PERBEDAAN SKOR HISTOLOGI C-erbB-2,PROLIFERASI ENDOTEL PEMBULUH DARAH : DENGAN DAN TANPA INFILTRASI LEVOBUPIVAKAIN PADA PENYEMBUHAN LUKA TIKUS WISTAR

Abstract

Background : Postoperative acute pain stimulates clinical pathophysiologic symtoms, depress immune responses which leads to delayed wound healing process. Levobupivacaine is a long acting local anaesthetic, proven good for pain controll. Angiogenesis plays an important role in wound healing. C-erbB-2 is a family of epidermal growth factor receptor that becomes actively mitogenic when binds to EFGR ligands, and stimulates cell proliferation. Levobupivakain infiltration enhances c-erbB-2 expression , leads to endothelial blood vessel proliferation and improves wound healing. Objective : To prove the difference between histologic score of c-erbB-2 , endothelial blood vessel proliferation of the wound healing process with and without levobupivacaine infiltration and to prove the correlation between c-erbB- 2 and endothelial blood vessels proliferation. Methods : This study was an animal experimental study with randomized post test only control group design. Randomly 15 Wistar rats were divided into 3 groups. Group I was the group for control without treatment. Group II, rats that got incisions without levobupivacaine infiltration. Group III, rats that got incisions and levobupivacaine infiltration every 8 hours for 24 hours. C-erbB-2 at the site of the wound was analized using the histologic score from samples with immunohistochemistry stainning and the amount of AgNOR expressed by m AgNOR and pAgNOR. The samples were taken from tissue biopsy on 5th day. Data were analyzed using Kruskal-Wallis test. The correlation between histologic score c-erbB-2 and the amount of AgNOR were analyzed using Spearmans correlation test. Results : This study showed that the tissue with levobupivacaine had higher c-erbB-2 histologic score (7.2 ± 2.16 vs 9.9 ± 1.29), and mAgNOR (5.94 ± 0.15 vs 11.86 ± 1.02), than tissue without levobupivacaine that significantly different (p = 0,015 and p = 0,02). There was a correlation between c-erbB-2 and mAgNOR = 0.693). Conclusions : The expression levels c-erbB-2 and mAgNOR in levobupivacaine infiltration group are higher than without levobupivacaine infiltration group. There is a correlation between the c-erbB-2 and mAgNOR Key words : Levobupivacaine, c-erbB-2, AgNOR, wound healing.