Curtis Fabio Geraldo, Vianna Pedro Thadeu Galvão, Viero Rosa Marlene, Fiorio Paulo Mateus, Silva Leopoldo Muniz da, Braz José Reinaldo Cerqueira, Oliveira Cristiano, Castiglia Yara Marcondes Machado
Postgraduate Program in Anesthesiology, Botucatu Medical School, UNESP, Brazil.
Acta Cir Bras. 2011 Jun;26(3):202-6. doi: 10.1590/s0102-86502011000300008.
To investigate blood creatinine and renal histology in rats anesthetized with S(+)-ketamine (keta) or dexmedetomidine (dex) and submitted to kidney ischemia/reperfusion injury (IRI).
Under intraperitoneal (ip) S(+)-ketamine, 20 male Wistar rats were divided into two groups (n=10): maintenance with iv S(+)-ketamine or dex (keta and dex groups), and submitted to right (R) nephrectomy and left (L) renal artery clamping for 45 min. Blood creatinine was measured before ischemia (T1) and 48h after reperfusion (T2), when L nephrectomy was performed. Histological analysis was performed in all kidneys.
Blood creatinine was significantly higher at T2 in both groups, but dex group results were lower than those of keta group. Histological changes: between groups, R kidneys did not differ; there were significant high scores for vascular dilation: keta L kidneys; for vascular congestion, tubular dilation, and necrosis: L kidneys from both groups; for tubular degeneration: keta R kidneys.
S(+)-ketamine plus IRI were aggressive to rat kidneys, according to histological changes, and dexmedetomidine may have not totally protected the kidneys from these injuries, despite the better results of blood creatinine.
研究用S(+)-氯胺酮(氯胺酮)或右美托咪定(右美托咪啶)麻醉并遭受肾脏缺血/再灌注损伤(IRI)的大鼠的血肌酐和肾脏组织学情况。
20只雄性Wistar大鼠腹腔内注射S(+)-氯胺酮后,分为两组(n = 10):静脉注射S(+)-氯胺酮或右美托咪定维持麻醉(氯胺酮组和右美托咪定组),然后进行右肾切除术,并夹闭左肾动脉45分钟。在缺血前(T1)和再灌注后48小时(T2,此时进行左肾切除术)测量血肌酐。对所有肾脏进行组织学分析。
两组在T2时血肌酐均显著升高,但右美托咪定组的结果低于氯胺酮组。组织学变化:两组之间,右肾无差异;血管扩张评分显著较高的是:氯胺酮组的左肾;血管充血、肾小管扩张和坏死评分显著较高的是:两组的左肾;肾小管变性评分显著较高的是:氯胺酮组的右肾。
根据组织学变化,S(+)-氯胺酮加IRI对大鼠肾脏具有侵袭性,尽管右美托咪定在血肌酐方面结果较好,但可能并未完全保护肾脏免受这些损伤。