Cengiz Bekir DEMİREL, Mustafa KÖSEM, İsmail KATI, HANEFİ ÖZBEK, Ürfettin A. HÜSEYİNOĞLU, HASAN KOÇOĞLU

Tekrarlanan halotan, izofluran ve sevofluran anestezisinin fare karaciğeri üzerine histopatolojik etkileri

Bu çalışmada halotan, izofluran ve sevofluranın fare karaciğeri üzerine olan histopatolojik etkileri araştırıldı. Karışık yetiştirilmiş Mus musculus Swiss-albino farelerden ortalama ağırlıkları 25-30 g olan toplam 80 fare çalışmada kullanıldı. Deney hayvanları (n=80) rasgele dört eşit gruba ayrıldılar; G I'e halotan, G II'ye izofluran ve G III'e sevofluran, (1'er MAC) verildi. G IV'e (kontrol) ise herhangi bir anestezik ajan verilmedi. Çalışma gruplarına on gün süre ile her gün ikişer saat olmak üzere %100 O2 içinde anestezik gazlar uygulandı. Çalışma sonunda farelerin karaciğerleri H-E (Hematoxylen-Eozin) ile boyandıktan sonra ışık mikroskobu ile portal ve sinüzoidal infiltrasyon (akut ve kronik iltihabı infiltrasyon), portal ve parankimal fibrozis, hepatositlerde hidropik dejenerasyon, mikro ve makroveziktiler yağlanma, apopitoz ve nükleer değişiklikler (nuklueslarda pleomorfizm, çift nükleus, şeffaf nükleus, inklüzyonlar) ve fokal nekroz, köprüleşme nekrozu, submasif ve masif nekroz ile portal ve intrahepatik safra stazı ve Kupffer hücre değişiklikleri (sayı ve şekil değişiklikleri) açısından değerlendirme yapılarak karaciğer hasarı histopatolojik olarak incelendi. Kontrol grubunda 3 farenin karaciğerlerinde çok hafif sel lüle r hasar vardı, diğerlerinde ise tamamen normal sellüler yapı saptandı. Halotan grubundaki bütün farelerin karaciğerlerinde hasar saptanırken, izofluran grubunda 17, sevofluran grubunda ise 13 farenin karaciğerinde hasar saptandı. Halotan grubundaki histopatolojik değişikliklerin derecesi izofluran grubuna göre daha fazla olmasına karşın, bu fark istatistiksel olarak anlamsız bulundu. Halotan ile sevofluran grupları arasındaki fark anlamlı idi (p

Anahtar Kelimeler:

Hepatit, toksik, Fare, Anestezikler, Halotan, Karaciğer, Anestezi, İzofluran

The histopathologic effect of repeated halothane, isoflurane and sevoflurane anesthesia on mice liver

In this study effects of halothane, isoflurane and sevoflurane were investigated on the liver cells in mice. Eigthy Mus musculus Swiss-albino mice weighing between 25-30 g grown heterogenously were included in this study. The animals were randomly divided into four groups: G I was received halothane, G II was received isoflurane and G III was received sevoflurane. G IV (control) was not received any anesthetic agent. The study groups were ventilated for 2 hour with 100% O<sub>2</sub> and appropriate inhalation agent for 10 days. After 10th day, histopathologic studies were performed on livers (portal and sinusoidal infiltration, portal and parenchymal fibrosis, focal necrosis, bridge necrosis, submassive and massive necrosis, portal and intrahepatic biliary stasis, hydropic degeneration, micro and macrovesicular fat, apoptosis and nuclear change). In control group three livers had very little cellular disconfiguration, while remaining livers were normal. Although necrotic tissues were seen in all of the mice in the halothane group, necrotic tissues were determined in 17 and 13 mice in the isoflurane and sevoflurane groups, respectively. Histopathologic grades and severity of lesions were higher in halothane group when compared with the isoflurane group, but differences were not significant. The difference between halothane and sevoflurane was determined significant (p<0.05), but it- was insignificant between isoflurane and sevoflurane groups. In halothane, isoflurane and sevoflurane groups histopathologic differences were regarded rather significant compared with the control group (p<0.001). We suggested that sevoflurane may be preferred during anesthesia especially in patients with liver disease.

Keywords:

Hepatitis, Toxic, Mice, Anesthetics, Halothane, Liver, Anesthesia, Isoflurane,

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