Examination of the effect of bupivacaine on brain tissue in rats with induced experimental renal failure: Neurotoxicity of bupivacaine in renal failure

Nezir Yılmaz; Mehmet  Tepe; Öznur Uludağ

doi:10.28982/josam.7924

Authors

Nezir Yılmaz Department of Anesthesiology and Reanimation, Adıyaman University, Faculty of Medicine, Adıyaman, Turkey https://orcid.org/0000-0002-4351-6256
Mehmet Tepe Department of Anesthesiology and Reanimation, Adıyaman University, Faculty of Medicine, Adıyaman, Turkey https://orcid.org/0000-0002-2596-1284
Öznur Uludağ Department of Anesthesiology and Reanimation, Adıyaman University, Faculty of Medicine, Adıyaman, Turkey https://orcid.org/0000-0002-6017-5836

DOI:

https://doi.org/10.28982/josam.7924

Keywords:

bupivacaine, neurotoxicity, renal failure

Abstract

Background/Aim: Local anesthetics are frequently used and often considered harmless, but they can precipitate local anesthetic systemic toxicity (LAST) when accidentally administered intravascularly or when a toxic dose is rapidly absorbed, which can result in mortality. In cases of renal function impairment, the altered pharmacokinetics of local anesthetics lead to a lowered toxicity threshold. In this study, the aim was to histopathologically investigate the increase in neurotoxicity in the central nervous system due to bupivacaine in experimental renal failure.

Methods: In the study, a total of 28 male Wistar albino rats, aged 8-10 weeks, were evenly divided into four groups: Group C (control group) received intraperitoneal 1 mL/kg saline; Group G (glycerol group) received intramuscular 10 mL/kg glycerol, Group GB (glycerol+bupivacaine group) received intramuscular 10 mL/kg glycerol followed by intraperitoneal 4 mg/kg bupivacaine; and Group B (bupivacaine group) received intraperitoneal 4 mg/kg bupivacaine. All rats were sacrificed after the experimental period. Tissue samples were preserved and stained with hematoxylin-eosin for histopathological analyses. TRPM2 and Reelin levels in brain tissue were measured using immunohistochemical methods.

Results: In the histopathological examination, Group G exhibited higher Reelin and TRPM2 levels compared to all other groups (P<0.001). In Group GB, both Reelin and TRPM2 immunoreactivity were significantly higher compared to Group B (P<0.001).

Conclusion: It can be concluded that renal dysfunction increases neurotoxicity in brain tissue associated with bupivacaine.

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