1
|
Comparison of thiol disulfide values in the cord blood of patients undergoing cesarean section under spinal or general anesthesia. JOURNAL OF SURGERY AND MEDICINE 2022. [DOI: 10.28982/josam.1000340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background/Aim: Oxidative stress is known to increase in patients receiving anesthesia before undergoing surgery. Since newborns are more sensitive to oxygen-free radicals, the effects and characteristics of anesthesia methods that are used for pregnant women require analysis. This study aimed to evaluate the effects of spinal and general anesthesia on oxidative stress by investigating thiol disulfide and ischemia modified albumin (IMA) concentrations in the cord blood of patients undergoing cesarean section (C-section) via spinal or general anesthesia.
Methods: This cross-sectional prospective study included 60 patients who were indicated for elective cesarean section. Patients with chronic disease, pregnancy complications and/or required emergency cesareans were not included. Group 1 (n = 30) underwent general anesthesia, and Group 2 (n = 30) underwent spinal anesthesia during their C-sections. Thiol–disulfide levels were evaluated concurrently in all blood samples taken from the umbilical artery remaining on the placental side.
Results: The mean age (SD) of the mothers was 30.6 (4.4) years and the mean gestational age (SD) was 39.0 (0.9) weeks. Gestational age, birth weight, and first and fifth min Apgar scores of the two groups were similar. The mean (SD) native thiol (362.4 [63.8]; 323.2 [45.8]), total thiol (409.6 [70.2]; 363.5 [46.1]), and disulfide values (23.6 (5.4); 20.2 (4.3)) were significantly higher in group 1 than group 2, while the median (interquartile range [IQR]) values of IMA (0.89 (0.85-max 0.92); 0.85 (min 0.82-max 0.879) were significantly higher in group 2 than group 1 (P < 0.05).
Conclusions: As general anesthesia may cause a higher degree of oxidative stress, selecting the appropriate anesthetic technique may be especially important for risky pregnancies in which increased oxidative stress in the mother and baby may be critical for the outcome.
Collapse
|
2
|
Oksuz M, Abitagaoglu S, Kaciroglu A, Koksal C, Ozturk BY, Erel O, Senat A, Erdogan Ari D. Effects of general anaesthesia and ultrasonography-guided interscalene block on pain and oxidative stress in shoulder arthroscopy: A randomised trial. Int J Clin Pract 2021; 75:e14948. [PMID: 34614288 DOI: 10.1111/ijcp.14948] [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: 06/05/2021] [Accepted: 10/04/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND/AIM The aim of this study was to evaluate the effects of general anaesthesia and ultrasonography-guided interscalene block on pain and oxidative stress evaluated by thiol-disulphide balance and C-reactive protein levels in patients undergoing shoulder arthroscopy. MATERIALS AND METHODS A total of 42 patients aged 18-75 years who were scheduled to undergo shoulder arthroscopy were randomised into interscalene block group (Group-IB, n = 20) and general anaesthesia group (Group-GA, n = 22). All patients received patient-controlled analgesia during the postoperative period. Additional analgesics were administered to patients with a visual analogue scale score of >4. Native-thiol, total-thiol, disulphide and C-reactive protein levels were measured. Patients' visual analogue scale scores, morphine and additional analgesic consumption were recorded. A shift in thiol-disulphide balance towards decreased thiol and increased disulphide levels was regarded as an indicator of oxidative stress. RESULTS Pain level, morphine and additional analgesic consumption were higher in Group-GA. Native-thiol and total-thiol levels were higher in Group-IB postoperatively and also disulphide levels were lower at postoperative 18 hours. C-reactive protein levels were similar in both the groups. CONCLUSION Interscalene block induced less oxidative stress during the postoperative period, as evaluated by thiol-disulphide balance. In shoulder arthroscopy, interscalene block provides more stable haemodynamics perioperatively and facilitates better postoperative pain control.
Collapse
Affiliation(s)
- Murat Oksuz
- Anesthesiology and Reanimation Department, University of Health Sciences Sancaktepe Şehit Prof. Dr. İlhan Varank Health Application and Research Center, Istanbul, Turkey
| | - Suheyla Abitagaoglu
- Anesthesiology and Reanimation Department, University of Health Sciences Fatih Sultan Mehmet Health Application and Research Center, Istanbul, Turkey
| | - Ahmet Kaciroglu
- Anesthesiology and Reanimation Department, University of Health Sciences Fatih Sultan Mehmet Health Application and Research Center, Istanbul, Turkey
- Ministery of Health Bursa City Hospital, Bursa, Turkey
| | - Ceren Koksal
- Anesthesiology and Reanimation Department, University of Health Sciences Fatih Sultan Mehmet Health Application and Research Center, Istanbul, Turkey
| | - Burak Yagmur Ozturk
- Orthopedic Surgery Department, University of Health Sciences Fatih Sultan Mehmet Health Application and Research Center, Istanbul, Turkey
| | - Ozcan Erel
- Biochemistry Department, Yıldırım Beyazıt University, Ankara, Turkey
| | - Almila Senat
- Biochemistry Department, Yıldırım Beyazıt University, Ankara, Turkey
| | - Dilek Erdogan Ari
- Anesthesiology and Reanimation Department, University of Health Sciences Fatih Sultan Mehmet Health Application and Research Center, Istanbul, Turkey
| |
Collapse
|
3
|
Akin F, Kozanhan B, Deniz CD, Sahin O, Goktepe H, Neselioglu S, Erel O. Effects of the anesthesia technique used during cesarean section on maternal-neonatal thiol disulfide homeostasis. Minerva Anestesiol 2019; 85:1175-1183. [PMID: 31213043 DOI: 10.23736/s0375-9393.19.13598-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Thiols are organic compounds consisting of a sulfhydryl group which exerts antioxidant effects via dynamic thiol-disulfide homeostasis (TDH). The shift towards the disulfide states signals an oxidative situation. Maternal-neonatal oxidative stress can be affected by the anesthetic technique used during cesarean section. This study aimed to evaluate the relationship between the type of anesthesia used and the maternal-neonatal TDH. METHODS ASA I-II, term parturients undergoing elective cesarean section either under general (Group G) or spinal (Group S) anesthesia were included. Blood specimens were collected preoperatively and postoperatively from the mothers and from the umbilical venous cords at delivery. TDH was studied by a new method developed by the authors (O.E. and S.N.). RESULTS Postoperative mother's native thiol, total thiol, disulfide/total thiol, native thiol/ disulfide and disulfide levels were higher in Group G than in Group S. There was no significant difference between the groups in umbilical venous cord albumin, native thiol/total thiol, disulfide, native thiol/ disulfide and total thiol/ disulfide. However, in Group G, umbilical venous cord native thiol and total thiol levels were statistically significantly lower than those in Group S. CONCLUSIONS Our results showed that general anesthesia in cesarean section leads to an impairment in TDH when compared with spinal anesthesia. Oxidative stress might be modified by the preferred anesthetic technique.
Collapse
Affiliation(s)
- Fatma Akin
- Department of Anesthesiology and Reanimation, Erzurum Training and Research Hospital, Erzurum, Turkey
| | - Betul Kozanhan
- Department of Anesthesiology and Reanimation, Konya Training and Research Hospital, Konya, Turkey -
| | - Cigdem D Deniz
- Department of Clinical Biochemistry, Konya Training and Research Hospital, Konya, Turkey
| | - Osman Sahin
- Department of Anesthesiology and Reanimation, Konya Training and Research Hospital, Konya, Turkey
| | - Halime Goktepe
- Department of Obstetrics and Gynecology Clinic, Konya Training and Research Hospital, Konya, Turkey
| | - Salim Neselioglu
- Department of Clinical Biochemistry, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
| | - Ozcan Erel
- Department of Clinical Biochemistry, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
| |
Collapse
|
4
|
Seshadri Reddy V, Duggina P, Vedhantam M, Manne M, Varma N, Nagaram S. Maternal serum and fetal cord-blood ischemia-modified albumin concentrations in normal pregnancy and preeclampsia: a systematic review and meta-analysis. J Matern Fetal Neonatal Med 2018; 31:3255-3266. [PMID: 28817994 DOI: 10.1080/14767058.2017.1368480] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND/AIMS A meta-analysis of maternal serum ischemia-modified albumin (IMA) and fetal cord-blood IMA concentrations in normal pregnancy (NP) compared to non-pregnant healthy controls (HC) and in preeclampsia (PE) compared with normal pregnant controls were studied. METHODS All major databases were searched for eligible studies. We included eight studies comparing serum IMA between NP and HC, 14 studies comparing serum IMA between PE and NP and five studies comparing cord-blood IMA between PE and NP groups. Meta-analyses on these included studies were performed using Review Manager 5.3. Pooled-overall effect size as standardized mean difference (SMD), publication bias, subgroup, and sensitivity analysis data were generated. RESULTS Random-effects meta-analysis indicated a significant increase in serum IMA in the NP group (SMD = 0.98, p = .01) and the PE group (SMD = 0.94, p < .0001) as compared with HC and NP groups, respectively. And, the cord-blood IMA has been found to be significantly increased in PE (SMD = 6.51, p < .0001) compared with the NP group. CONCLUSIONS This meta-analysis, the first of its kind showed that the increased serum IMA concentrations were indicative of increased oxidative stress in NP and PE. Measurement of maternal serum IMA and fetal cord-blood IMA concentrations were useful as simple, novel, and inexpensive markers of oxidative stress (OS) status in PE patients. Future large-scale studies are needed to explore IMA in relationship to the disease severity in PE.
Collapse
Affiliation(s)
- Varikasuvu Seshadri Reddy
- a Department of Biochemistry, Maheshwara Medical College & Hospital , Chitkul, Patancheru, Telangana , India
| | - Pragathi Duggina
- b Department of Biotechnology , Sri Venkateswara University , Tirupati, Andhra Pradesh , India
| | - Mrudula Vedhantam
- c Department of Botany , Sri Venkateswara University , Tirupati, Andhra Pradesh , India
| | - Munikumar Manne
- d Biomedical Informatics Center (BMIC), National Institute of Nutrition-Indian Council of Medical Research , Hyderabad, Telangana , India
| | - Neelakant Varma
- e Institute of Forensic Science, Gujarat Forensic Sciences University , Gandhinagar , India
| | - Srinivas Nagaram
- a Department of Biochemistry, Maheshwara Medical College & Hospital , Chitkul, Patancheru, Telangana , India
| |
Collapse
|
5
|
Aksoy M, Aksoy AN, Ahıskalıoğlu A, İnce İ, Laloğlu E, Dostbil A, Çelik MG. The Effect of Anaesthetic Techniques on Maternal and Cord Blood Brain-Derived Neurotrophic Factor Levels. Turk J Anaesthesiol Reanim 2018; 46:139-146. [PMID: 29744249 DOI: 10.5152/tjar.2018.90187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Accepted: 11/22/2017] [Indexed: 11/22/2022] Open
Abstract
Objective Brain-derived neurotrophic factor (BDNF), a member of neurotrophins, plays a critical role in neuronal tissue. In this study, the effects of spinal or general anaesthesia on cord and maternal peripheral blood BDNF and malondialdehyde (MDA) levels were investigated in patients undergoing elective caesarean section. Methods Eighty patients with term pregnancy were included. General anaesthesia was induced with intravenous (IV) propofol 2 mg kg-1 in the general anaesthesia group (n=36). In the spinal anaesthesia group (n=35), hyperbaric bupivacaine 0.5%, 9 mg (1.8 mL) was injected intrathecally. Maternal blood samples were taken immediately after positioning the patient on the operating table (T1), before clamping the umbilical cord (T2) and 24 hours after the first sample was obtained (T3). Cord blood samples were drawn from the umbilical artery (T4). Results Maternal BDNF levels (pg mL-1) measured at T2 time point were higher in the general anaesthesia group compared to the spinal anaesthesia group (p<0.001). Cord blood BDNF levels were higher in the general anaesthesia group compared to the spinal anaesthesia group (p<0.001). In both groups, cord blood BDNF levels were significantly lower compared to the maternal blood samples collected at any time point (p<0.001, for all). There was a negative association between both maternal and cord blood BDNF levels with maternal MDA and cord blood MDA levels, respectively (r=-0.379, p<0.001; r=-0.375, p=0.001, respectively). Conclusion The anaesthetic technique may have an influence on maternal peripheral and cord blood BDNF levels.
Collapse
Affiliation(s)
- Mehmet Aksoy
- Department of Anesthesiology and Reanimation, Atatürk University School of Medicine, Erzurum, Turkey
| | - Ayşe Nur Aksoy
- Clinic of Obstetrics and Gynecology, Nenehatun Hospital, Erzurum, Turkey
| | - Ali Ahıskalıoğlu
- Department of Anesthesiology and Reanimation, Atatürk University School of Medicine, Erzurum, Turkey
| | - İlker İnce
- Department of Anesthesiology and Reanimation, Atatürk University School of Medicine, Erzurum, Turkey
| | - Esra Laloğlu
- Department of Biochemistry, Atatürk University School of Medicine, Erzurum, Turkey
| | - Ayşenur Dostbil
- Department of Anesthesiology and Reanimation, Atatürk University School of Medicine, Erzurum, Turkey
| | - Mine Gürsaç Çelik
- Department of Anesthesiology and Reanimation, Atatürk University School of Medicine, Erzurum, Turkey
| |
Collapse
|
6
|
Yarcı Gursoy A, Caglar GS, Demirtas S. Ischemia modified albumin in perinatology. Eur J Obstet Gynecol Reprod Biol 2016; 210:182-188. [PMID: 28056434 DOI: 10.1016/j.ejogrb.2016.12.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 10/20/2016] [Accepted: 12/19/2016] [Indexed: 11/30/2022]
Abstract
Ischemia modified albumin is a novel marker of ischemia generated due to hypooxygenation and increased hydroxyl free radicals in low pH. The molecule has been licenced for clinical use as an early marker for acute coronary syndrome in cardiology. Since presence of ischemia might have serious and sometimes devastating effects in perinatology, various researches have evaluated its value in different clinical conditions. This narrative review aims to summarize the literature concerning the value of IMA in perinatology and guide for further research.
Collapse
Affiliation(s)
- Aslı Yarcı Gursoy
- Ufuk University Faculty of Medicine, Obstetrics and Gynecology Department, Ankara, Turkey.
| | - Gamze S Caglar
- Ufuk University Faculty of Medicine, Obstetrics and Gynecology Department, Ankara, Turkey
| | - Selda Demirtas
- Ufuk University Faculty of Medicine, Biochemistry Department, Ankara, Turkey
| |
Collapse
|
7
|
Keplinger M, Marhofer P, Eppel W, Macholz F, Hachemian N, Karmakar MK, Marhofer D, Klug W, Kettner SC. Lumbar neuraxial anatomical changes throughout pregnancy: a longitudinal study using serial ultrasound scans. Anaesthesia 2016; 71:669-74. [DOI: 10.1111/anae.13399] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2016] [Indexed: 11/29/2022]
Affiliation(s)
- M. Keplinger
- Department of Anaesthesiology and General Intensive Care Medicine; Medical University of Vienna; Vienna Austria
| | - P. Marhofer
- Department of Anaesthesiology and General Intensive Care Medicine; Medical University of Vienna; Vienna Austria
| | - W. Eppel
- Department of Obstetrics and Gynaecology; Medical University of Vienna; Vienna Austria
| | - F. Macholz
- Department of Anaesthesiology, Peri-operative Medicine and General Intensive Care Medicine; Medical University Salzburg; Salzburg Austria
| | - N. Hachemian
- Department of Obstetrics and Gynaecology; Medical University of Vienna; Vienna Austria
| | - M. K. Karmakar
- Department of Anaesthesia and Intensive Care; The Chinese University of Hong Kong; Prince of Wales Hospital; Shatin Hong Kong
| | - D. Marhofer
- Department of Anaesthesiology and General Intensive Care Medicine; Medical University of Vienna; Vienna Austria
| | - W. Klug
- Department of Anaesthesiology and General Intensive Care Medicine; Medical University of Vienna; Vienna Austria
| | - S. C. Kettner
- Department of Anaesthesiology and General Intensive Care Medicine; Medical University of Vienna; Vienna Austria
| |
Collapse
|
8
|
Satoh M, Kotani K, Gugliucci A, Horie H, Caccavello R, Takeuchi M. Changes of Ischemia- Modified Albumin During the Postoperative Period in Patients With Colorectal Surgery. Arch Pathol Lab Med 2015; 139:968-9. [PMID: 26230588 DOI: 10.5858/arpa.2014-0484-le] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Masaaki Satoh
- Department of 1 Anesthesiology and Critical Care Medicine
| | - Kazuhiko Kotani
- 2 Department of Clinical Laboratory, Jichi Medical University, Shimotsuke, Japan Medicine.,3 Glycation, Oxidation, and Disease Laboratory, Touro University California, Vallejo
| | - Alejandro Gugliucci
- 3 Glycation, Oxidation, and Disease Laboratory, Touro University California, Vallejo
| | - Hisanaga Horie
- 4 Department of Surgery, Jichi Medical University, Shimotsuke, Japan
| | - Russell Caccavello
- 3 Glycation, Oxidation, and Disease Laboratory, Touro University California, Vallejo
| | | |
Collapse
|
9
|
Dahiya K, Kulshrestha MR, Bansal P, Ghalaut VS, Kulshrestha R, Dahiya P, Dhupper V. Evaluation of cord blood ischemia modified albumin in normal pregnancies and pre-eclampsia. Hypertens Pregnancy 2015; 34:204-8. [PMID: 25775261 DOI: 10.3109/10641955.2014.1001901] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Pre-eclampsia is associated with ischemia and increased oxidative stress, which may lead to modification of plasma albumin to ischemia modified albumin (IMA). METHODS IMA levels were estimated in cord blood of 30 newborns born to pre-eclamptic mothers and compared with 30 normal newborns. IMA was estimated colorimetrically and the results were compared statistically. RESULTS The levels of IMA were found to be significantly higher (p < 0.001) in newborns born to pre-eclamptic mothers (0.835 ± 0.02 ABSU) as compared to those born to normal mothers (0.325 ± 0.01 ABSU). CONCLUSION IMA may act as a marker of ischemia and oxidative stress in newborns delivered to pre-eclamptic mothers.
Collapse
|