Remifentanil protects uterus against ischemia-reperfusion injury in rats

Abstract

PURPOSE:To investigate the effects of remifentanil as an antioxidant and analyze the histopathologic, biochemical changes in experimental ischemia-reperfusion (I/R) exposed rat uteri. METHODS:Wistar albino rats were assigned to three groups (n = 7). 2h period of ischemia was followed by 1h of reperfusion in the I/R and the I/R-remifentanil groups. After ischemia, no drug was administered in the sham and I/R groups. In the I/R-remifentanil group, remifentanil infusion (2 μg/kg/min) was started in the ischemia period, and continued until the end of reperfusion. After the ischemic and reperfusion period, the ischemic uterine horns were removed surgically for biochemical and histopathologic examination.Tissue damage scores (endometrial epithelial glandular leukocytosis, degeneration, and endometrial stromal changes) were examined.Malondialdehyde levels and catalase, superoxide dismutase enzyme activities in tissue were measured. RESULTS:We found significantly lower epithelial leukocytosis and cell degeneration in the I/R-remifentanil group (p<0.05).Remifentanil administration significantly decreased concentrations of malondialdehyde, and increased catalase and superoxide dismutase enzyme activities (p<0.05).CONCLUSION: Remifentanil appears to protect the uterine tissue against ischemia-reperfusion and can be used safely in uterus transplantation.

Remifentanil up‐regulates HIF1α expression to ameliorate hepatic ischaemia/reperfusion injury via the ZEB1/LIF axis

“…Hepatic I/R injury after transplantation or surgery is a major reason of liver failure. In recent years, remifentanil has gained increasing attention as a protective agent against I/R‐induced injury in liver, intestine, uterus, heart and other organs 5,34,42‐45 . However, the underlying mechanism of this effect remained to be elucidated.…”

Uterine Reperfusion Ischemia and Use of Elastic Tourniquet

“…At the end of this investigation, the average tourniquet duration was 51.56 ± 14.12 minutes, with extremes of 30 and 88 minutes. Apart from myocardial ischemia, which is usually established in less than an hour [1] [2] [8], in the majority of studies concerning the phenomena of tissue ischemia in general, and more specifically that of origin these lesions occur downstream and beyond the 2 nd hour during a circulatory interruption upstream [7] [51]. In other words, the duration of tourniquet less than 90 minutes could also be a factor explaining the absence of significant variation in plasma marker levels between groups of women M + G + and M + G −, despite their elevation within each of the two groups.…”

“…The name ischemia-reperfusion (I/R or IR) recalls that tissue damage is a direct result of hypoxia-ischemia and indirectly reperfusion-reoxygenation [6] [7] [8] [9]. Outside medical situations [1] [2] [9] [10] [11], certain types of surgeries are providers of I/R phenomena [1] [12]- [17], this is the case of the use of the tourniquet during myomectomy [17] [18] [19] [20].…”

Does remifentanil attenuate renal ischemia&ndash;reperfusion injury better than dexmedetomidine in rat kidney?

“…As there are reports suggesting the effectiveness of continuous infusion of remifentanil as much as pre-/post-conditioning with it, we also preferred to infuse remifentanil, following anesthesia induction 38. In a clinical study performed in uterine I/R injury, the authors demonstrated remifentanil’s activity in reduction of histopathological lesions and oxidative stress markers 39. This is probably due to the opioid-binding sites in rat kidneys.…”