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Kahraman E, Cevik B, Tolga Saracoglu K. The effects of pre-emptive intravenous ibuprofen on the thiol/disulfide homeostasis and C-reactive protein level as the markers of oxidative stress and inflammation during gynecologic laparoscopy: A randomised clinical trial. Int J Clin Pract 2021; 75:e14872. [PMID: 34525247 DOI: 10.1111/ijcp.14872] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/16/2021] [Accepted: 09/10/2021] [Indexed: 11/27/2022] Open
Abstract
AIMS In this study, we aimed to investigate the anti-inflammatory and antioxidant effects of intravenous ibuprofen by using the C-reactive protein level and thiol/disulfide homeostasis as the oxidative stress marker. MATERIALS AND METHODS This study was conducted on 70 patients aged between 30 and 65 who were scheduled for elective laparoscopic hysterectomy. The patients were divided into two groups to receive either pre-emptive 800mg of intravenous ibuprofen plus 1000 mg of intravenous paracetamol (Group IP) or only 1000 mg of intravenous paracetamol as a control group (Group P). The blood samples for thiol/disulfide homeostasis were collected as follows: before induction of anesthesia (T0), before pneumoperitoneum (T1), following postdeflation and discontinuation of anesthesia (T2), and postoperative 24th hour (T3). Simultaneous blood samples for C-reactive protein (CRP) were also collected. The pre- and postoperative urea, creatinine, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) levels were measured. RESULTS A total of 69 patients were included in the study. The patient's characteristics and intraoperative variables were comparable between groups (P > .05). The number of patients requiring rescue analgesia, the total amount of analgesic used, Visual Analog Scale (VAS) scores, and postoperative side effects were significantly lower in Group IP (P < .001). The decrease in native and total thiol levels at T1, T2, and T3 measurement points was significant in Group IP (P < .001). In both groups, the comparison to baseline values demonstrated no significant changes in terms of disulfide level (P > .05). The simultaneous CRP levels indicated a significant increase at the postoperative 24 hour in both groups (P < .001). The difference between groups was insignificant (P > .05). There was a significant increase in urea and creatinine levels in patients of Group IP (P < .05). CONCLUSION The pre-emptive administration of ibuprofen provided effective pain control after gynecologic laparoscopy. However, ibuprofen changed the thiol/disulfide homeostasis in favor of oxidation and had no beneficial effect in surgically induced oxidative stress.
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Affiliation(s)
- Ersin Kahraman
- The Department of Anesthesiology and Reanimation, University of Health Sciences, Kartal Dr. Lütfi Kırdar City Hospital, Istanbul, Turkey
| | - Banu Cevik
- The Department of Anesthesiology and Reanimation, University of Health Sciences, Kartal Dr. Lütfi Kırdar City Hospital, Istanbul, Turkey
| | - Kemal Tolga Saracoglu
- The Department of Anesthesiology and Reanimation, University of Health Sciences, Kartal Dr. Lütfi Kırdar City Hospital, Istanbul, Turkey
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Kazancioglu L, Batcik S, Arpa M, Erdivanli B, Ozergin Coskun Z, Celebi Erdivanli O, Bahceci I, Kazdal H, Erel O, Neselioglu S. Dynamic thiol/disulphide balance in patients undergoing hypotensive anesthesia in elective septoplasties. Int J Clin Pract 2021; 75:e14838. [PMID: 34519144 DOI: 10.1111/ijcp.14838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 09/08/2021] [Accepted: 09/10/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE We aimed to investigate the effects of hypotensive anaesthesia on oxidative stress with serum thiol/disulphide balance in patients undergoing elective septoplasty procedures under general anaesthesia. METHODS Seventy-two patients between the ages of 18-60, with a physical condition I -II, according to the American Society of Anesthesiologists, were included in this prospective observational study. Septoplasty was chosen for standard surgical stress. According to the maintenance of anaesthesia, patients were divided into the groups as Hypotensive Anaesthesia (n = 40) and Normotensive Anaesthesia (n = 32). Serum thiol/disulphide levels were measured by the method developed by Erel & Neşelioğlu. RESULTS The native thiol and total thiol values of both groups measured at the 60th min intraoperatively were significantly lower than the preoperative values (both P < .01). Intraoperatively, at the 60th min, there was no significant difference in terms of post-native thiol and post-total thiol levels between hypotensive and normotensive anaesthesia groups (P = .68 and .81, respectively). Age >40 years and female gender were found to have a significant effect on dynamic oxidative stress (P = .002 and .001, respectively). CONCLUSION This pilot study has found that hypotensive anaesthesia had no adverse effect on dynamic thiol/disulphide balance in elective surgeries.
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Affiliation(s)
- Leyla Kazancioglu
- Department of Anesthesiology and Reanimation, Recep Tayyip Erdogan University, Rize, Turkey
| | - Sule Batcik
- Department of Anesthesiology and Reanimation, Recep Tayyip Erdogan University, Rize, Turkey
| | - Medeni Arpa
- Department of Medical Biochemistry, Recep Tayyip Erdogan University, Rize, Turkey
| | - Basar Erdivanli
- Department of Anesthesiology and Reanimation, Recep Tayyip Erdogan University, Rize, Turkey
| | | | | | - Ilkay Bahceci
- Department of Medical Microbiology and Clinical Microbiology, Recep Tayyip Erdogan University, Rize, Turkey
| | - Hizir Kazdal
- Department of Anesthesiology and Reanimation, Recep Tayyip Erdogan University, Rize, Turkey
| | - Ozcan Erel
- Department of Medical Biochemistry, Ankara Yildirim Beyazit University Medical Faculty, Ankara, Turkey
| | - Salim Neselioglu
- Department of Medical Biochemistry, Ankara Yildirim Beyazit University Medical Faculty, Ankara, Turkey
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Kutluhan H, Yuce Y, Geyık FD, Saracoglu KT, Cevik B. Stress response in vertebra surgery by total intravenous and inhalation anaesthesia. Int J Clin Pract 2021; 75:e14602. [PMID: 34228856 DOI: 10.1111/ijcp.14602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 07/02/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE We compared inhalational and total intravenous anaesthesia about haemodynamic stability and oxidative stress response in vertebral surgery. BACKGROUNDS AND METHODS Fifty-nine elective vertebral surgery patients were randomly divided into propofol (Group P) and desflurane (Group D) groups. Intraoperative haemodynamic parameters, preoperative and post-operative native thiol, total thiol, disulfide, C-reactive protein (CRP), albumin, cortisol and catalase levels were studied. RESULTS Post-operative native thiol and total thiol values in Group P were higher (P = .044 and P = .031). Post-operative albumin value in Group P was lower than the preoperative value (P < .001). The post-operative CRP and albumin values in Group D were lower than the preoperative value. The cortisol value was high (P = .03, P < .001 and P < .001). The post-operative albumin value in Group P was higher (P = .03). There is a positive correlation between CRP and disulfide values (P = .017), between albumin and native thiol values (P < .001), between total thiol value (P < .001), between the cortisol value and the disulfide/native thiol value (P = .002) and between native/total thiol value (P = .003) and a negative correlation between disulfide/native thiol value (P = .005), between disulfide/total thiol value (P = .003) and between the native/total thiol value (P = .001). CONCLUSION Dynamic thiol/disulfide haemostasis reflects oxidative stress. Propofol positively contributes to oxidative stress in elective vertebral surgery.
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Affiliation(s)
- Hilal Kutluhan
- Anaesthesiology and Reanimation Department, University of Health Sciences Kartal Dr. Lutfi Kirdar Education and Research Hospital, Istanbul, Turkey
| | - Yucel Yuce
- Anaesthesiology and Reanimation Department, University of Health Sciences Kartal Dr. Lutfi Kirdar Education and Research Hospital, Istanbul, Turkey
| | - Fatih Dogu Geyık
- Anaesthesiology and Reanimation Department, University of Health Sciences Kartal Dr. Lutfi Kirdar Education and Research Hospital, Istanbul, Turkey
| | - Kemal Tolga Saracoglu
- Anaesthesiology and Reanimation Department, University of Health Sciences Kartal Dr. Lutfi Kirdar Education and Research Hospital, Istanbul, Turkey
| | - Banu Cevik
- Anaesthesiology and Reanimation Department, University of Health Sciences Kartal Dr. Lutfi Kirdar Education and Research Hospital, Istanbul, Turkey
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Kaya-Ugur B, Erkutlu I, Saracaloglu A, Geyik AM, Demiryürek S, Demiryürek AT. Comparison of serum dynamic thiol/disulphide homeostasis and nitric oxide levels of total intravenous vs inhaled anaesthesia in endoscopic transsphenoidal pituitary surgery. Int J Clin Pract 2021; 75:e14485. [PMID: 34107152 DOI: 10.1111/ijcp.14485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/24/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Transsphenoidal pituitary surgery (TPS) is traditionally performed under general anaesthesia. This study aimed to compare the effects of total intravenous anaesthesia (TIVA) or sevoflurane, an inhalation anaesthetic, on thiol-disulphide homeostasis in patients undergoing endoscopic endonasal TPS. METHODS In this study, 84 patients scheduled for TPS were randomly categorised into two groups: propofol (n = 42, the TIVA group) or sevoflurane (n = 42, the SEVO group). Blood samples were taken before induction of general anaesthesia and at the 30 minutes of postoperation. Serum native thiol and total thiol levels were detected, and the number of dynamic disulphide bonds and related ratios were calculated from these values. Serum nitric oxide (NO) levels were measured using a chemiluminescence method. RESULTS Although native thiol levels in TIVA postoperation group were markedly increased (P < .05), total thiol levels in SEVO postoperation group were significantly decreased (P < .01). Disulphide levels were declined in both groups (P < .05 for TIVA and P = .001 for SEVO groups). Disulphide/native thiol (P < .05 for both groups) and disulphide/total thiol ratios (P < .05 for TIVA and P < .01 for SEVO groups) were depressed in postoperation groups. We found a marked elevation in native thiol/total thiol ratio in both groups (P < .05 for TIVA and P < .01 for SEVO groups). There was significant augmentation in serum NO levels in the SEVO postoperation group (P < .05). CONCLUSION These results are the first to show that both TIVA and sevoflurane showed similar antioxidant effect with reduced disulphide levels, but sevoflurane may offer more robust oxidative stress protection and augmented NO production than TIVA during TPS. However, the clinical effect is needed to further investigate.
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Affiliation(s)
- Berna Kaya-Ugur
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Ibrahim Erkutlu
- Department of Neurosurgery, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Ahmet Saracaloglu
- Department of Medical Pharmacology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Abidin M Geyik
- Department of Neurosurgery, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Seniz Demiryürek
- Department of Physiology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Abdullah T Demiryürek
- Department of Medical Pharmacology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
- Vocational School of Health Services, Gaziantep University, Gaziantep, Turkey
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DÖĞER C, DUMANLI ÖZCAN AT, ERKILIÇ E, ELLİK S, AKSOY ŞM, ALIŞIK M, EREL Ö. Oxidative Stress in Controlled Hypotension: Assessment with A Novel Oxidative Stress Marker. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2021. [DOI: 10.33808/clinexphealthsci.798527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Soliman R, Yacoub A, Abdellatif M. Comparative effect of desflurane and sevoflurane on liver function tests of patients with impaired hepatic function undergoing cholecystectomy: A randomized clinical study. Indian J Anaesth 2020; 64:383-390. [PMID: 32724246 PMCID: PMC7286405 DOI: 10.4103/ija.ija_168_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 03/21/2020] [Accepted: 04/08/2020] [Indexed: 11/10/2022] Open
Abstract
Background and Aim: Desflurane and sevoflurane are the most common volatile anesthetics used during laparoscopic and hepatic surgery. The objective of the study was to evaluate the effect of desflurane and sevoflurane in patients with elevated preoperative liver functions undergoing laparoscopic cholecystectomy. Methods: The study was a randomized study and included 162 patients classified randomly into two groups: Desflurane group: The patients received desflurane (end-tidal concentration 4%–6%) as an inhalational agent during the whole procedure. Sevoflurane group: The patients received sevoflurane (end-tidal concentration 2%–4%) as an inhalational agent during the whole procedure. The investigations included serum level of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyltransferase (GGT), and total bilirubin. The values were serially collected at the following timepoints; T0:at the preoperative period, T1:directly after surgery, T2:1st postoperative day, T3:2nd postoperative day, T4:3rd postoperative day, T5:5th postoperative day, T6:7th postoperative day, and T7:10th postoperative day. The statistics were described in terms of mean ± standard deviation, frequencies, and percentages. Results: The preoperative liver enzymes and total bilirubin were higher than the normal range in patients of the two groups. Postoperatively, there was a decrease in the AST and ALT with desflurane more than sevoflurane from T1 to T6(P < 0.05). The ALP, GGT, and bilirubin decreased in patients of the two groups, but the comparison was insignificant (P > 0.05). Conclusion: The desflurane is a safe inhalational volatile for maintenance of anesthesia in patients with impaired liver function undergoing laparoscopic cholecystectomy. It was associated with a decrease in the liver enzymes more than the sevoflurane.
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Affiliation(s)
- Rabie Soliman
- Department of Anesthesia, Aldar Hospital, Almadinah Almonwarah, Saudi Arabia.,Department of Anesthesia, Faculty of Medicine, Cairo University, Egypt
| | - Abdelbadee Yacoub
- Department of Anesthesia, Aldar Hospital, Almadinah Almonwarah, Saudi Arabia.,Department of Anesthesia, Faculty of Medicine, Al Azhar University, Cairo, Egypt
| | - Mostafa Abdellatif
- Department of Surgery Aldar Hospital, Almadinah Almonwarah, Saudi Arabia.,Department of Surgery, Faculty of Medicine, Ein Shams University, Cairo, Egypt
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