Sevgi GÜNEŞ, Nurcan DORUK, Handan ÇAMDEVİREN, Ülkü ÇÖMELEKOĞLU, Belgin BÜYÜKAKILLI

Do adjuncts (Tramadol and Magnesium) potentiate impulse inhibition by a local anaesthetic in isolated frog siatic nerves?

Amaç: Klinik uygulamalarda, farklı birçok nedenlerle lokal anesteziklere adjuvan ajanlar (magnezyum veya tramadol vb.) ilave edilmektedir. Ancak, magnezyum+bupivakain veya tramadol+bupivakain karışımlarının in vitro preparatlar üzerinde etkileri konusunda yapılan çalışmalar oldukça kısıtlıdır. Çalışmamızda in vitro olarak, bupivakaine tramadol veya magnezyum ilavesinin bileşik sinir aksiyon potansiyeli üzerine etkisini araştırmayı planladık.Yöntem ve Gereç: Deneyler, ekstraseiiüier kayıt tekniği kullanılarak kurbağa siyatik sinirleri üzerinde yapılmıştır. İzole kurbağa siyatik sinirleri her bir test solüsyonunda 10 dakika süreyle banyo edilmiştir. Test solüsyonunda bekletmeden önce, her bir sinirden aksiyon potansiyelleri kaydedilmiş ve bu eğriler kontrol verileri olarak kabul edilmiştir. Ekstrasellüler aksiyon potansiyellerinin kaydedilmesi amacıyla BIOPAC MP 100 Veri Toplama Sistemi Version 3.5.7 (Santa Barbara, USA) kullanılmıştır.Bulgular: Bileşik sinir aksiyon potansiyellerinin bupivakain ile inhibisyonu, ortama magnezyum eklenmesi sonucu belirgin bir biçimde artmış, fakat ortama tramadol eklenmesi sonuçlarda herhangi bir değişiklik oluşturmamıştır. Bupivakain içeren test solüsyonunda bileşik sinir aksiyon potansiyellerinin genliğinde gözlenen %15,10 luk inhibisyon, ortama magnezyum eklenmesi sonucu %35,43 olarak saptanmıştır. Sonuç: Kullandığımız konsantrasyonlarda bupivakaine magnezyum eklenmesinin sadece bupivakain kullanılması ile oluşturulan sinir bloku üzerinde artırıcı bir etkisi olduğu, fakat aynı etkinin bupivakaine tramadol eklenmesi sonucu oluşmadığı kanısına varılmıştır.

İzole kurbağa siyatik sinirlerinin lokal anestezik blokajı, adjuvan ajanlar (Tramadol ve Magnezyum) ile güçlenebilirler mi?

Aim: In clinical use, the addition of adjuncts (magnesium or tramadol) to local anesthetic agents is used for different reasons. However, reports about the effect of magnesium plus bupivacaine and of tramadol plus bupivacaine on in vitro preparations are scarce. The aim of this study was to examine the ability of local anesthetics to reduce the amplitude of compound nerve action potentials of the isolated frog sciatic nerve in the absence and presence of adjuncts (magnesium and tramadol).Materials and Methods: The experiments were done on frog sciatic nerves, using an extracellular recording technique. Isolated frog sciatic nerves were bathed in each test solution for 10 min. In each nerve, action potentials were recorded before exposure to the test solution, which served as the control data. The extracellular action potentials were recorded after 10 min of exposure to the test solution by using a BIOPAC MP 100 Acquisition System Version 3.5.7 (Santa Barbara, USA).Results: Inhibition of the compound nerve action potentials induced by bupivacaine was markedly enhanced by magnesium but was not changed by tramadol. The amplitude of compound nerve action potentials increased from 15.10% with bupivacaine alone to 35.43% with bupivacaine plus magnesium.Conclusions: These results suggest a potentially important interaction between magnesium and bupivacaine for nerve block, but there was no interaction between tramadol and bupivacaine.

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