Efeitos da dexmedetomidina em rins isquêmicos e sobre a concentração plasmática do hormônio antidiurético: estudo experimental em cães anestesiados e hipovolêmicos
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Data
2010-02-26
Autores
Bitencourt, Wesley Semboloni [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
A insuficiência renal é uma entidade grave, com incidência elevada. As altas taxas de morbidade e mortalidade associadas a esse evento justificam a realização de pesquisas na tentativa de prevenir a sua ocorrência. Os agonistas 2- adrenérgicos, quando utilizados como adjuvantes na anestesia, aumentam o débito urinário, podendo reduzir a incidência ou diminuir a gravidade da insuficiência renal aguda peri-operatória. O objetivo desta pesquisa foi avaliar os efeitos da dexmedetomidina sobre a função renal e a concentração plasmática do hormônio antidiurético em cães hipovolêmicos e submetidos à isquemia e reperfusão renais, empregando-se dose semelhante àquela utilizada na prática em anestesiologia. Dezoito cães adultos, anestesiados com propofol, cloridrato de fentanil, isoflurano e brometo de rocurônio, foram distribuídos, de forma aleatória e encoberta, em dois grupos com 9 cães: Grupo Placebo: injeção de 20 ml de solução de cloreto de sódio a 0,9% em 10 minutos, seguida de injeção de 20 ml da mesma solução, em 1 hora; Grupo Dex: injeção de 20 ml de solução de cloreto de sódio a 0,9% contendo dexmedetomidina 2 μg.kg-1, em 10 minutos seguida de injeção de 20 ml da mesma solução com a mesma dose de dexmedetomidina (2 μg.kg-1), em 1 hora Foram realizados cateterismos, instalação de aparelhos de registro, preparação cirúrgica com lombotomia direita para nefrectomia e lombotomia esquerda para ligadura da artéria renal esquerda, por período de 30 minutos, com reperfusão, e cateterização do ureter esquerdo para coleta de urina, foi retirado 20 ml.kg-1 de sangue. Foram estudados os atributos hemodinâmicos cardiovasculares, a função renal e a concentração plasmática de hormônio antidiurético em 5 momentos: M1 (controle), após período de estabilização; M2, após injeção da solução em estudo; M3, imediatamente após o término do...
Renal failure is a serious entity with a high incidence. High morbidity and mortality rates associated with this event call for research studies in order to prevent its occurrence. When a2 - adrenergic agonists are used as an adjuvant to anesthesia, they increase urinary output and may either reduce the incidence or the seriousness of acute renal failure per-operatively. The objective of this study was to evaluate dexmedetomidine effects on function and plasma concentration of vasopressin in hypovolemic dogs subjected to renal ischemia and reperfusion. Doses were similar to those used in anesthetic practice. A total of 18 male dogs anesthetized with propofol, fentanyl hydrochloride, isoflurane and rocuronium bromide were randomly and blindly allocated to 2 groups with 9 dogs each: Placebo group – injection of 20 ml of sodium chloride solution at 0.9% concentration in 10 minutes, followed by injection of 20 ml of the same solution in 1 hour; Dex group – injection of 20 ml of sodium chloride solution at 0.9% concentration containing 2 μg.kg-1 dexmedetomidine in 10 minutes followed by injection of 20 ml of the same solution using the same dose of dexmedetomidine (2 μg.kg-1) in 1 hour. Catheterizations were performed and monitoring devices were installed. Right lumbotomy for nephrectomy and left lumbotomy for ligation of renal artery for 30 minutes with reperfusion and catheterization of the left ureter for urine collection were performed. A total of 20 ml.kg-1 of blood was withdrawn. Cardiovascular hemodynamics, renal function and plasma concentration of antidiuretic hormone were evaluated in 5 different periods: P1 (control), after a period of stabilization; P2, after injection of the study solution; P3, immediately after unclamping of left renal artery; P4, 30 minutes after unclamping, and P5, 45 minutes after unclamping. Heart rate decreased in the DEX group in P2 with an ... (Complete abstract click electronic access below)
Renal failure is a serious entity with a high incidence. High morbidity and mortality rates associated with this event call for research studies in order to prevent its occurrence. When a2 - adrenergic agonists are used as an adjuvant to anesthesia, they increase urinary output and may either reduce the incidence or the seriousness of acute renal failure per-operatively. The objective of this study was to evaluate dexmedetomidine effects on function and plasma concentration of vasopressin in hypovolemic dogs subjected to renal ischemia and reperfusion. Doses were similar to those used in anesthetic practice. A total of 18 male dogs anesthetized with propofol, fentanyl hydrochloride, isoflurane and rocuronium bromide were randomly and blindly allocated to 2 groups with 9 dogs each: Placebo group – injection of 20 ml of sodium chloride solution at 0.9% concentration in 10 minutes, followed by injection of 20 ml of the same solution in 1 hour; Dex group – injection of 20 ml of sodium chloride solution at 0.9% concentration containing 2 μg.kg-1 dexmedetomidine in 10 minutes followed by injection of 20 ml of the same solution using the same dose of dexmedetomidine (2 μg.kg-1) in 1 hour. Catheterizations were performed and monitoring devices were installed. Right lumbotomy for nephrectomy and left lumbotomy for ligation of renal artery for 30 minutes with reperfusion and catheterization of the left ureter for urine collection were performed. A total of 20 ml.kg-1 of blood was withdrawn. Cardiovascular hemodynamics, renal function and plasma concentration of antidiuretic hormone were evaluated in 5 different periods: P1 (control), after a period of stabilization; P2, after injection of the study solution; P3, immediately after unclamping of left renal artery; P4, 30 minutes after unclamping, and P5, 45 minutes after unclamping. Heart rate decreased in the DEX group in P2 with an ... (Complete abstract click electronic access below)
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Anestesicos - Efeito fisiologico, Cão como animal de laboratorio
Como citar
BITENCOURT, Wesley Semboloni. Efeitos da dexmedetomidina em rins isquêmicos e sobre a concentração plasmática do hormônio antidiurético: estudo experimental em cães anestesiados e hipovolêmicos. 2010. 164 f. Tese (doutorado) - Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, 2010.