Rat siyatik sinirine uygulanan kapsaisin ve bupivakainin aksiyon potansiyeli, blok kalitesi ve nörotoksik etkilerinin karşılaştırılması
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Dosyalar
Tarih
2022
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Yayıncı
Düzce Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş: Periferik sinir bloklarında uygulanan lokal anestezikler ve lokal anesteziklerin doz bağımlı toksik etkilerini azaltmak için eklenen adjuvan ilaçların blok sürelerine etkilerinin karşılaştırılması sadece klinik çalışmalarda bulunmaktadır. Çalışmamızda amacımız rat deney modeli üzerinde bupivakaine eklenen farklı dozlarda kapsaisinin sinir iletim hızını, blok kalitesini ve nörotoksik etkilerini değerlendirmektir. Böylece adjuvan bir ajan olarak kapsaisinin değerlendirilmesini amaçladık. Gereç ve Yöntemler: Çalışmamızda 36 adet rat kullanıldı; Salin (n=4) ve kontrol (n=4) grupları, çalışma grupları olarak Grup DK: Kapsaisin düşük doz (% 0,01 kapsaisin, n=7), Grup YK: Kapsaisin yüksek doz (% 0,1 kapsaisin, n=7), Grup DKB: Bupivakin+düşük doz kapsaisin (% 0,01 kapsaisin + % 0,25 bupivakain, n=7), Grup YKB: Bupivakain+yüksek doz kapsaisin (% 0,1 kapsaisin +% 0,25 bupivakain, n=7) grupları olmak üzere toplam 6 grup oluşturuldu. Ratlara ketamin hidroklorit 90 mg/kg ve ksilazin 3 mg/kg intraperitoneal verilerek anestezileri sağlandıktan sonra sol siyatik sinirleri longitudinal kesi yapılarak açıldı. Eksplore edilen kısmın distaline ve proksimaline olmak üzere iki kayıt elektrodu yerleştirilerek kontrol kaydı alındı, çalışma ilaçları 0,2 ml volüm olarak hazırlanarak rat siyatik siniri üzerine damlatıldı. Bioamplifikatör cihazıyla 5 dakikalık aralıklarla 10 mA şiddetinde 10 adet akım verilerek, bileşik aksiyon potansiyelleri ve sinir ileti hızları elektronik ortamda kaydedildi (0.dk, 5.dk, 10.dk, 15.dk, 20.dk, 25.dk, 30.dk, 35.dk, 40.dk, 45.dk). İlaçların yol açtığı motor ve duyu bloğunu cerrahiye bağlı ağrıdan bağımsız olarak değerlendirebilmek için işlemden 18 saat sonra sağlam taraf olan sağ siyatik sinir bölgesine de aynı ilaç infiltre edildikten sonra her iki ekstremitede 0.dk, 30dk., 1, 2, 6, 12 ve 24. saat Hot-plate (Sıcak Plaka) ve Pençe Çekme testleriyle ratların motor ve duyu testleri yapıldı. Sonrasında sakrifiye edilen deneklerden alınan siyatik sinir örnekleri histopatolojik olarak değerlendirildi. Bulgular: Rat siyatik sinirine % 0,1'lik ve % 0,01 konsantrasyonlarda uygulanan kapsaisinin sinir ileti hızlarını anlamlı derecede azalttığı görüldü. Bileşik aksiyon potansiyeline etkisinin ise bupivakain içeren hem % 0,1'lik konsantrasyonun iii hem de % 0,01'lik konsantrasyonların, bupivakain içermeyen % 0,1'lik konsantrasyonla birlikte benzer sonuçlara sahip olduğu, kontrol ve bupivakainsiz % 0,01'lik konsantrasyonda uygulanan gruplardan ise anlamlı farklı oldukları bulundu. Davranış testleri değerlendirildiğinde ise % 0,1'lik konsantrasyondaki kapsaisinin tüm gruplara göre motor ve duyu yanıtını en fazla baskılayan grup olduğu görüldü. Aksine % 0,01'lik konsantrasyondaki kapsaisin ise sinir ileti hızını azaltıp, bileşik aksiyon potansiyelinde anlamlı değişiklik yapmasına karşın motor ve duyu yanıtını bariz baskılamadan hem kontrol gruba göre ve hem de kendi içinde anlamlı değişiklikler oluşturduğu görüldü. Histopatolojik incelemede herhangi bir grupta nörodegenerasyon saptanmadı. Mast hücre sayımına bakıldığında ise % 0,25'lik bupivakainle kombine edilen % 0,01'lik kapsaisinin kontrol ve salin gruplarına benzer histopatolojik özelliklere sahip olduğu diğer çalışma gruplarında ise mast hücre sayısının kontrol ve saline göre daha yüksek çıktığı gözlendi. Sonuç: Kapsaisin % 0,1 konsantrasyonda bupivakainli veya bupivakainsiz olarak etkin bir şekilde sinir bloğu oluşturmakla birlikte her ne kadar nörodegenerasyon gözlenmesede nöroinflamasyona neden olabileceği, bununla birlikte % 0,01 konsantrasyondaki kapsaisinin bupivakainle birlikte uygulanmasının yeterli sinir blok etkisi ile birlikte antiinflamatuar etkinliğe sahip olabileceğini düşünüyoruz. Anahtar Kelimeler: Kapsaisin, bupivakain, aksiyon potansiyeli, nosisepsiyon, rat.
Introduction: Comparison of the effects of local anesthetics applied in peripheral nerve blocks and adjuvant drugs added to avoid dose-dependent toxic effects of local anesthetics on the block durations are only available in clinical studies. In our study, our aim is to evaluate the nerve conduction velocity, block quality and neurotoxic effects of capsaicin at different doses added to bupivacaine on a rat experimental model. Thus, we aimed to assess capsaicin as an adjuvant agent. Material and methods: In our study, 36 rats were used; Saline (n=4) and Control (n=4) groups, as study groups Group DK: Capsaicin low dose (0,01 % capsaicin, n=7), Group YK: Capsaicin high dose (0,1 % capsaicin, n =7), Group DKB: Bupivacine+low-dose capsaicin (0,01 % capsaicin + 0,25 % bupivacaine, n=7), Group YKB: Bupivacaine+high-dose capsaicin (0,1 % capsaicin + 0.25 % bupivacaine), n=7), a total of 6 groups were formed. After the rats were anesthetized by administering ketamine hydrochloride 90 mg/kg and xylazine 3 mg/kg intraperitoneally, the left sciatic nerves were opened by making a longitudinal incision. Control recording was taken by placing two recording electrodes distal and proximal to the explored part. Study drugs were prepared in 0.2 ml volume and dripped onto the rat sciatic nerve. Compound action potentials and nerve conduction velocities were recorded electronically by giving 10 currents of 10 mA at 5-minute intervals with a bioamplifier device (0.min, 5.min, 10.min, 15.min, 20.min, 25.min, 30.min, 35.min, 40.min, 45.min). In order to evaluate the motor and sensory block caused by the drugs independently of the pain due to surgery, 18 hours after the procedure, after the same drug was infiltrated into the right sciatic nerve region, which is the intact side, motor and sensory tests of the rats were performed with 0.min, 30.min, 1, 2, 6, 12 and 24 hours with Hot-Plate and Paw-Withdrawal tests in both extremities. Afterwards, sciatic nerve samples taken from the sacrificed rats were evaluated histopathologically. Results: It was observed that 0,1 % and 0,01 % concentrations of capsaicin applied to the rat sciatic nerve significantly reduced nerve conduction velocities. The effect on the compound action potential was found that both 0,1 % concentration and 0,01 % concentration containing bupivacaine had similar results with the 0,1 % concentration without bupivacaine, but was significantly different from the control and v 0,01 % concentration without bupivacaine. When behavioral tests were evaluated, it was observed that capsaicin at a concentration of 0,1 % was the group that suppressed the motor and sensory response the most compared to all groups. On the contrary, although capsaicin at a concentration of 0.01% decreased nerve conduction velocity and made a significant change in the compound action potential, it was observed that it caused significant changes both in itself and in the control group without suppressing the motor and sensory response. Neurodegeneration was not detected in any group in histopathological examination. When the mast cell count was examined, it was observed that 0,01 % capsaicin combined with 0,25 % bupivacaine had similar histopathological features to the control and saline groups, while the mast cell count was higher in the other study groups than in the control and saline groups. Conclusion: Although capsaicin at a concentration of 0,1% with or without bupivacaine effectively creates nerve block, although neurodegeneration is not observed, we think that it may cause neuroinflammation. Keywords: Capsaicin, bupivacaine, action potential, nociception, rat
Introduction: Comparison of the effects of local anesthetics applied in peripheral nerve blocks and adjuvant drugs added to avoid dose-dependent toxic effects of local anesthetics on the block durations are only available in clinical studies. In our study, our aim is to evaluate the nerve conduction velocity, block quality and neurotoxic effects of capsaicin at different doses added to bupivacaine on a rat experimental model. Thus, we aimed to assess capsaicin as an adjuvant agent. Material and methods: In our study, 36 rats were used; Saline (n=4) and Control (n=4) groups, as study groups Group DK: Capsaicin low dose (0,01 % capsaicin, n=7), Group YK: Capsaicin high dose (0,1 % capsaicin, n =7), Group DKB: Bupivacine+low-dose capsaicin (0,01 % capsaicin + 0,25 % bupivacaine, n=7), Group YKB: Bupivacaine+high-dose capsaicin (0,1 % capsaicin + 0.25 % bupivacaine), n=7), a total of 6 groups were formed. After the rats were anesthetized by administering ketamine hydrochloride 90 mg/kg and xylazine 3 mg/kg intraperitoneally, the left sciatic nerves were opened by making a longitudinal incision. Control recording was taken by placing two recording electrodes distal and proximal to the explored part. Study drugs were prepared in 0.2 ml volume and dripped onto the rat sciatic nerve. Compound action potentials and nerve conduction velocities were recorded electronically by giving 10 currents of 10 mA at 5-minute intervals with a bioamplifier device (0.min, 5.min, 10.min, 15.min, 20.min, 25.min, 30.min, 35.min, 40.min, 45.min). In order to evaluate the motor and sensory block caused by the drugs independently of the pain due to surgery, 18 hours after the procedure, after the same drug was infiltrated into the right sciatic nerve region, which is the intact side, motor and sensory tests of the rats were performed with 0.min, 30.min, 1, 2, 6, 12 and 24 hours with Hot-Plate and Paw-Withdrawal tests in both extremities. Afterwards, sciatic nerve samples taken from the sacrificed rats were evaluated histopathologically. Results: It was observed that 0,1 % and 0,01 % concentrations of capsaicin applied to the rat sciatic nerve significantly reduced nerve conduction velocities. The effect on the compound action potential was found that both 0,1 % concentration and 0,01 % concentration containing bupivacaine had similar results with the 0,1 % concentration without bupivacaine, but was significantly different from the control and v 0,01 % concentration without bupivacaine. When behavioral tests were evaluated, it was observed that capsaicin at a concentration of 0,1 % was the group that suppressed the motor and sensory response the most compared to all groups. On the contrary, although capsaicin at a concentration of 0.01% decreased nerve conduction velocity and made a significant change in the compound action potential, it was observed that it caused significant changes both in itself and in the control group without suppressing the motor and sensory response. Neurodegeneration was not detected in any group in histopathological examination. When the mast cell count was examined, it was observed that 0,01 % capsaicin combined with 0,25 % bupivacaine had similar histopathological features to the control and saline groups, while the mast cell count was higher in the other study groups than in the control and saline groups. Conclusion: Although capsaicin at a concentration of 0,1% with or without bupivacaine effectively creates nerve block, although neurodegeneration is not observed, we think that it may cause neuroinflammation. Keywords: Capsaicin, bupivacaine, action potential, nociception, rat
Açıklama
Anahtar Kelimeler
Kapsaisin, bupivakain, aksiyon potansiyeli, nosisepsiyon, rat., Capsaicin, bupivacaine, action potential, nociception, rat, Anestezi ve Reanimasyon, Anesthesiology and Reanimation
