Abstract:

Objective   To observe the protective effects of fentanil and methylprednisolone sodium succinate on ischemia-reperfusion injury after rabbit limb replantation. Methods   60 adult male rabbits, weighting (2.5±0.5)kg, were randomized devided into four groups(15 rabbits in each group)to establish the replantation models of the right posterior limb. In the control group (group A), limbs were replanted without treatment. The fentanil group (group B) was given fentanil around replantation and the methylprednisolone sodium succinate group (group C) was given methylprednisolone sodium succinate. In the combining group (group D), both of the two drugs were given around replantation. Bax and Bcl-2 gene expressions and the ultra microstructure changes of the ischemia limb muscle of group B, C and D were dectected at 4h, 24h and 72h after replantation. Results   There was no difference between group A and B within 24h(P>0.05). But at 72h, the expression of Bax gene was lower and the expression of Bcl-2 was higher(P<0.05) in group B.The expression of Bax gene was significantly lower in group C and D, while the expression of Bcl-2 gene was on the contrary. Compared to group B and C, the expression of Bax gene was significantly lower and the expression of Bcl-2 gene was higher in group D (P<0.05). The mitochondrions in group A and B were seriously injured under electron microscope.While the injuries in group C and D were slighter. Conclusion   Fentanil has no protective effect on IRI after limb replantation, while methylprednisolone sodium succinate has. Combination of the two drugs shows synergistic efferts on ischemia-reperfusion injury protertion after limb replantation.

Key words: Fentanil; Methylprednisolone sodium succinate; Ischemia-Reperfusion injury; Apoptosis