Klonidin, deksmedetomidin ve midazolamın normal ve peritonitli sıçan kolon peristaltik hareketleri üzerine olan inhibitör etkilerinin karşılaştırılması
Abstract
Özet
Amaç. Bu deneysel çalışmada, genellikle yoğun bakımda sedasyon amacı ile kullanılan deksmedetomidin, midazolam ve klonidinin normal ve peritonitli sıçan kalın barsak motilitesi üzerindeki inhibitör etkileri araştırılmıştır. Yöntem. Çalışmamızda her grupta 8 adet rat olan 2 grup oluşturuldu. Kontrol grubuna sham operasyonu, peritonit grubuna ise çekum ligasyonu ve perforasyonu operasyonu yapıldı. Operasyonlardan 24 saat sonra her iki gruptaki sıçanlar öldürülerek proksimal kolon ve distal kolon dokuları alınıp Krebs Bikarbonat solüsyonu içinde 1 cm’lik preparatlar halinde organ banyosuna asılarak KCl ile kastırıldıktan sonra, spontan kasılma yanıtları ve spontan kasılmalar üzerine deksmedetomidin, midazolam ve klonidin’in inhibitör etkilerine bakıldı. Bulgular. Çalışmamızda KCl yanıtları arasında fark yoktu. Proksimal kolonun spontan kasılmaları distal kolona göre daha fazlaydı ve peritonitli grupta kontrol grubuna göre spontan kasılmalar daha fazlaydı. İlaçların üçü de her iki grupta konsantrasyona bağlı olarak spontan kasılmalarda inhibisyon yaptı. Bu inhibitör etkiler kontrol grubunda peritonitli gruba göre daha fazlaydı. Her grup ve her dokuda da bu 3 ilacın spontan kasılmalar üzerinde inhibitör etki bakımından en güçlüsü deksmedetomidin ve distal kolon peritonitli grup hariç en zayıfı da klonidin’di. Sonuç. Bu sonuçlar bize spontan aktiviteleri azaltma ve önleme açısından özellikle kontrol gruplarında deksmedetomidinin diğerlerine göre daha etkili olduğunu ve yoğun bakımdaki ishalli hastalarda (peritonit veya değil) bu 3 ilacın da kullanılabileceği ama deksmedetomidinin diğerlerine göre daha faydalı olabileceğini düşündürmektedir.
Anahtar sözcükler: Deksmedetomidin, midazolam, klonidin, peritonit, spontan kasılmalar, yoğun bakım
Abstract
Aims. In this experimental study, the inhibitor effects of dexmedetomidine, midazolam and clonidine, generally used for sedation in intensive care units, on rat colon motility in control and peritonitis groups were investigated. Methods. Sixteen rats were allocated into two groups (eight in each). The first sham group underwent the same surgical procesure with the peritonitis group. Rats in the second group underwent cecal puncture and ligation. At the second laparotomy, 24 h later the rats were killed. The abdomen was opened and proximal and distal colon were removed and placed in Krebs-bicarbonate solution. Proximal and distal colon segments with 1 cm thickness were placed in circular direction in tissue baths, filled with Krebs Bicarbonate solution (KBS). By this way, after KCl contraction responses, spontaneous contraction responses and inhibitor effects of dexmedetomidine, midazolam and clonidine on spontaneous contractions were evaluated. Results. In our study, contractions induced by KCl were not significantly different between the peritonitis group and the control group. The amplitude of spontaneous contractions of proximal colon was higher than distal colon. Also the amplitude of spontaneous contractions of peritonitis group was higher than control group. Dexmedetomidine, midazolam and clonidine inhibited spontaneous contractions of colon strips in both peritonitis and control groups. This inhibitor effect was prominent in control group. In case of inhibitor effect on colon motility, in all groups and tissues, although the most potent drug was dexmedetomidine, the less was clonidine except in distal colon. The inhibitor effects of midazolam and colonidine was similar in distal colon. Conclusion. These results suggest that Dexmedetomidine is more effective that other drugs in inhibition of spontaneous contractions, especially in control groups and these drugs, especially dexmedetomidine, may be used for the patients with diarrhea in intensive care units.
Keywords: Dexmedetomidine, midazolam, clonidine, peritonitis, spontaneous contractions, intensive care unit.
Keywords
References
- Thijs LG, Hack CE. Time course of cytokine levels in sepsis. Int Care Med 1995; 21: 258-63.
- Pinsky MR, Matunschak GM. A unifying hypothesis of multiple systems organ failure: failure of host defense homeostasis. J Crit Care 1990; 5: 108-14.
- Yıldız T, Köylüoğlu G, Bagcıvan I, Kaya T, Karadas B, Sarac B, Cankorkmaz L. Alterations in spontaneous contractions of rat proximal and distal colon after peritonitis. J Pediatr Surg 2007; 42: 1215-20.
- Lodato RF, Khan AR, Zembowicz MJ, Weisbrodt NW, Presley TA, Li YF, Lodato JA, Zemboeicz A, Moody FG. Roles of IL-1 and TNF in the decreased ileal muscle contractilitiy induced by lipopolysaccharide. Am J Physiol 1999 ; 276: 1356-62.
- Kamibayashi T.,Maze M., Clinical uses of α2 adrenergic agonists. Anesthesiology 2000; 93: 1345-9.
- Segal IS, Vickery RG, Walton JK, Doze VA, Maze M. Dexmedetomidine diminishes halothane aneshetic requirements in rats through a postsynaptic α2 adrenergic receptor. Anesthesiology 1988; 69: 818-22.
- Herbert MK, Goldbrunner SR, Holzer P, Roewer N. Clonidine and dexmedetomidine potently inhibit peristalsis in the guinea pig ileum in vitro. Anesthesiology 2002; 97: 1491-9.
- Virtanen R, Savola JM, Saano V, Lyman L. Characterizetion of selectivity, spesifity and potency of medetomidine as an alpha 2-adrenoceptor agonist. Eur J Pharmacol 198; 150: 9-14.
- Lowson SM, Sawh S. Adjuncts to analgesia. Sedation and neuromuscular blokade. Crit Care Clin 1999; 15: 119-41.
- Asai T, Mapleson WW, Power I. Differential effects clonidine and dexmedetomidine on gastric emptying and gastrointestinal transit in the rat. Br J Anaesth 1997; 78: 301-7.
- Rubinoff MJ, Piccione PR, Holt PR. Clonidine prolongs human small intestine transit time: Use of thelactulose-breath hydrogen test. Am J Gastroenterol 1989; 84: 372-4.
- Bauer GE, Hellesstrand KJ. Pseudo-obstruction due to clonidine (short report) Br Med J 1976; 1: 769.
- Stieger DS, Cantieni R, Frutiger A. Acute colonic pseudoobstruction (Ogilvie’s syndrome) in two patients receiving high dose clonidine for delirium tremens. Intensive Care Med 1997; 23: 780-2.
- Walder B, Tramer MR. Analgesia and sedation in critically ill patients. Swiss Med Wkly 2004; 134: 333-46.
- Koyluoglu G, Bagcivan İ, Karadas B, Guney C, Durmus N, Altun A, Kaya T. Alterations in spontaneous contractions of rat ilum and jejunum after peritonitis. Eur J Pharmacol 2008; 580: 250-55.
- Avila A, Warshawki F, Sibbld W, Finley R, Wells G, Holiday R. İncreased peripheral microvascular permeability accompanying systemic sepsis. Surgery 1985; 97: 685-95.
- Hersch M, Gnidec AA, Bertsen AD, Troster M, Rutledge FS, Sibbald WJ. Histologic and ultrastructural changes in nonpulmonary organs durin early hyperdynamic sepsis. Surgery 1990; 107: 397-410.
- Judges D, Sharkey P, Cheung H, Craing I, Driedger AA, Sibbald WJ, Finley R. Pulmonary microvascular fluid flux in alarge animal model of sepsis: Evidence for increased pulmanary endothelial permeability accompanying surgically peritonitis in sheep. Surgery 1986; 99: 222-34.
- Liu L, Coupar IM. Characterisation of pre- and post-synaptic alpha-adrenoceptors in modulation of the rat ileum longitudinal and circular muscle activities. Naunyn Schmiedebergs Arch Pharmacol 1997; 356: 248-56.
- Ostermann ME, Kenan SP, Seiferling RA, Sibbald WJ. Sedation in the intensive care unit. A systematic rewiew. JAMA 2000; 283: 1451-59.
- Castedal M, Björnsson E, Abrahamsson H. Effects of midazolam on small bowel motility in humans. Aliment Pharmacol Ther. 2000; 14: 571-7.
Abstract
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Keywords
References
- Thijs LG, Hack CE. Time course of cytokine levels in sepsis. Int Care Med 1995; 21: 258-63.
- Pinsky MR, Matunschak GM. A unifying hypothesis of multiple systems organ failure: failure of host defense homeostasis. J Crit Care 1990; 5: 108-14.
- Yıldız T, Köylüoğlu G, Bagcıvan I, Kaya T, Karadas B, Sarac B, Cankorkmaz L. Alterations in spontaneous contractions of rat proximal and distal colon after peritonitis. J Pediatr Surg 2007; 42: 1215-20.
- Lodato RF, Khan AR, Zembowicz MJ, Weisbrodt NW, Presley TA, Li YF, Lodato JA, Zemboeicz A, Moody FG. Roles of IL-1 and TNF in the decreased ileal muscle contractilitiy induced by lipopolysaccharide. Am J Physiol 1999 ; 276: 1356-62.
- Kamibayashi T.,Maze M., Clinical uses of α2 adrenergic agonists. Anesthesiology 2000; 93: 1345-9.
- Segal IS, Vickery RG, Walton JK, Doze VA, Maze M. Dexmedetomidine diminishes halothane aneshetic requirements in rats through a postsynaptic α2 adrenergic receptor. Anesthesiology 1988; 69: 818-22.
- Herbert MK, Goldbrunner SR, Holzer P, Roewer N. Clonidine and dexmedetomidine potently inhibit peristalsis in the guinea pig ileum in vitro. Anesthesiology 2002; 97: 1491-9.
- Virtanen R, Savola JM, Saano V, Lyman L. Characterizetion of selectivity, spesifity and potency of medetomidine as an alpha 2-adrenoceptor agonist. Eur J Pharmacol 198; 150: 9-14.
- Lowson SM, Sawh S. Adjuncts to analgesia. Sedation and neuromuscular blokade. Crit Care Clin 1999; 15: 119-41.
- Asai T, Mapleson WW, Power I. Differential effects clonidine and dexmedetomidine on gastric emptying and gastrointestinal transit in the rat. Br J Anaesth 1997; 78: 301-7.
- Rubinoff MJ, Piccione PR, Holt PR. Clonidine prolongs human small intestine transit time: Use of thelactulose-breath hydrogen test. Am J Gastroenterol 1989; 84: 372-4.
- Bauer GE, Hellesstrand KJ. Pseudo-obstruction due to clonidine (short report) Br Med J 1976; 1: 769.
- Stieger DS, Cantieni R, Frutiger A. Acute colonic pseudoobstruction (Ogilvie’s syndrome) in two patients receiving high dose clonidine for delirium tremens. Intensive Care Med 1997; 23: 780-2.
- Walder B, Tramer MR. Analgesia and sedation in critically ill patients. Swiss Med Wkly 2004; 134: 333-46.
- Koyluoglu G, Bagcivan İ, Karadas B, Guney C, Durmus N, Altun A, Kaya T. Alterations in spontaneous contractions of rat ilum and jejunum after peritonitis. Eur J Pharmacol 2008; 580: 250-55.
- Avila A, Warshawki F, Sibbld W, Finley R, Wells G, Holiday R. İncreased peripheral microvascular permeability accompanying systemic sepsis. Surgery 1985; 97: 685-95.
- Hersch M, Gnidec AA, Bertsen AD, Troster M, Rutledge FS, Sibbald WJ. Histologic and ultrastructural changes in nonpulmonary organs durin early hyperdynamic sepsis. Surgery 1990; 107: 397-410.
- Judges D, Sharkey P, Cheung H, Craing I, Driedger AA, Sibbald WJ, Finley R. Pulmonary microvascular fluid flux in alarge animal model of sepsis: Evidence for increased pulmanary endothelial permeability accompanying surgically peritonitis in sheep. Surgery 1986; 99: 222-34.
- Liu L, Coupar IM. Characterisation of pre- and post-synaptic alpha-adrenoceptors in modulation of the rat ileum longitudinal and circular muscle activities. Naunyn Schmiedebergs Arch Pharmacol 1997; 356: 248-56.
- Ostermann ME, Kenan SP, Seiferling RA, Sibbald WJ. Sedation in the intensive care unit. A systematic rewiew. JAMA 2000; 283: 1451-59.
- Castedal M, Björnsson E, Abrahamsson H. Effects of midazolam on small bowel motility in humans. Aliment Pharmacol Ther. 2000; 14: 571-7.
Klonidin, deksmedetomidin ve midazolamın normal ve peritonitli sıçan kolon peristaltik hareketleri üzerine olan inhibitör etkilerinin karşılaştırılması
Abstract
Amaç. Bu deneysel çalışmada, genellikle yoğun bakımda sedasyon amacı ile kullanılan
deksmedetomidin, midazolam ve klonidinin normal ve peritonitli sıçan kalın barsak motilitesi
üzerindeki inhibitör etkileri araştırılmıştır. Yöntem. Çalışmamızda her grupta 8 adet rat olan 2
grup oluşturuldu. Kontrol grubuna sham operasyonu, peritonit grubuna ise çekum ligasyonu ve
perforasyonu operasyonu yapıldı. Operasyonlardan 24 saat sonra her iki gruptaki sıçanlar
öldürülerek proksimal kolon ve distal kolon dokuları alınıp Krebs Bikarbonat solüsyonu içinde 1
cm’lik preparatlar halinde organ banyosuna asılarak KCl ile kastırıldıktan sonra, spontan kasılma
yanıtları ve spontan kasılmalar üzerine deksmedetomidin, midazolam ve klonidin’in inhibitör
etkilerine bakıldı. Bulgular. Çalışmamızda KCl yanıtları arasında fark yoktu. Proksimal kolonun
spontan kasılmaları distal kolona göre daha fazlaydı ve peritonitli grupta kontrol grubuna göre
spontan kasılmalar daha fazlaydı. İlaçların üçü de her iki grupta konsantrasyona bağlı olarak
spontan kasılmalarda inhibisyon yaptı. Bu inhibitör etkiler kontrol grubunda peritonitli gruba göre
daha fazlaydı. Her grup ve her dokuda da bu 3 ilacın spontan kasılmalar üzerinde inhibitör etki
bakımından en güçlüsü deksmedetomidin ve distal kolon peritonitli grup hariç en zayıfı da
klonidin’di. Sonuç. Bu sonuçlar bize spontan aktiviteleri azaltma ve önleme açısından özellikle
kontrol gruplarında deksmedetomidinin diğerlerine göre daha etkili olduğunu ve yoğun bakımdaki
ishalli hastalarda (peritonit veya değil) bu 3 ilacın da kullanılabileceği ama deksmedetomidinin
diğerlerine göre daha faydalı olabileceğini düşündürmektedir.
References
- Thijs LG, Hack CE. Time course of cytokine levels in sepsis. Int Care Med 1995; 21: 258-63.
- Pinsky MR, Matunschak GM. A unifying hypothesis of multiple systems organ failure: failure of host defense homeostasis. J Crit Care 1990; 5: 108-14.
- Yıldız T, Köylüoğlu G, Bagcıvan I, Kaya T, Karadas B, Sarac B, Cankorkmaz L. Alterations in spontaneous contractions of rat proximal and distal colon after peritonitis. J Pediatr Surg 2007; 42: 1215-20.
- Lodato RF, Khan AR, Zembowicz MJ, Weisbrodt NW, Presley TA, Li YF, Lodato JA, Zemboeicz A, Moody FG. Roles of IL-1 and TNF in the decreased ileal muscle contractilitiy induced by lipopolysaccharide. Am J Physiol 1999 ; 276: 1356-62.
- Kamibayashi T.,Maze M., Clinical uses of α2 adrenergic agonists. Anesthesiology 2000; 93: 1345-9.
- Segal IS, Vickery RG, Walton JK, Doze VA, Maze M. Dexmedetomidine diminishes halothane aneshetic requirements in rats through a postsynaptic α2 adrenergic receptor. Anesthesiology 1988; 69: 818-22.
- Herbert MK, Goldbrunner SR, Holzer P, Roewer N. Clonidine and dexmedetomidine potently inhibit peristalsis in the guinea pig ileum in vitro. Anesthesiology 2002; 97: 1491-9.
- Virtanen R, Savola JM, Saano V, Lyman L. Characterizetion of selectivity, spesifity and potency of medetomidine as an alpha 2-adrenoceptor agonist. Eur J Pharmacol 198; 150: 9-14.
- Lowson SM, Sawh S. Adjuncts to analgesia. Sedation and neuromuscular blokade. Crit Care Clin 1999; 15: 119-41.
- Asai T, Mapleson WW, Power I. Differential effects clonidine and dexmedetomidine on gastric emptying and gastrointestinal transit in the rat. Br J Anaesth 1997; 78: 301-7.
- Rubinoff MJ, Piccione PR, Holt PR. Clonidine prolongs human small intestine transit time: Use of thelactulose-breath hydrogen test. Am J Gastroenterol 1989; 84: 372-4.
- Bauer GE, Hellesstrand KJ. Pseudo-obstruction due to clonidine (short report) Br Med J 1976; 1: 769.
- Stieger DS, Cantieni R, Frutiger A. Acute colonic pseudoobstruction (Ogilvie’s syndrome) in two patients receiving high dose clonidine for delirium tremens. Intensive Care Med 1997; 23: 780-2.
- Walder B, Tramer MR. Analgesia and sedation in critically ill patients. Swiss Med Wkly 2004; 134: 333-46.
- Koyluoglu G, Bagcivan İ, Karadas B, Guney C, Durmus N, Altun A, Kaya T. Alterations in spontaneous contractions of rat ilum and jejunum after peritonitis. Eur J Pharmacol 2008; 580: 250-55.
- Avila A, Warshawki F, Sibbld W, Finley R, Wells G, Holiday R. İncreased peripheral microvascular permeability accompanying systemic sepsis. Surgery 1985; 97: 685-95.
- Hersch M, Gnidec AA, Bertsen AD, Troster M, Rutledge FS, Sibbald WJ. Histologic and ultrastructural changes in nonpulmonary organs durin early hyperdynamic sepsis. Surgery 1990; 107: 397-410.
- Judges D, Sharkey P, Cheung H, Craing I, Driedger AA, Sibbald WJ, Finley R. Pulmonary microvascular fluid flux in alarge animal model of sepsis: Evidence for increased pulmanary endothelial permeability accompanying surgically peritonitis in sheep. Surgery 1986; 99: 222-34.
- Liu L, Coupar IM. Characterisation of pre- and post-synaptic alpha-adrenoceptors in modulation of the rat ileum longitudinal and circular muscle activities. Naunyn Schmiedebergs Arch Pharmacol 1997; 356: 248-56.
- Ostermann ME, Kenan SP, Seiferling RA, Sibbald WJ. Sedation in the intensive care unit. A systematic rewiew. JAMA 2000; 283: 1451-59.
- Castedal M, Björnsson E, Abrahamsson H. Effects of midazolam on small bowel motility in humans. Aliment Pharmacol Ther. 2000; 14: 571-7.
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Basic Science Research Articles |
| Authors | |
| Publication Date | August 13, 2009 |
| Published in Issue | Year 2009Volume: 31 Issue: 4 |