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Vertebra cerrahisinde uygulanan total intravenöz ve inhalasyon anestezisinin oksidatif stres ve inflamasyon markerleri üzerine etkilerinin karşılaştırılması

Year 2012, Volume: 9 Issue: 2, 47 - 54, 01.08.2012

Abstract

Amaç: Bu çalışmada, vertebra cerrahisi yapılan hastalarda sevofluran ile inhalasyon anestezisi ve propofol ile TİVA'nın hemodinamik stabilite, inflamasyon ve oksidatif stres parametreleri bakımından karşılaştırılması planlandı.Materyal ve metod: Çalışmaya toplam 48 diskektomi ve laminektomi veya stabilizasyon cerrahisi uygulanacak hasta dahil edildi. Propofol grubunda genel anestezi idamesi propofol ve remifentanil infüzyonu ile sağlanırken, sevofluran grubunda anestezi idamesi sevofluran ve remifentanil infüzyonu ile sağlandı. Grupların intraoperatif hemodinamik verileri, end-tidal CO2 kaydedildi. Preoperatif ve postoperatif kan örnekleri alınarak total antioksidan seviye TAS , total oksidan seviye TOS , oksidatif stres indeksi OSİ ve interlökin 6 IL-6 düzeyleri çalışıldı. Bulgular: Gruplar arası demografik, hemodinamik veriler, ETCO periferik oksijen saturasyonları, anestezi ve cerrahi süreleri açısından operasyon öncesi ve sonrası anlamlı bir farka rastlanmadı. Gruplar arası karşılaştırmada operasyon öncesi TAS, TOS, OSİ, IL 6 değerleri arasında anlamlı bir farklılık görülmezken p>0,05 , operasyon sonrası propofol grubunda TOS ve OSİ değerleri sevofloran grubuna göre anlamlı ölçüde yüksek bulundu p0,05 .Sonuç: Vertebra cerrahisinde sevofluran ile inhalasyon anestezisi ve propofol ile TİVA'nın hemodinamik stabilite ve inflamasyon açısından benzer etkileri olduğu bulunurken oksidatif stres açısından Sevofluranın propofole göre daha olumlu etkileri olduğu tespit edildi. Bu bulguların daha geniş kapsamlı çalışmalarla desteklenerek, inhalasyon anesteziklerinin oksidatif stres üzerine olası olumlu etkilerinin vertebra cerrahisinde nöronal korunma açısından moleküler ve klinik yansımalarının ortaya konmasına ihtiyaç vardır

References

  • Akkuş İ. Serbest Radikaller ve Fizyopatolojik Etkileri. 1. Ed, Konya; Mimoza Yayınları 1995.
  • Sánchez-Conde P, Rodríguez-López JM, Nicolás JL, et al. The comparative abilities of propofol and sevoflurane to modulate inflammation and oxidative stress in the kidney after aortic cross- clamping. Anesth Analg. 2008; 106: 371-8
  • Sivaci R, Kahraman A, Serteser M, Sahin DA, Dilek ON. Cytotoxic effects of volatile anesthetics with free radicals undergoing laparoscopic surgery. Clin Biochem. 2006; 39: 293-8.
  • Allaouchiche B, Debon R, Goudable J, Chassard D, Duflo F. Oxidative stress status during exposure to propofol, sevoflurane and desflurane. Anesth Analg. 2001; 93: 981-5.
  • Ansley DM, Lee J, Godin DV, Garnett ME, Qayumi AK. Propofol enhances red cell antioxidant capacity in swine and humans. Can J Anaesth. ; 45: 233-9. Murphy PG, Davies MJ, Columb MO, Stratford N. Effect of propofol and thiopentone on free radical mediated oxidative stress of the erythrocyte. Br J Anaesth. 1996; 76: 536-43.
  • Abou-Elenain K. Study of the systemic and pulmonary oxidative stress status during exposure to propofol and sevoflurane anaesthesia during thoracic surgery. Eur J Anaesthesiol. 2010; 27: 71.
  • D i k m e n B , E r k G , E t G v e a r k . Propofol/remifentanil anestezisi ile sevofluran anestezisinin insan eritrositlerindeki oksidan ve antioksidan sistem üzerine etkileri. Türkiye Klinikleri J Anest Reanim. 2005; 3: 15-20
  • De Conno E, Steurer MP, Wittlinger M, et al. Anesthetic-induced improvement of the inflammatory response to one-lung ventilation. Anesthesiology. 2009; 110: 1316-26.
  • Corcoran TB, Engel A, Sakamoto H, et al. The effects of propofol on neutrophil function, lipid peroxidation and inflammatory response during elective coronary artery bypass grafting in patients with impaired ventricular function. Br J Anaesth. ; 97: 825-31. Corcoran TB, Engel A, Sakamoto H, et al. The effects of propofol on lipid peroxidation and inflammatory response in elective coronary artery bypass grafting. J Cardiothorac Vasc Anesth. 2004; : 592-604.
  • Cho EJ, Yoon JH, Hong SJ, Lee SH, Sim SB. The effects of sevoflurane on systemic and pulmonary inflammatory responses after cardiopulmonary bypass. J Cardiothorac Vasc Anesth. 2009; 23: 639-45.
  • Fleisher LA, Beckman JA, Brown KA, et al. ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery: executive summary: a report of the American College of Cardiology/American Heart
  • Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery). Anesth Analg. 2008; 106: 712.
  • Wang Q, Chen Q, Ding Q, et al. Sevoflurane postconditioning attenuates spinal cord reperfusion injury through free radicals-mediated up-regulation of antioxidant enzymes in rabbits.J.Jss.2009;11:1-9
  • Lee SA, Choi JG, Zuo Z.Volatile anesthetics attenuate oxidative stress-reduced activity of glutamate transporter type 3.Anesth Analg. 2009; : 1506-10.
  • Hans P, Deby-Dupont G, Deby C, et al. Increase in antioxidant capacity of plasma during propofol anaesthesia.J. Neurosurg. Anesthesiol. 1997; 9: –6
  • Manataki A.D, Tselepis A.D, Glantzounis G.K, et al.. Lipid peroxidation and the use of emulsified propofol in laparoscopic surgery. Surg. Endosc. ; 15: 950–3 Stratford N, Murphy P.. Antioxidant activity of propofol in blood from anaesthetized patients. Eur. J. Anaesthesiol.1998; 15: 158–60.
  • Acquaviva R, Campisi A, Murabito P, et al. Propofol attenuates peroxynitritemediated DNA damage and apoptosis in cultured astrocytes: an alternative protective mechanism. Anesthesiology ; 101: 1363–71
  • Scapagnini G, Foresti R, Calabrese V, et al. Caffeic acid phenethyl ester and curcumin: a novel class of heme oxygenase-1 inducers. Mol. Pharmacol. 2002; 61: 554–61
  • Kochs E., Hoffman,W.E.,Werner, C., et al. The effects of propofol on brain electrical activity, neurologic outcome, and neuronal damage following incomplete ischemia in rats. Anesthesiology 1992; : 245–52.
  • Sitar S.M., Hanifi-Moghaddam P, Gelb A, et al. Propofol prevents peroxide-induced inhibition of glutamate transport in cultured astrocytes. Anesthesiology 1999; 90: 1446–53.
  • Peters, C.E., Korcok, J., Gelb, A.W., Wilson, J.X.,. Anaesthetic concentrations of propofol protect against oxidative stress in primary astrocyte cultures: comparison with hypothermia. Anesthesiology ;94: 313–21. Song XM, Wang YL, Li JG, et al. Effects of propofol on pro-inflammatory cytokines and nuclear factor kappaB during polymicrobial sepsis in rats. Mol Biol Rep. 2009; 36: 2345-51.
  • Ihn CH, Joo JD, Choi JW, et al. Comparison of stress hormone response, interleukin-6 and anaesthetic characteristics of two anaesthetic techniques: volatile induction and maintenance of anaesthesia using sevoflurane versus total intravenous anaesthesia using propofol and remifentanil. J Int Med Res. 2009; 37: 1760-71.

The comparison of the effects of total intravenous and inhalation anesthesia on oxidative stress and inflammation markers in spine surgery

Year 2012, Volume: 9 Issue: 2, 47 - 54, 01.08.2012

Abstract

Background: In this study, it is planned to compare the inhalation anesthesia of sevoflurane and total intravenous anesthesia TIVA with propofol in terms of hemodynamic stability, inflammation and oxidative stress in patients undergoing spine surgery. Methods: Forty-eight patients who underwent laminectomy and discectomy or vertebral stabilisation enrolled to the study. In propofol group, general anesthesia maintained with propofol and remifentanil infusion; and in sevoflurane group, anesthesia maintained with sevoflurane inhalation and remifentanil infusion. Hemodynamic data, end-tidal CO 2 ETCO peripheral oxygen saturation were monitorised in each group. Anesthesia and surgery time were recorded. 2 , Preoperative and postoperative blood samples were collected and total antioxidant status TAS , total oxidant status TOS , oxidative stress index OSI and IL-6 levels were studied. Results: Demographic, hemodynamic data, ETCO peripheral oxygen saturation, anesthesia and surgery times were 2, not significantly among groups. There were no significantly difference in preoperative TAS, TOS, OSI, IL 6 levels between groups. Postoperative TOS and OSI levels were significantly increased in propofol group p

References

  • Akkuş İ. Serbest Radikaller ve Fizyopatolojik Etkileri. 1. Ed, Konya; Mimoza Yayınları 1995.
  • Sánchez-Conde P, Rodríguez-López JM, Nicolás JL, et al. The comparative abilities of propofol and sevoflurane to modulate inflammation and oxidative stress in the kidney after aortic cross- clamping. Anesth Analg. 2008; 106: 371-8
  • Sivaci R, Kahraman A, Serteser M, Sahin DA, Dilek ON. Cytotoxic effects of volatile anesthetics with free radicals undergoing laparoscopic surgery. Clin Biochem. 2006; 39: 293-8.
  • Allaouchiche B, Debon R, Goudable J, Chassard D, Duflo F. Oxidative stress status during exposure to propofol, sevoflurane and desflurane. Anesth Analg. 2001; 93: 981-5.
  • Ansley DM, Lee J, Godin DV, Garnett ME, Qayumi AK. Propofol enhances red cell antioxidant capacity in swine and humans. Can J Anaesth. ; 45: 233-9. Murphy PG, Davies MJ, Columb MO, Stratford N. Effect of propofol and thiopentone on free radical mediated oxidative stress of the erythrocyte. Br J Anaesth. 1996; 76: 536-43.
  • Abou-Elenain K. Study of the systemic and pulmonary oxidative stress status during exposure to propofol and sevoflurane anaesthesia during thoracic surgery. Eur J Anaesthesiol. 2010; 27: 71.
  • D i k m e n B , E r k G , E t G v e a r k . Propofol/remifentanil anestezisi ile sevofluran anestezisinin insan eritrositlerindeki oksidan ve antioksidan sistem üzerine etkileri. Türkiye Klinikleri J Anest Reanim. 2005; 3: 15-20
  • De Conno E, Steurer MP, Wittlinger M, et al. Anesthetic-induced improvement of the inflammatory response to one-lung ventilation. Anesthesiology. 2009; 110: 1316-26.
  • Corcoran TB, Engel A, Sakamoto H, et al. The effects of propofol on neutrophil function, lipid peroxidation and inflammatory response during elective coronary artery bypass grafting in patients with impaired ventricular function. Br J Anaesth. ; 97: 825-31. Corcoran TB, Engel A, Sakamoto H, et al. The effects of propofol on lipid peroxidation and inflammatory response in elective coronary artery bypass grafting. J Cardiothorac Vasc Anesth. 2004; : 592-604.
  • Cho EJ, Yoon JH, Hong SJ, Lee SH, Sim SB. The effects of sevoflurane on systemic and pulmonary inflammatory responses after cardiopulmonary bypass. J Cardiothorac Vasc Anesth. 2009; 23: 639-45.
  • Fleisher LA, Beckman JA, Brown KA, et al. ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery: executive summary: a report of the American College of Cardiology/American Heart
  • Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery). Anesth Analg. 2008; 106: 712.
  • Wang Q, Chen Q, Ding Q, et al. Sevoflurane postconditioning attenuates spinal cord reperfusion injury through free radicals-mediated up-regulation of antioxidant enzymes in rabbits.J.Jss.2009;11:1-9
  • Lee SA, Choi JG, Zuo Z.Volatile anesthetics attenuate oxidative stress-reduced activity of glutamate transporter type 3.Anesth Analg. 2009; : 1506-10.
  • Hans P, Deby-Dupont G, Deby C, et al. Increase in antioxidant capacity of plasma during propofol anaesthesia.J. Neurosurg. Anesthesiol. 1997; 9: –6
  • Manataki A.D, Tselepis A.D, Glantzounis G.K, et al.. Lipid peroxidation and the use of emulsified propofol in laparoscopic surgery. Surg. Endosc. ; 15: 950–3 Stratford N, Murphy P.. Antioxidant activity of propofol in blood from anaesthetized patients. Eur. J. Anaesthesiol.1998; 15: 158–60.
  • Acquaviva R, Campisi A, Murabito P, et al. Propofol attenuates peroxynitritemediated DNA damage and apoptosis in cultured astrocytes: an alternative protective mechanism. Anesthesiology ; 101: 1363–71
  • Scapagnini G, Foresti R, Calabrese V, et al. Caffeic acid phenethyl ester and curcumin: a novel class of heme oxygenase-1 inducers. Mol. Pharmacol. 2002; 61: 554–61
  • Kochs E., Hoffman,W.E.,Werner, C., et al. The effects of propofol on brain electrical activity, neurologic outcome, and neuronal damage following incomplete ischemia in rats. Anesthesiology 1992; : 245–52.
  • Sitar S.M., Hanifi-Moghaddam P, Gelb A, et al. Propofol prevents peroxide-induced inhibition of glutamate transport in cultured astrocytes. Anesthesiology 1999; 90: 1446–53.
  • Peters, C.E., Korcok, J., Gelb, A.W., Wilson, J.X.,. Anaesthetic concentrations of propofol protect against oxidative stress in primary astrocyte cultures: comparison with hypothermia. Anesthesiology ;94: 313–21. Song XM, Wang YL, Li JG, et al. Effects of propofol on pro-inflammatory cytokines and nuclear factor kappaB during polymicrobial sepsis in rats. Mol Biol Rep. 2009; 36: 2345-51.
  • Ihn CH, Joo JD, Choi JW, et al. Comparison of stress hormone response, interleukin-6 and anaesthetic characteristics of two anaesthetic techniques: volatile induction and maintenance of anaesthesia using sevoflurane versus total intravenous anaesthesia using propofol and remifentanil. J Int Med Res. 2009; 37: 1760-71.
There are 22 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Ali Çiçek This is me

Şaban Yalçın This is me

Harun Aydoğan This is me

Evren Büyükfırat This is me

Mahmut Alp Karahan This is me

Hasan Bilinç This is me

Mehmet Fuat This is me

Publication Date August 1, 2012
Published in Issue Year 2012 Volume: 9 Issue: 2

Cite

Vancouver Çiçek A, Yalçın Ş, Aydoğan H, Büyükfırat E, Karahan MA, Bilinç H, Fuat M. Vertebra cerrahisinde uygulanan total intravenöz ve inhalasyon anestezisinin oksidatif stres ve inflamasyon markerleri üzerine etkilerinin karşılaştırılması. Harran Üniversitesi Tıp Fakültesi Dergisi. 2012;9(2):47-54.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty