Uysal Hale Yarkan, Cuzdan Suat Sedat, Kayıran Oğuz, Başar Hülya, Fidancı Vildan, Afyoncu Ebru, Üstün Hüseyin, Gülbahçe Rukiye
Anaesthesiology and Reanimation Clinic, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey.
J Craniofac Surg. 2012 Sep;23(5):1287-91. doi: 10.1097/SCS.0b013e3182519f24.
The aim of this study was to evaluate the effects of dexmedetomidine on ischemia-reperfusion injury of epigastric island flaps of rats.
Eighty Wistar rats were divided into 4 groups. After the flap elevation, in group 1, the flaps were sutured back without ischemic insult. Groups 2, 3, and 4 were exposed to ischemia for 12 hours. In groups 1 and 2, saline, in group 3, 10 μg/kg dexmedetomidine, and in group 4, 30 μg/kg dexmedetomidine were administered i.p. 45 minutes before I/R periods. Each group was subdivided further into 2 equal groups (a and b). Tissue samples of groups 1a, 2a, 3a, and 4a were obtained 12 hours after the reperfusion, and those of groups 1b, 2b, 3b, and 4b were obtained after 7 days. The necrotic areas were also calculated. Nitric oxide, malondialdehyde (MDA), and myeloperoxidase (MPO) activity were assessed in the tissue samples.
Nitric oxide, MDA, and MPO activity levels in group 2a were significantly higher those in group 1a (P < 0.05). The levels in groups 3a and 4a were lower than those in group 2a (P < 0.05). Nitric oxide, MDA, and MPO activity levels were significantly higher in group 2b compared with group 1b (P < 0.05). The levels were lower in Groups 3b and 4b compared with group 2b (P < 0.05). Flap necrosis area was significantly lower in groups 3b and 4b than that in group 2b (P < 0.05).
We conclude that administering dexmedetomidine before I/R periods can reduce ischemia-reperfusion injury of flaps, and it has a beneficial effect on flap survival.
本研究旨在评估右美托咪定对大鼠上腹部岛状皮瓣缺血再灌注损伤的影响。
将80只Wistar大鼠分为4组。皮瓣掀起后,第1组皮瓣缝合回原处,未遭受缺血损伤。第2、3、4组经历12小时缺血。在第1组和第2组中,于缺血/再灌注期前45分钟腹腔注射生理盐水,第3组注射10μg/kg右美托咪定,第4组注射30μg/kg右美托咪定。每组再进一步分为2个相等的亚组(a和b)。再灌注12小时后获取第1a、2a、3a和4a组的组织样本,7天后获取第1b、2b、3b和4b组的组织样本。同时计算坏死面积。对组织样本中的一氧化氮、丙二醛(MDA)和髓过氧化物酶(MPO)活性进行评估。
第2a组的一氧化氮、MDA和MPO活性水平显著高于第1a组(P<0.05)。第3a组和第4a组的水平低于第2a组(P<0.05)。与第1b组相比,第2b组的一氧化氮、MDA和MPO活性水平显著更高(P<0.05)。第3b组和第4b组的水平低于第2b组(P<0.05)。第3b组和第4b组的皮瓣坏死面积显著低于第2b组(P<0.05)。
我们得出结论,在缺血/再灌注期前给予右美托咪定可减少皮瓣的缺血再灌注损伤,并对皮瓣存活具有有益作用。