Evaluation of sugammadex and mannitol effectiveness after head trauma in experimental animal model

EVALUATION OF SUGAMMADEX AND MANNITOL EFFECTIVENESS AFTER HEAD TRAUMA IN EXPERIMENTAL ANIMAL MODEL Ali Osman Muçuoğlu, MD, Dokuz Eylul University Faculty of Medicine, Department of Neurosurgery, İnciraltı, İzmir – TURKEY E-mail: aliosmanmucuoglu@hotmail.com Purpose: Head trauma, which is a lethal pathology, disabling, needing long-term treatment and care, is one of the leading causes of death. In this study, we aimed to investigate sugammadex activity in head trauma and to compare the efficacy of mannitol in clinical applications. Material and Method: Thirty-five male Wistar-type albino rats were randomly selected and divided into five groups, which contain 7 (seven) rats in each group, and head trauma was performed under general anesthesia. The animals were grouped as follows: Group I Sham (n=7), Group II Control (n=7), Group III Mannitol (head trauma, mannitol 20% 1gr/kg, n=7), Group IV Sugammadex (head trauma, sugammadex 100mg/kg, n=7), Group V Mannitol & Sugammadex (head trauma, mannitol 20% 1gr/kg & sugammadeks 100mg/kg, n=7). Cerebral blood flow was measured by doppler ultrasonography from the carotid artery before and after trauma. After sacrification, the rats' brains were collected for histological examination and immunohistochemical staining. Results: Doppler flow was detected in 27 of 35 rats 4 hours after head trauma. The mean neuronal density was the highest in group I, while Neu N and activated caspase-3 immunohistochemistry were lowest. Although the mean neuronal density of group III was higher than group IV, group V values were higher than both groups. Neuronal density, Neu N and activated caspase-3 immunohistochemistry results from prefrontal cortex were evaluated with Mann-Whitney U test. Neuronal density of group III which shows neuron viability was significantly increased compared to group IV but Neu N immunohistochemistry which shows apoptotic neurons was significantly increased in group III than group IV. There was no significant difference in Group V values according to Group III and Group IV. Conclusion: We found that sugammadex, which is an agent that reverses the effects of neuromuscular blockade, has neuroprotective effects and this was effective as mannitol. There was no statistically significant difference between mannitol and sugammadex treatments in head trauma. Key words: head trauma, mannitol, sugammadex, doppler, neu N, caspase-3