Reşit SEVİMLİ, Sedat AKBAŞ, Erol KARAASLAN, Ahmet Selim ÖZKAN, Saadet ALAN

The clinical and histopathological effects of perineural dexmedetomidine in combination with bupivacaine in sciatic nerve block in rabbits undergoing sevoflurane anesthesia

Many drugs or additives have been tried as adjuvants in the blocking of nerve blocks with local anesthetics, and it is aimed to increase the duration of action and analgesia quality of local anesthetics in this way. In this study, we aimed to see the adjuvant efficacy of Dexmedetomidine [Dex] added to bupivacaine and its effect on analgesia and histopathological effects in rabbits by administering sevoflurane anesthesia. Twenty-four rabbits were randomly allocated to 3 groups; Group S: sham [0.5 ml saline], Group B: perineural bupivacaine [0.5 mg/kg] [0.5 ml] and Group BD: perineural bupivacaine [0.5 mg/kg] combined with Dex [20 µr/kg] [0.5 ml]. Analgesia measurement was evaluated by hotplate test, the paw withdrawal response was performed for sensorial and motor blockades also were recorded at baseline, 30, 60, 90, and 120 min after drug administration. Dissected nerve tissue was also examined for histopathologic evaluation. In the hot-plate test applied for the measurement of acute thermal pain; when compared to Group S, significant prolongation was found in Group B and Group BD at 0, 30, 60, 90, and 120 minutes [p

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1. Coursin BD, Coursin BD, Maccioli AG. Dexmedetomidine. Current Op Critical Care. 2001;7:221-66.
2. Marhofer P, Brummett CM. Safety and efficiency of dexmedetomidine as adjuvant to local anesthetics. Curr Opin Anaesthesiol. 2016;29:632-37.
3. Peng K, Zhang J, Meng XW, et al. Optimization of Postoperative Intravenous Patient-Controlled Analgesia with Opioid-Dexmedetomidine Combinations: An Updated Meta-Analysis with Trial Sequential Analysis of Randomized Controlled Trials. Pain Physician. 2017;20:569-96.
4. Akbas S, Ozkan AS, Sevimli R, et al. The clinical and histopathological effects of perineural dexmedetomidine and in combination with sodium bicarbonate in sciatic nerve block in rabbits after sevoflurane anesthesia: A placebo controlled, randomized experimental study. Ann Med Res. 2019;26:169-76.
5. Erdogan MA, Polat A, Yucel A, et al. Effects of Perineural Administration of Dexmedetomidine in Combination with Levobupivacaine in a Rat Sciatic Nerve Block. Curr Ther Res Clin Exp. 2013;74:74-8.
6. Ozkan AS, Akbas S, Durak MA, et al. Effects of perineural administration of phenytoin in combination with levobupivacaine in a rat sciatic nerve block. Med Sci. 2018;7:891-7.
7. Oksuz E, Yasar S, Erten R, et al. Comparison of effects of high and low dose paracetamol treatment and toxicity on brain and liver in rats. North Clin Istanb. 2020;7:541-50.
8. Brummett CM, Norat MA, Palmisano JM, et al. Perineural administration of dexmedetomidine in combination with bupivacaine enhances sensory and motor blockade in sciatic nerve block without inducing neurotoxicity in rat. Anesthesiology. 2008;109:502-11.
9. Yektas A, Cabalar M, Sar M, et al. Perineural dexmedetomidine effects on sciatic nerve in rat. Braz J Anesthesiol. 2017;67:57-66.
10. Hu X, Li J, Zhou R, et al. Dexmedetomidine added to local anesthetic mixture of lidocaine and ropivacaine enhances onset and prolongs duration of a popliteal approach to sciatic nerve blockade. Clin Ther. 2017;39:89-97.
11. Trein TA, Floriano BP, Wagatsuma JT, et al. Effects of dexmedetomidine combined with ropivacaine on sciatic and femoral nerve blockade in dogs. Vet Anaesth Analg. 2017;44:144-53.
12. Ulger F, Bozkurt A, Bilge SS, et al. The antinociceptive effects of intravenous dexmedetomidine in colorectal distension-induced visceral pain in rats: the role of opioid receptors. Anesth Analg. 2009;109:616-22.
13. Sabetkasaie M, Vala S, Khansefid N, et al. Clonidine and guanfacine induced antinociception in visceral pain: possible role of alpha 2/I2 binding sites. Eur J Pharmacol. 2004;501:95-101.
14. Brummett CM, Padda AK, Amodeo FS, et al. Perineural dexmedetomidine added to ropivacaine causes a dose-dependent increase in the duration of thermal antinociception in sciatic nerve block in rat. Anesthesiology. 2009;111:1111-9.
15. Brummett CM, Amodeo FS, Janda AM, et al. Perineural dexmedetomidine provides an increased duration of analgesia to a thermal stimulus when compared with a systemic control in a rat sciatic nerve block. Reg Anesth Pain Med. 2010;35:427-31.
16. Memari E, Hosseinian MA, Mirkheshti A, et al. Comparison of histopathological effects of perineural administration of bupivacaine and bupivacaine-dexmedetomidine in rat sciatic nerve. Exp Toxicol Pathol. 2016;68:559-64.
17. Huang Y, Lu Y, Zhang L, et al. Perineural dexmedetomidine attenuates inflammation in rat sciatic nerve via the NF-κB pathway. Int J Mol Sci. 2014;15:4049-59.
18. Kim BS, Choi JH, Baek SH, et al. Effects of Intraneural Injection of Dexmedetomidine in Combination With Ropivacaine in Rat Sciatic Nerve Block. Reg Anesth Pain Med. 2018;43:378-84.
19. Durmus M, Karaaslan E, Ozturk E, et al. The effects of single-dose dexamethasone on wound healing in rats. Anesth Analg. 2003;97:1377-80.