Ali ÇİÇEK, Şaban YALÇIN, Harun AYDOĞAN, Evren BÜYÜKFIRAT, Mahmut Alp KARAHAN, Hasan BİLİNÇ, Mehmet FUAT

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

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

Anahtar Kelimeler:

Vertebra cerrahisi, oksidatif stres, IL-6, propofol, sevofluran

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

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

Keywords:

Spine surgery, oxidative stress, Interleukin 6, propofol, sevoflurane,

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