Ebru BİRİCİK, Feride KARACAER, Ersel GÜLEÇ, Murat ILGINEL, Selçuk MATYAR, Ömer Sunkar BİÇER, Dilek ÖZCENGİZ

Erişkin hastalarda genel ve rejyonel anestezinin kemik belirteçleri ve kırık iyileşmesi üzerine uzun dönem etkileri

Amaç: Kemik metabolizması serum ve/veya idrarda kemik belirteçlerinin ölçülmesi ile kanditatif olarak izlenebilmektedir. Anestezi tipinin kemik belirteçleri ve kırık iyileşmesi üzerine uzun dönem etkilerini araştırmayı amaçladık.Gereç ve Yöntem: Amerikan Anestezi Cemiyeti klinik durum klasifikasyonu I-II olan 40-70 yaş arası kalça fraktürü nedeniyle opere olacak 30 hasta çalışmaya dahil edildi. Hastalar genel ve rejyonel anestezi olarak iki gruba ayrıldı. Postoperatif analjezi için 12th haftaya kadar sadece tramadol kullanıldı.Serum kemik spesifik alkalen fosfataz, osteokalsin, β-C terminal telopeptide ve idrar β-C terminal telopeptide düzeyleri postoperatif 4th ve 12th haftalarda ölçüldü.Bulgular: Toplam 25 hasta çalışmaya uygun bulundu. Postoperatif 4th ve 12th haftalardaki kemik belirteçleri açısından gruplar arasında istatistiksel olarak anlamlı fark bulunamadı. Lineer regresyon analizi uygulandığında 4th haftadaki β-CTX düzeyi ile 12th haftadaki serum β-CTX seviyelerinin (R2: 0.944) ve ilk haftadaki idrar β-CTX düzeyleri ile 12th haftadaki idrar β-CTX seviyelerinin tahmin edilebileceği tespit edildi.Sonuç: Bu pilot çalışma genel ve rejyonel anestezinin kemik belirteçleri ve kırık iyileşmesi üzerine benzer etkisi olduğunu göstermiştir.

Anahtar Kelimeler:

Kemik Belirteçleri, Kırık İyileşmesi, Genel Anestezi, Rejyonel Anestezi

Long term effect of general and regional anesthesia on bone turnover markers and fracture healing in adult patients

Purpose: Bone metabolism can be monitored quantitatively by measuring bone turnover markers in serum and/or urine. We aimed to investigate long-term effect of the type of the anesthesia on bone turnover markers and fracture healingMaterials and Methods:Thirty patients with American Society of Anesthesiologist physical status I-II whom were aged 40-70 years, scheduled for hip fracture were recruited. Patients were divided into the two groups as general anesthesia and regional anesthesia. Only morphine and tramadol were used for postoperative analgesia till the 12th weeks. Serum bone-specific alkaline phosphatase, osteocalcine, β-C terminal telopeptide and urine β-C terminal telopeptide levels were measured at preoperative, 4.th week and 12.th week of fracture. Results:A total of 25 patients were eligible for the study. There were no statistically significant between groups for values of bone turnover markers at the time point of preoperative, 4.th and 12.th weeks. With using linear regression analysis, serum β-CTX levels at 12.th week can be predict by 4.th weeks β-CTX levels (R2: 0.944) and urine β-CTX levels at 12.th week can be predicted by first week level.Conclusion: This pilot study showed that both general and regional anesthesia has similar effect on bone turnover markers and fracture healing.

Keywords:

: Bone turnover markers, Fracture healing, general anesthesia, regional anesthesia,

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