Serum concentrations and renal expressions of IL-1 and TNF-a early after hemorrhage in rats under the effect of glibenclamide.

PURPOSE: To investigate changes in the serum concentration and renal expression of IL-1 and TNF-α cytokines in rats that received sevoflurane and glibenclamide prior to hemorrhage. METHODS: Two groups of sevoflurane-anesthetized Wistar rats (n=10): G1 (control) and G2 (glibenclamide, 1 µg/g i.v.); hemorrhage of 30% blood volume (10% every 10 min), with replacement using Ringer solution, 5 ml/kg/h. Serum concentrations of IL-1 and TNF-α were studied in the first hemorrhage (T1) and 50 min later (T2), renal expression, at T2. RESULTS: In serum, G1 TNF-α (pg/mL) was T1=178.6±33.5, T2=509.2±118.8 (p<0.05); IL-1 (pg/mL) was T1=148.8±31.3, T2=322.6±115.4 (p<0.05); in G2, TNF-α was T1=486.2±83.6, T2=261.8±79.5 (p<0.05); IL-1 was T1=347.0±72.0, T2= 327.3±90.9 (p>0.05). The expression of TNF-α and IL-1 in the glomerular and tubular cells was significantly higher in the G2 group. CONCLUSIONS: Hemorrhage and glibenclamide elevated TNF-α and IL-1 concentrations in serum and kidneys. High levels of TNF-α already present before the hemorrhage in the glibenclamide group may have attenuated the damages found in the kidneys after the ischemia event.

Serum concentrations and renal expressions of IL-1 and TNF-a early after hemorrhage in rats under the effect of glibenclamide

ABSTRACT PURPOSE: To investigate changes in the serum concentration and renal expression of IL-1 and TNF-α cytokines in rats that received sevoflurane and glibenclamide prior to hemorrhage. METHODS: Two groups of sevoflurane-anesthetized Wistar rats (n=10): G1 (control) and G2 (glibenclamide, 1 µg/g i.v.); hemorrhage of 30% blood volume (10% every 10 min), with replacement using Ringer solution, 5 ml/kg/h. Serum concentrations of IL-1 and TNF-α were studied in the first hemorrhage (T1) and 50 min later (T2), renal expression, at T2. RESULTS: In serum, G1 TNF-α (pg/mL) was T1=178.6±33.5, T2=509.2±118.8 (p<0.05); IL-1 (pg/mL) was T1=148.8±31.3, T2=322.6±115.4 (p<0.05); in G2, TNF-α was T1=486.2±83.6, T2=261.8±79.5 (p<0.05); IL-1 was T1=347.0±72.0, T2= 327.3±90.9 (p>0.05). The expression of TNF-α and IL-1 in the glomerular and tubular cells was significantly higher in the G2 group. CONCLUSIONS: Hemorrhage and glibenclamide elevated TNF-α and IL-1 concentrations in serum and kidneys. High levels of TNF-α already present before the hemorrhage in the glibenclamide group may have attenuated the damages found in the kidneys after the ischemia event.

Glibenclamide effects on renal function and histology after acute hemorrhage in rats under sevoflurane anesthesia.

INTRODUCTION: Hypovolemia from hemorrhage evokes protective compensatory reactions, such as the renin-angiotensin system, which interferes in the clearance function and can lead to ischemia. This study was designed to evaluate the effects of glibenclamide, a K(+)(ATP) channel blocker, on renal function and histology in rats in a state of hemorrhagic shock under sevoflurane anesthesia. MATERIAL AND METHODS: Twenty Wistar rats were randomized into two groups of 10 animals each (G1 and G2), only one of which (G2) received intravenous glibenclamide (1 microg.g(-1)), 60 min before bleeding was begun. Both groups were anesthetized with sevoflurane and kept on spontaneous respiration with oxygen-air, while being bled of 30% of volemia in three stages with 10 min intervals. There was an evaluation of renal function - sodium para-aminohippurate and iothalamate clearances, filtration fraction, renal blood flow, renal vascular resistance - and renal histology. Renal function attributes were evaluated at three moments: M1 and M2, coinciding with the first and third stages of bleeding; and M3, 30 min after M2, when the animals were subjected to bilateral nephrectomy before being sacrificed. RESULTS: Significant differences were found in para-aminohippurate clearance, G1 < G2, and higher renal vascular resistance values were observed in G1. Histological examination showed the greater vulnerability of kidneys exposed to sevoflurane alone (G1) with higher scores of vascular and tubular dilatation. There were vascular congestion and tubular vacuolization only in G1. Necrosis and signs of tubular regeneration did not differ in both groups. CONCLUSION: Treatment with glibenclamide attenuated acutely the renal histological changes after hemorrhage in rats under sevoflurane anesthesia.

Interação entre a analgesia de parto e o seu resultado: avaliação pelo peso e índice de Apgar do recém-nascido / The interaction between labor analgesia and its results: assessment using the newbornïs weight and Apgar score

JUSTIFICATIVA E OBJETIVOS: Existem controvérsias quanto à possibilidade de a analgesia de parto interferir no andamento do trabalho de parto e na vitalidade do recém-nascido. O objetivo deste estudo foi a interação entre analgesia do parto pelas técnicas peridural contínua e duplo bloqueio, com pequena dose de anestésico local, e o tipo de parto ocorrido, pela análise do peso e índice de Apgar do recém-nascido. MÉTODO: Analisaram-se, prospectivamente, os resultados de 168 analgesias de parto (janeiro de 2002 a janeiro de 2003), divididas em quatro grupos: G1 (n = 58) peridural contínua e evolução para parto vaginal; G2 (n = 69) duplo bloqueio e evolução para parto vaginal; G3 (n = 25) peridural contínua e evolução para cesariana; G4 (n = 16) duplo bloqueio e evolução para cesariana. Para G1 foi administrada ropivacaína a 0,125 por cento (12 a 15 mL), para G2, bupivacaína a 0,5 por cento (0,5 a 1 mL), sufentanil (10 mg), por via subaracnóidea. Administrou-se ropivacaína a 0,5 por cento, por via peridural, para o parto vaginal (8 mL) e para cesariana (20 mL). Avaliaram-se idade, peso, altura, índice de massa corpórea (IMC), idade gestacional (IG), paridade e complicações (hipotensão arterial, bradicardia e hipóxia), e, do recém-nascido, peso e índice de Apgar (1°, 5° e 10° min). RESULTADOS: A maioria das parturientes era primigesta, com gestação de termo (uma IG de 28 semanas e nenhum pós-datismo), com peso, G2 < G4, e, IMC, G2 £ G4. Para o peso do RN, G1 < G3 e G2 < G4, e o Apgar do 1° min, G1 > G3. CONCLUSÕES: As técnicas de analgesia, peridural contínua e duplo bloqueio, com pequenas doses de anestésico local, não apresentaram interação com o resultado do parto, se a análise estiver focalizada no peso e no índice de Apgar do recém-nascido.

[The interaction between labor analgesia and its results: assessment using the newborn s weight and Apgar score.]. / Interação entre a analgesia de parto e o seu resultado: avaliação pelo peso e índice de Apgar do recém-nascido.

BACKGROUND AND OBJECTIVES: There are controversies regarding whether labor analgesia can interfere with labor and the vitality of the newborn. The objective of this study was the interaction between labor analgesia, using the continuous epidural and combined spinal-epidural techniques with a small dose of local anesthetic, and the type of delivery analyzing the newborn's weight and Apgar score. METHODS: The results of 168 labor analgesias (from January 2002 to January 2003) were analyzed. They were divided in 4 groups: G1 (n = 58), continuous epidural and evolution to vaginal delivery; G2 (n = 69), combined spinal-epidural and evolution to vaginal delivery; G3 (n = 25), continuous epidural and evolution to cesarean; G4 (n = 16), combined spinal-epidural and evolution to cesarean. G1 received 0.125% ropivacaine (12 to 15 mL), G2 received subarachnoid 0.5% bupivacaine (0.5 to 1 mL) and sufentanil (10 mg). Epidural ropivacaine 0.5% for the vaginal delivery (8 mL) and for cesarean (20 mL). The patient's age, weight, height, body mass index (BMI), gestational age, number of prior pregnancies, and complications (arterial hypotension, bradycardia, and hypoxia) and the newborn's weight and Apgar score (at 1, 5, and 10 minutes) were evaluated. RESULTS: The majority of pregnant women were primiparous and presented with a term pregnancy (one with gestational age of 28 weeks and none post-term pregnancy); weight, G2 < G4; and MBI, G2 pound G4. For the weight of the newborn, G1 < G3 and G2 < G4, and for the Apgar score at 1st minute, G1 > G3. CONCLUSIONS: If the analysis focuses the newborn's weight and Apgar score, the techniques of analgesia, continuous epidural and combined spinal-epidural with small doses of local anesthetic, do not interfere with the result of the delivery.