Habib Bostan

Reversal of Rocuronium-Induced Neuromuscular Block with Sugammadex and Resulting Histopathological Effects in Rat Kidneys

Background: This study investigated the effect of injection of rocuronium or sugammadex alone and rocuronium + sugammadex on urea, creatinine, electrolyte levels, and histopathological findings in rats. Methods: Thirty-six Sprague-Dawley male rats were divided to receive intravenously 16 or 96 mg/kg sugammadex, 1 mg/kg rocuronium, 1 mg/kg rocuronium + 16 mg/kg sugammadex, or 1 mg/kg rocuronium + 96 mg/kg sugammadex. The control group received an equal volume of physiological serum. Rats receiving rocuronium were ventilated until resumption of spontaneous ventilation and followed for 72 h. Blood samples were withdrawn from the tail vein to measure urea, creatinine, and electrolyte values; then both kidneys were excised, and the tissues were used for histopathological examination. Results: Rats receiving rocuronium and high doses of sugammadex (96 mg/kg) showed increased glomerular vacuolation, tubular dilatation, vascular vacuolation and hypertrophy, lymphocyte infiltration, and tubular cell sloughing compared to the control group (p = 0.002). Biochemical markers of renal function were not significantly altered after treatment with high doses of sugammadex. Conclusion: The elimination half-life of the rocuronium–sugammadex complex was found to be greater than that of free rocuronium or sugammadex, which led to marginal histopathological changes in the kidney without affecting any renal functions.

In vitro evaluation of antimicrobial features of vasopressors

BACKGROUND Drugs administered as intravenous infusion may be contaminated during several stages of production or preparation. However studies focusing on antibacterial effects of vasopressor drugs are very rare. This study investigates the in vitro antimicrobial activity of the clinically used forms of vasopressors. MATERIALS AND METHODS In vitro antimicrobial activities of vasopressor drugs of different concentrations were investigated by using the micro dilution technique. Microorganisms used in the test were Escherichia coli ATCC 25922, Yersinia pseudotuberculosis ATCC 911, Pseudomonas aeruginosa ATCC 10145, Listeria monocytogenes ATCC 43251, Enterococcus faecalis ATCC 29212, Staphylococcus aureus ATCC 25923, Bacillus cereus 702 Roma, Mycobacterium smegmatis ATCC607, Candida albicans ATCC 60193, and Saccharomyces cerevisiae RSKK 251. Antibacterial assays were performed in Mueller-Hinton broth at pH 7.3 and antifungal assays were performed in buffered Yeast Nitrogen Base at pH 7.0. RESULTS Two different dopamine preparations showed antimicrobial activity. No other study drug showed any antimicrobial activity. CONCLUSIONS In our opinion, dopamines antibacterial effects may be advantageous for inhibiting the spread of bacterial contamination during the preparation of the infusion solutions. However, it is important that strict guidelines regarding the need for sterile equipment and deliverables be adhered to during all procedures performed in the intensive care units.

Effect of sugammadex on rocuronium induced changes in pancreatic mast cells

Mast cells play a vital role in hypersensitivity reactions. Rocuronium is known to cause mast cell mobilization, hypersensitivity, and pancreatitis. The aim of this study was to investigate the effects of sugammadex on pancreatic changes due to rocuronium. A total of 42 Sprague-Dawley male rats were divided into six equal groups to receive either rocuronium 1 mg/kg intravenously (i.v., R group), rocuronium 1 mg/kg + sugammadex 16 mg/kg i.v. (RS16 group), rocuronium 1 mg/kg + sugammadex 96 mg/kg i.v. (RS96 group), sugammadex 16 mg/kg (S16), sugammadex 96 mg/kg i.v. (S96 group), or 0.9% sodium chloride (control group). Sugammadex was administered 5s later following rocuronium. In R group, mast count was higher, and the distribution rate of granules and nuclear changes were different compared with other groups. Distribution rate of granules in groups S16 and S96 were similar to the control group and lower compared with other groups. The amount of mast cells and granule density in groups RS16 and RS96 was lower compared with R group. The amount of mast cells in groups RS16 and RS96 was significantly lower compared with other treatment groups. These results suggest that sugammadex may have an inhibitory effect on mobilization and morphological changes in pancreatic mast cells induced by administration of rocuronium and sugammadex in rats.

The Effects of Long Term Ketamine Use on Pancreatic Islet Cells

Objective: Ketamine is a frequently used anesthetic with a prominent effect on blood glucose levels. Therefore, ketamine may alter the mode of action of pancreatic islet cells, and the prolonged use of this agent may cause functional or morphological alterations of the pancreatic tissue. This study compared prolonged and different doses of intraperitoneal ketamine administration on pancreatic islet cell morphology and secretory function in rats. Material and Methods: A total of 30 rats in five groups were used. Rats in groups K40, K60, K80 and K100 received 40, 60, 80, and 100 mg/kg ketamine hydrochloride intraperitoneally (i.p.), respectively. Control group received 0.9% NaCl i.p.. Injections were repeated twice daily for 2 weeks. After 2 weeks, the animals were sacrificed under anesthesia, pancreas tissues were removed and examined using immunohistological staining, light microscopy, and electron microscopy. Results: Prolonged use of ketamine caused histological alterations as observed by electron microscopy in all groups and by light microscopy in all groups except K40. Immunopositivities for insulin and glucagon was statistically significantly higher in the control group compared to study groups, but did not differ between study groups. Conclusions: We demonstrated that the long-term ketamine use had pathological effects on the pancreas histology. Therefore, it should be kept in mind that ketamine causes pancreas damage and should be used cautiously. Further investigations are needed to find out whether these effects are permanent or not.