Investigation of histopathological effects after intra-arterial sugammadex injection in an experimental animal model.

PURPOSE: Intra-arterial injection of medications are related to mortality and morbidity. It was aimed to investigate the histopathological effects caused by two different intra-arterial doses of sugammadex, a new selective relaxant binding agent used to reverse the effects of steroidal systemic muscle relaxants used in surgeries carried out under general anesthesia. METHODS: A total of 15 rabbits were randomly divided into 3 groups. The control group was given 1 mL saline bolus into the central artery of the ear. The other two groups (Group Sgdx2 and group Sgdx16) were given 2 and 16 mg/kg sugammadex, respectively, intra-arterially. RESULTS: In control group, histopathological evaluation was in normal limits. The cross-sections belonging to Group Sgdx2 did not have any significant pathological change compared with control group (p > 0.05). Edema and single-cell necrosis were significantly higher in Group Sgdx16 when compared to control group (p < 0.05). In comparison to Group Sgdx2, single-cell necrosis was significantly higher in Group Sgdx16 (p < 0.05). CONCLUSION: Being broadly used in anesthesia, sugammadex should be administered with care because when given by intra-arterial route it may cause tissue damage and tissue loss and the patients' arteries should be carefully checked.

Effects of tenoxicam in experimental corrosive esophagitis model.

Esophageal stricture, one of the important complications of corrosive esophagus, develops following edema and granulation tissue that forms during and after the inflammatory reactions. Tenoxicam, a non-steroid anti-inflammatory drug with a long half-life, prevents various leukocyte functions including phagocyte and histamine secretion by inhibiting prostaglandin synthesis and removes various oxygen radicals in the region of inflammation. We designed this as a histopathological study using tenoxicam in rats for which we created a corrosive esophagus model. After necessary authorizations were obtained, the study was performed in Çanakkale 18 Mart University experimental animal laboratory. Twenty-four Wistar albino rats, weighing 220-240 g, were used for the experiment. Experimental animals were randomized into three groups: tenoxicam group (group T, n:8), control group (group C, n:8), and sham group (group S, n:8). Tenoxicam 0.5 mg/kg/day was administered to animals in group T, where esophageal burn was developed experimentally, 5 mg/kg 0.9% NaCL was administered i.p. to rats in group C for 15 days, once in 24 hours. No procedure was applied to rats in group S. After 15 days, all animals were sacrificed under general anesthesia and their esophagi were extracted. As a result of histopathological evaluation, inflammation and fibroblast proliferation was not observed in rats in the sham group (group S). Intense inflammation was observed in six rats (6+/2-) in the control group, and fibroblast proliferation was observed as 5+/3-. And in treatment groups, inflammation was evaluated as 3+/5-, and fibroblast proliferation as 3+/5-. In our study, histopathologic damage score was higher in the control group (P < 0.005). We deduce that tenoxicam can be useful in the treatment of caustic esophageal injuries in the acute phase, but think that these drugs require further researches and clinical studies before routine clinical use.

Comparison of effects of classic LMA, cobraPLA and V-gel rabbit on QTc interval.

AIM: We aimed to compare the effects of three different supraglottic airway devices, the classic LMA, PLA, and V-gel, on hemodynamics and QTc in rabbits under general anesthesia. METHOD: The rabbits were divided into four groups: Group C (n=5) control group with no airway device used, Group L (n=5, classic LMA), Group P (n=5, CobraPLA) and Group V (n=5, V-gel-rabbit). Basal values of heart rate (HR), mean arterial pressure (MAP) and ECG for QTc interval were measured and the measurements were evaluated at 1, 5, 15, and 30 minutes after inserting the airway device RESULTS: The values of HR, MAP and QTc in Group V at minutes 1 and 5 were significantly different to those in Group L and Group P (p<0.05). DISCUSSION: The classic-LMA and cobraPLA cover a wide part of the perilaryngeal area with cuffs inflated to about 60 cmH2O of pressure resulting in mucosal compression. As V-gel rabbit does not have a cuff, it covers a smaller part of the laryngopharyngeal area, and thus does not cause mucosal compression, and the hemodynamic response is weaker. CONCLUSION: When comparing hemodynamic responses to other supraglottic airway devices, the response to V-gel rabbit is minimal and we consider that similar studies using the I-gel on humans are required (Fig. 5, Ref. 31).

Effects of fine-needle aspiration biopsy (FNAB) nodule depth on pain score.

PURPOSE: Fine-needle aspiration biopsy (FNAB) of the thyroid is generally a well-tolerated procedure associated with weak levels of pain. However, pain may be very intense in some patients. The cause for the pain in these patients has not been identified. The hypothesis of this study is that there is a likely relationship between pain level and nodule depth during FNAB. MATERIALS AND METHODS: Included in the study were 98 patients with euthyroid nodular goiter who underwent FNAB. When ultrasound guided thyroid fine-needle aspiration biopsy was performed findings such as the distance of the nodule to the skin, the size of the nodule, visual analogue scale (VAS) score values were recorded. FINDINGS: The distance of nodule to skin and nodule size was measured, respectively, as 10.7 ± 2.8 mm and 21.7 ± 8.6 mm. Mean VAS score was 36 ± 16. FNAB-related pain was correlated with the nodule depth (r = 0.43, p < 0.001). In the logistic regression analysis, we also found that high VAS score class was effected by only nodule depth (B = -1.619; OR 1.287; CI 1.057-1.565, p < 0.05). CONCLUSION: Our results show that pain increased significantly during FNAB in patients who had more deeply situated nodules. Local anesthetic methods may be recommended for these patients.