Comparison of Dexmedetomedine-Ketamine Anesthetic Combination to
Propofol-Isoflurane in Renal Ischemia-Reperfusion Injury
Eman M Nour1, Khaled I Khalil2*,
Hazem H Saleh3, Haytham G Aamer4, Mohamed Abd
EL-Hamid5, Wael I Mortada6, Ahmed A Shokeir7
and Mahmoud Othman8
1Veterinarian
Surgery, Animal Research Facility, Mansoura Urology and Nephrology Center; 2Human
Physiology,
College of Medicine, Mansoura University - Egypt, Majmaah University
- KSA;3MicrobiologyLab, Mansoura Urology and
Nephrology Center; 4Animal
Research Facility, Mansoura Urology and Nephrology Center;5Pathology Department, Mansoura Urology and
Nephrology Center;6Clinical
Chemistry Labs,
Mansoura Urology and Nephrology Center; 7Mansoura Urology
and Nephrology Center, College of Medicine;
8Department
of Anesthesia, Urology &
Nephrology
center,
Mansoura faculty of Medicine,
Mansoura University,
Egypt *Corresponding author: kk1313kk@gmail.com
Abstract
Perioperative acute kidney injury (AKI)
frequently complicates renal ischemia. Anesthesia of such cases may be
hazardous. The current study aimed to evaluate and compare the renal protection
and anesthetic values of the injected ketamine-dexmedetomidine combination to
the inhaled isoflurane pre-medicated with propofol. 20 mongrel dogs were
randomized into Propofol-Isoflurane (Pro-Iso) Group: that premedicated with
propofol and maintained with isoflurane and Ketamine-Dexmedetomidine (Ket-Dex)
Group: that received a combination of ketamine and dexmedetomidine. Heart rate,
Respiratory rate, Oxygen saturation and noninvasive mean arterial blood pressure
were monitored. Serum levels of Creatinine, Blood Urea Nitrogen and Kidney
Injury Molecule-1 (KIM-1) were measured. Tissue Malondialdehyde (MDA) was
assessed whereas histopathological assessment was done using a numerical scoring
system. The level of KIM-1 decreased 24 hours after the end of reperfusion in
dogs anesthetized with Pro-Iso group but remained significantly high for Ket-Dex
group. Renal MDA levels for Ket-Dex was significantly higher when compared with
Pro-Iso. The numerical scoring system showed significantly lower renal damage
for Pro-Iso group. When compared to ketamine-dexmedetomidine, combination of
propofol and isoflurane provided more renal protection and effective anesthesia
for dogs at risk of perioperative acute kidney injury caused by
ischemia-reperfusion injury.