ABSTRACT
Abstract Objectives: The increase in the prevalence of obesity presents a significant health and economic problem. Obesity has been reported to be a major contributor to variety of chronic diseases. Childhood obesity has been rising over the past decades leading to various complications in health. Millions of infants and children undergo surgery every year on various health grounds. The present investigation was undertaken to evaluate the effect of spinal anesthesia of equipotent doses of ropivacaine and bupivacaine on over-weight neonatal rats. Methods: The Sprague-Dawley rat pups were overfed on high fat diet to induce obesity. Behavioral assessments for sensory and motor blockade was made by evaluating thermal and mechanical withdrawal latencies at various time intervals following intrathecal injections of bupivacaine (5.0 mg·kg-1) and ropivacaine (7.5 mg·kg-1) in P14 rats. Spinal tissue was analyzed for apoptosis by determination of activated caspase-3 using monoclonal anti-activated caspase-3 and Fluoro-Jade C staining. Long-term spinal function in P30 rat pups was evaluated. Results: Exposure to intrathecal anesthesia in P14 increased thermal and mechanical latencies and was observed to increase apoptosis as presented by increase in activated caspase-3 and Fluro-Jade C positive cells. Significant alterations in spinal function were observed in high fat diet-fed pups as against non-obese control pups that were on standard diet. Bupivacaine produced more pronounced apoptotic effects on P14 pups; ropivacaine however produced long lasting effects as evidenced in motor function tests at P30. Conclusion: Ropivacaine and bupivacaine induced spinal toxicity that was more pronounced in over-fed rat pups as against normal controls.
Resumo Objetivos: O aumento da prevalência da obesidade é um problema sério de saúde e econômico. A obesidade tem sido relatada como um dos principais contribuintes para uma variedade de doenças crônicas. A obesidade infantil tem aumentado nas últimas décadas e levado a complicações de saúde. Milhões de bebês e crianças são submetidos a cirurgia todos os anos por diversos motivos de saúde. O presente estudo foi feito para avaliar o efeito da raquianestesia com doses equipotentes de ropivacaína e bupivacaína em ratos recém-nascidos com sobrepeso. Métodos: As crias de ratos Sprague-Dawley foram alimentadas em excesso com dieta rica em gordura para induzir obesidade. Avaliações comportamentais para bloqueio sensorial e motor foram feitas por meio da avaliação das latências de retirada térmicas e mecânicas em vários intervalos de tempo após injeções por via intratecal de bupivacaína (5,0 mg·kg-1) e ropivacaína (7,5 mg·kg-1) em ratos P14. Tecido medular foi analisado para apoptose por determinação da caspase-3 ativada, com o uso de anticorpo monoclonal anti-caspase 3 ativada e ecoloração com Fluoro-Jade C. A função da coluna vertebral em longo prazo em filhotes de ratos P30 foi avaliada. Resultados: A exposição à anestesia intratecal em P14 aumentou as latências térmicas e mecânicas e observamos aumento da apoptose, como apresentado pelo aumento da caspase-3 ativada e células positivas para Fluro-Jade C. Alterações significativas da função da coluna vertebral foram observadas em filhotes alimentados com dieta rica em gordura versus filhotes controles não obesos em dieta padrão. Bupivacaína produziu efeitos apoptóticos mais pronunciados sobre os filhotes P14; ropivacaína, entretanto, produziu efeitos duradouros, como evidenciado nos testes de função motora em P30. Conclusão: Ropivacaína e bupivacaína induziram toxicidade medular mais pronunciada nos filhotes de ratos sobrealimentados do que nos controles normais.
Subject(s)
Animals , Male , Female , Rats , Bupivacaine/administration & dosage , Amides/administration & dosage , Anesthetics, Local/administration & dosage , Obesity/complications , Time Factors , Injections, Spinal , Bupivacaine/toxicity , Rats, Sprague-Dawley , Apoptosis/drug effects , Disease Models, Animal , Overweight/complications , Caspase 3/metabolism , Diet, High-Fat , Ropivacaine , Amides/toxicity , Anesthesia, Spinal/adverse effects , Anesthesia, Spinal/methods , Anesthetics, Local/toxicity , Animals, NewbornABSTRACT
Objective To investigate the related factors for postoperative urinary retention in patients with intrathecal anesthesia. Methods Collect 230 patients of orthopaedic surgery with intrathecal anesthesia in our hospital from June 2012 to June 2013. Prospective analysis the related factors of postoperative urinary retention in patients with intrathecal anesthesia. Results 48 cases have postoperative urinary retention from 230 patients of orthopaedic surgerywith intrathecal anesthesia. Difference of urinary retention group and unurinary retention group is statistically significant (P 0.05) in Sex, body mass index, smoking history, the mode of anesthesia Age, operation time, intraoperative rehydration, anesthetic dosage ≥11.25 mg and postoperative analgesia are the risk factors of postoperative urinary retention with multiariable Logistic regression analysis. The urine excretion before anesthesia are protective factors. Conclusion postoperative urinary retention with intrathecal anesthesia is many factors caused by a temporary performance of bladder dysfunction , Perioperative appropriate management (minimize anesthetic doses, shorten the operation time, control intraoperatie rehydration , preoperative try to drain urine ) can reduce the occurrence of postoperative urinary retention.