Selçuk SÜRÜCÜ, Hülya BAŞAR, Ömer KURTİPEK, Nurten ÜNAL, Fersun BOMBA, Zöhre ŞENTÜRK, Çetin KAYMAK, Esra ERDEMLİ

Effects of repeated sevoflurane anesthesia on renal function: An animal study

Amaç: Bu çalışmada, raflarda sevofluranm tekrarlı uygulamaları sonucunda, sevofluranm plazma inorganik flor düzeyleri ve renal sistem üzerine olan etkileri incelendi. Metod: Çalışmada 35 rat iki gruba ayrıldı (kontrol-sevofluran). Kontrol grubu 7 rattan ve sevofluran grubu 28 rattan oluşuyordu. Sevofluran grubu, rafların sakrifiye edilme zamanına gore herbiri 7 rat içeren 4 subgruba ayrıldı (Sİ, S3, S5, S10). Sevofluran grubuna ait tüm raflara, 5 gün 30 dakika süreyle % 3 konsantrasyonda sevofluran anestezisi uygulandı. Raflar 1., 3. ve 5. gün anestezi aldıktan sonra sakrifiye edildi. Kalan 7 rat, 5 gün anestezi almadan bekletildi ve 10. gün sakrifiye edildi. Plazma inorganik florid konsantrasyonu aspire edilen kalp kanından, iyon selektij elektrot metodu ile ölçüldü. Raflardan böbrek biyopsileri sakrifiye edildikten hemen sonra alındı. Sevofluranm renal histopatolojik etkileri ışık ve transmisyon elektron mikroskopisi ile değerlendirildi (TEM). Bulgular: Plazma inorganik flor konsantrasyonları her iki grup arasında anlamlı farklıydı. Buna karşın sevofluran subgrupları arasında fark yoktu. Her iki grup arasında plazma BUN ve kreatinin düzeyleri arasında fark yok iken, yalnızca 10. gündeki plazma BUN düzeyleri farklı bulundu. Elektromikroskobik görünüm olarak sevofluran subgrupları ile kontrol grubu arasında anlamlı tübüler değişiklikler izlendi. Ancak bu değişiklikler 10. günde belirgin regresyon gösterdi. Tartışma: Sonuç olarak, histopatolojik değişiklikler reversibl olduğu için, bizim metodumuzla tekrarlı sevofluran uygulamasının güvenilir olduğu sonucuna varıldı.

Tekrarlı sevofluran anestezisinin renal fonksiyonlar üzerine etkileri: Deneysel çalışma

Purpose: The effect of repeated administrations oj sevoflurane in rats was evaluated with free inorganic plasma fluoride concentrations and the effect of sevoflurane on the kidneys. Methods: Thirty-five rats were divided into two groups. The control group consisted of 7 rats, and the sevoflurane group consisted of 28 rats. The sevoflurane group was divided equally into 4 subgroups according to the time of sacrifice (SI, S3, S5, S10). All rats in the sevoflurane group were administered 3% sevoflurane for 30 minutes for 5 days. After anesthesia, the rats were sacrificed at the end of the 1st, 3rd and 5th days. The other 7 were kept without anesthesia for 5 days and they were sacrificed at the end of the 10th day. Plasma inorganic fluoride concentrations were measured by ion-selective electrode methods in aspirated heart blood samples. Renal biopsies were taken just after sacrifice and the renal histopathologic effects of sevoflurane were investigated under light and transmission electron microscopy (TEM). Results: Plasma fluoride concentrations were significantly different between the sevoflurane and control groups. However, there was no statistical difference between the sevoflurane subgroups. Plasma BUN levels did not differ between the control and sevoflurane groups, except on the 10th day. Ultrastructurally, the sevoflurane subgroups (S-3, S-5, S-10) showed significant tubular histopathologic changes compared to the control group. However, these changes showed a significant regression on the 10th day. Conclusion: Repeated sevoflurane administration is a safe procedure since histopathological changes showed significant regression.

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