Protective effects of intravenous anesthetics on kidney tissue in obstructive jaundice.
OBJECTIVE
To evaluate the protective effects on kidney tissue of frequently used intravenous anesthetics (ketamine, propofol, thiopental, and fentanyl) in rats with obstructive jaundice.


METHODS
There is an increased incidence of postoperative acute renal failure in patients with obstructive jaundice. Thirty-two Wistar-albino rats were randomly divided into four equal groups. Laparatomy was performed on each animal in the four groups and common bile ducts were ligated and severed on day 0. After 7 d, laparotomy was again performed using ketamine, propofol, thiopental, or fentanyl anesthesia whose antioxidative properties are well known in oxidative stress in a rat liver model of obstructive jaundice. After 2 h, the rats were sacrificed. Renal tissue specimens were analyzed for catalase, superoxide dismutase and malondialdehyde enzymes activities. All values are expressed as the mean ± SD. P values less than 0.05 were considered statistically significant.


RESULTS
All animals survived without complications until the end of the study. Enlargement in the bile duct and obstructive jaundice were observed in all rats. Catalase was found to be significantly lower in the fentanyl group than in the ketamine (P = 0.039), propofol (P = 0.012), and thiopental (P = 0.001) groups. Superoxide dismutase activities were similar in all groups (P > 0.05). Malondialdehyde was found to be significantly lower in the ketamine group than in the propofol (P = 0.028), thiopental (P = 0.002) and fentanyl (P = 0.005) groups. Malondialdehyde was also lower in the fentanyl group than in the thiopental group (P = 0.001). The results showed that obstructive jaundice sensitizes renal tissue to damage under the different anesthetics.


CONCLUSIONS
Among the agents tested, ketamine and propofol generated the least amount of oxidative stres on renal tissues in this rat model of obstructive jaundice created by common bile duct ligation. The importance of free radical injury in renal tissue in obstructive jaundice under different intravenous anesthetics during hepatobiliary and liver transplant surgery should be considered for prevention of postoperative acute renal failure.
Sinan Hatipoglu, Department of General Surgery Unit, School of Medicine, Adiyaman University, 02040 Adiyaman, Turkey.
Sinan
S
Hatipoglu
Sinan Hatipoglu, Department of General Surgery Unit, School of Medicine, Adiyaman University, 02040 Adiyaman, Turkey.
Huseyin
H
Yildiz
Sinan Hatipoglu, Department of General Surgery Unit, School of Medicine, Adiyaman University, 02040 Adiyaman, Turkey.
Ertan
E
Bulbuloglu
Sinan Hatipoglu, Department of General Surgery Unit, School of Medicine, Adiyaman University, 02040 Adiyaman, Turkey.
Ismail
I
Coskuner
Sinan Hatipoglu, Department of General Surgery Unit, School of Medicine, Adiyaman University, 02040 Adiyaman, Turkey.
Ergul Belge
EB
Kurutas
Sinan Hatipoglu, Department of General Surgery Unit, School of Medicine, Adiyaman University, 02040 Adiyaman, Turkey.
Filiz
F
Hatipoglu
Sinan Hatipoglu, Department of General Surgery Unit, School of Medicine, Adiyaman University, 02040 Adiyaman, Turkey.
Harun
H
Ciralik
Sinan Hatipoglu, Department of General Surgery Unit, School of Medicine, Adiyaman University, 02040 Adiyaman, Turkey.
Mehmet Sait
MS
Berhuni
D061605:Administration, Intravenous; D018686:Anesthetics, Intravenous / Q000627:therapeutic use*; D000818:Animals; D000975:Antioxidants / Q000378:metabolism; D002374:Catalase / Q000378:metabolism; D005283:Fentanyl / Q000008:administration & dosage; D041781:Jaundice, Obstructive / Q000188:drug therapy* / Q000473:pathology*; D007649:Ketamine / Q000008:administration & dosage; D007668:Kidney / Q000187:drug effects* / Q000473:pathology*; D008297:Male; D008315:Malondialdehyde / Q000378:metabolism; D018384:Oxidative Stress; D015742:Propofol / Q000008:administration & dosage; D051381:Rats; D017208:Rats, Wistar; D013482:Superoxide Dismutase / Q000378:metabolism; D013874:Thiopental / Q000008:administration & dosage
D018686:Anesthetics, Intravenous; D000975:Antioxidants; D008315:Malondialdehyde; D007649:Ketamine; D002374:Catalase; D013482:Superoxide Dismutase; D013874:Thiopental; D005283:Fentanyl; D015742:Propofol
Intravenous anesthetics; Obstructive jaundice; Oxidative stress; Postoperative acute renal failure; Renal tissue damage