoflurane anesthesia: A placebo controlled, randomized experimental study. Annals of Medical Research. 2019; 26(2): 169 - 176. 10.5455/annalsmedres.2018.10.229
Vancouver Akbas S,ÖZKAN A,SEVİMLİ R,ALAN S The clinical and histopathological effects of perineural dexmedetomidine and in combination with sodium bicarbonate in sciatic nerve block in rabbits after sevoflurane anesthesia: A placebo controlled, randomized experimental study. Annals of Medical Research. 2019; 26(2): 169 - 176. 10.5455/annalsmedres.2018.10.229
IEEE Akbas S,ÖZKAN A,SEVİMLİ R,ALAN S "The clinical and histopathological effects of perineural dexmedetomidine and in combination with sodium bicarbonate in sciatic nerve block in rabbits after sevoflurane anesthesia: A placebo controlled, randomized experimental study." Annals of Medical Research, 26, ss.169 - 176, 2019. 10.5455/annalsmedres.2018.10.229
ISNAD Akbas, Sedat vd. "The clinical and histopathological effects of perineural dexmedetomidine and in combination with sodium bicarbonate in sciatic nerve block in rabbits after sevoflurane anesthesia: A placebo controlled, randomized experimental study". Annals of Medical Research 26/2 (2019), 169-176. https://doi.org/10.5455/annalsmedres.2018.10.229