Cerrahi Stres Altındaki Kronik Obstruktif Akciğer Hastalığı Olan Hastalarda Anestezi Yöntemlerinin Dinamik Tiyol/disülfid Dengesine Etkilerinin Karşılaştırılması

Year 2024, , 104 - 110, 29.04.2024

Fatma Çelik , Recai Dağlı , Bilal İlanbey

https://doi.org/10.46332/aemj.1347211

Abstract

Amaç: Kronik Obstrüktif Akciğer Hastalığı (KOAH), artan oksidatif stres ile bağlantılıdır. Anestezi uygulamalarına bağlı olarak değişen oksidatif stres durumu, cerrahi stresi ve postoperatif komplikasyon insidansını etkileyebilir.
Bu çalışma, inguinal herni operasyonu geçiren KOAH’lı hastalarda genel anestezi (GA) ve spinal anestezinin (SA) dinamik tiyol-disülfid dengesi üzerindeki etkilerini karşılaştırmayı amaçlamaktadır.

Araçlar ve Yöntem: KOAH’ın Teşhisi, Yönetimi ve Önlenmesi için 2017 Küresel Strateji Raporuna göre, hava akımı obstrüksiyonu (%50≤FEV 1<%79) ve FEV1/FVC<0.7 olan hastalar değerlendirildi. Bu gözlemsel çalışmaya inguinal herni cerrahisi planlanan, grup GA (n=26) ve grup SA (n=26) olmak üzere toplam 52 KOAH hastası dahil edildi. Preoperatif dönemde ve postoperatif 24. saatte kan örnekleri alındı. Tiyol/disülfid dengesinin parametreleri analiz edildi.

Bulgular: Hem grup GA hem de grup SA’da anestezi öncesine göre anestezi sonrasında total tiyol, native tiyol ve disülfid değerlerinde bir azalma gözlendi. Ancak sadece Grup SA’da anestezi sonrası total tiyol (p<0.01) ve nativ tiyol (p=0.012) değerlerinin anestezi öncesi değerlerine göre azalması istatistiksel olarak anlamlıydı. Diğer değişkenlerdeki değişim istatiksel olarak anlamlı değildi. Grup GA ve grup SA arasındaki karşılaştırmalarda anestezi öncesi ve sonrası tiyol/disülfit değişkenlerinde kayda değer bir fark gözlenmedi.

Sonuç: Cerrahi stres altındaki KOAH hastalarında genel ve spinal anestezi yöntemleri dinamik tiyol/disülfid dengesi üzerine benzer bir yanıt göstermiştir.

Keywords

disülfid, KOAH, oksidatif stres, spinal anestezi, tiyol

Project Number

Project Number: TIP.A4.18.003

Comparison of the Effects of Anesthesia Methods on Dynamic Thiol/Disulfide Homeostasis in Patients with Chronic Obstructive Pulmonary Disease Under Surgical Stress

Abstract

Purpose: Chronic Obstructive Pulmonary Disease (COPD) is linked to increased oxidative stress. Changing oxidative stress status due to anesthesia applications may affect surgical stress and the incidence of postoperative complications.
This study aims to contrast the impacts of general anesthesia (GA) and spinal anesthesia (SA) on the dynamic thiol-disulfide homeostasis among patients with COPD who are undergoing inguinal hernia surgery.

Materials and Methods: According to the 2017 Global Strategy Report for the Diagnosis, Management and Prevention of COPD, patients with airflow obstruction (50%≤FEV1<79%) and FEV1/FVC<0.7% were evaluated. A total of 52 COPD patients, group GA (n=26) and group SA (n=26), scheduled for inguinal hernia surgery were included in this observational study. Blood samples were collected preoperatively and at 24 hours postoperatively. Parameters of thiol/disulfide balance were analyzed.

Results: In both group GA and group SA, a decrease in total thiol, native thiol and disulfide values was observed after anesthesia compared to pre-anesthesia. However, only in group SA, the decrease in total thiol (p<0.01) and native thiol (p=0.012) values after anesthesia was statistically significant. The change in other variables was not statistically significant. There was no significant difference between group GA and group SA in the thiol/disulfite variables before and after anesthesia.

Conclusion: General and spinal anesthesia methods demonstrated a similar response on dynamic thiol/disulfide homeostasis in COPD patients under surgical stress.

Keywords

COPD, disulfide, oxidative stress, spinal anesthesia, thiol

Supporting Institution

This study was supported by the Ahi Evran University Scientific Research Projects Coordination Unit.

Project Number

Project Number: TIP.A4.18.003

Thanks

We would like to extend our gratitude to Kirsehir Ahi Evran University Scientific Research Projects Coordination Unit for their financial support to this study and to the staff of Kirsehir Ahi Evran University Hospital for their collaboration.

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