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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:


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.

Key words: Dexmedetomidine-Ketamine, Ischemia- reperfusion injury, Isoflurane-Propofol, Kidney Injury Molecule-1


ISSN 0253-8318 (Print)
ISSN 2074-7764 (Online)