Comparison of the effects of hypotensive anesthesia techniques based on systolic and mean arterial pressure on cerebral perfusion, blood oxidant-antioxidant levels and HIF-1a levels

Ayşe Şencan; Hayrettin Daşkaya; Harun Uysal; Muhittin Çalım; Kazım Karaaslan; İsmail Sümer

Makale detayları

Comparison of the effects of hypotensive anesthesia techniques based on systolic and mean arterial pressure on cerebral perfusion, blood oxidant-antioxidant levels and HIF-1a levels

Yazarlar:

Ayşe Şencan | Hayrettin Daşkaya | Harun Uysal | Muhittin Çalım | Kazım Karaaslan | İsmail Sümer

Yayıncı:

Cukurova University

Ana Başlıklar:

Anesteziyoloji

Dergi:

Cukurova Medical Journal Vol.49 Issue 4, pp.996-1005

Belge Tipi:

Makale

Yayın Tarihi:

12/2024

Belge Dili:

İngilizce

Document ID (Org No.):

2001329050

pISSN:

2602-3032

Anahtar kelimeler:

Özet:

 Purpose: This study aims to compare and evaluate changes in tissue and cerebral perfusion when systolic blood pressure SBP or mean arterial pressure MAP is used as the reference parameter to achieve controlled hypotension. Materials and Methods: Patients scheduled for planned rhinoplasty or jaw surgery requiring controlled hypotension were included in the study. The patients were categorized into two groups: Group 1 systolic blood pressure group and Group 2 mean arterial pressure group. Before anesthesia induction and emergence, levels of total oxidant status TOS, total antioxidant status TAS, oxidative stress index OSI, and hypoxia-inducible factor HIF-1α in the blood were measured. Perioperative cerebral perfusion monitoring was performed using near-infrared spectroscopy NIRS. Results: There was no significant difference between the two groups in preoperative and postoperative levels of TAS, TOS, OSI, and HIF-1α, which are used as indicators of oxidative stress. Similarly, there was no significant difference in RsO2 values between the groups. Surgical satisfaction scores were significantly higher in Group 2, while bleeding scores were significantly lower. Conclusion: MAP-targeted controlled hypotension provides higher surgical satisfaction and lower bleeding scores without causing disadvantages in terms of cerebral oxygenation or oxidative stress.

 Purpose: This study aims to compare and evaluate changes in tissue and cerebral perfusion when systolic blood pressure SBP or mean arterial pressure MAP is used as the reference parameter to achieve controlled hypotension. Materials and Methods: Patients scheduled for planned rhinoplasty or jaw surgery requiring controlled hypotension were included in the study. The patients were categorized into two groups: Group 1 systolic blood pressure group and Group 2 mean arterial pressure group. Before anesthesia induction and emergence, levels of total oxidant status TOS, total antioxidant status TAS, oxidative stress index OSI, and hypoxia-inducible factor HIF-1α in the blood were measured. Perioperative cerebral perfusion monitoring was performed using near-infrared spectroscopy NIRS. Results: There was no significant difference between the two groups in preoperative and postoperative levels of TAS, TOS, OSI, and HIF-1α, which are used as indicators of oxidative stress. Similarly, there was no significant difference in RsO2 values between the groups. Surgical satisfaction scores were significantly higher in Group 2, while bleeding scores were significantly lower. Conclusion: MAP-targeted controlled hypotension provides higher surgical satisfaction and lower bleeding scores without causing disadvantages in terms of cerebral oxygenation or oxidative stress.

 Purpose: This study aims to compare and evaluate changes in tissue and cerebral perfusion when systolic blood pressure SBP or mean arterial pressure MAP is used as the reference parameter to achieve controlled hypotension. Materials and Methods: Patients scheduled for planned rhinoplasty or jaw surgery requiring controlled hypotension were included in the study. The patients were categorized into two groups: Group 1 systolic blood pressure group and Group 2 mean arterial pressure group. Before anesthesia induction and emergence, levels of total oxidant status TOS, total antioxidant status TAS, oxidative stress index OSI, and hypoxia-inducible factor HIF-1α in the blood were measured. Perioperative cerebral perfusion monitoring was performed using near-infrared spectroscopy NIRS. Results: There was no significant difference between the two groups in preoperative and postoperative levels of TAS, TOS, OSI, and HIF-1α, which are used as indicators of oxidative stress. Similarly, there was no significant difference in RsO2 values between the groups. Surgical satisfaction scores were significantly higher in Group 2, while bleeding scores were significantly lower. Conclusion: MAP-targeted controlled hypotension provides higher surgical satisfaction and lower bleeding scores without causing disadvantages in terms of cerebral oxygenation or oxidative stress.

 Amaç: Bu çalışmanın amacı, kontrollü hipotansiyon sırasında arteriyel kan basıncının ayarlanmasında referans parametre olarak sistolik kan basıncı SKB veya ortalama kan basıncının OKB kullanılması durumunda doku ve beyin perfüzyonundaki değişiklikleri değerlendirmektir. Gereç ve Yöntem: Kontrollü hipotansiyon uygulanacak planlı rinoplasti ya da çene cerrrahisi yapılacak hastalar çalışmaya dahil edildi. Hastalar, Grup 1 sistolik kan basıncı grubu ve Grup 2 ortalama kan basıncı grubu olarak kategorize edildi. Anestezi indüksiyonundan ve uyandırmadan önce kandaki toplam oksidan durumu TOS, toplam antioksidan durumu TAS, oksidatif stres indeksi OSI ve hipoksi inducible factör HIF-1a seviyeleri ölçüldü. Perioperatif beyin perfüzyonu monitörizasyonu near infraraed spectroscopy NIRS kullanılarak gerçekleştirildi. Bulgular: İki grup arasında oksidatif stres göstergesi olarak kullanılan TAS, TOS, OSI, ve HIF-1α değerlerinde preoperatif ve postoperatif anlamlı bir fark bulunmadı. İki grup arasında RsO2 değerlerinde anlamlı fark bulunmadı. Grup 2de cerrahi memnuniyet skorları anlamlı olarak daha yüksek, kanama skorları ise anlamlı olarak daha düşüktü. Sonuç: OKB hedefli kontrollü hipotansiyonun, serebral oksijenasyon ve oksidatif stres açısından bir dezavantaj yaratmadan daha yüksek cerrahi memnuniyet ve daha düşük kanama skorları sağladığını göstermektedir.

Makale detayları

Comparison of the effects of hypotensive anesthesia techniques based on systolic and mean arterial pressure on cerebral perfusion, blood oxidant-antioxidant levels and HIF-1a levels

Yazarlar:

Ayşe Şencan | Hayrettin Daşkaya | Harun Uysal | Muhittin Çalım | Kazım Karaaslan | İsmail Sümer

Yayıncı:

Cukurova University

Ana Başlıklar:

Anesteziyoloji

Dergi:

Cukurova Medical Journal Vol.49 Issue 4, pp.996-1005

Belge Tipi:

Makale

Yayın Tarihi:

12/2024

Belge Dili:

İngilizce

Document ID (Org No.):

2001329050

pISSN:

2602-3032

Hypotensive anesthesia

Hypoxia

Hypoxia inducible factör

Near infrared spectroscopy

Tissue perfusionHipotansif anestezi

hipoksi

hipoksi indüklenebilir faktör

yakın kızılötesi spektroskopisi

Sayı

Makale detayları

Yazarlar: Ayşe Şencan | Hayrettin Daşkaya | Harun Uysal | Muhittin Çalım | Kazım Karaaslan | İsmail Sümer

Yayıncı: Cukurova University

Ana Başlıklar: Anesteziyoloji

Dergi: Cukurova Medical Journal Vol.49 Issue 4, pp.996-1005

Belge Tipi: Makale

Yayın Tarihi: 12/2024

Belge Dili: İngilizce

Document ID (Org No.): 2001329050

pISSN: 2602-3032

Sayı

Yazarlar:

Ayşe Şencan | Hayrettin Daşkaya | Harun Uysal | Muhittin Çalım | Kazım Karaaslan | İsmail Sümer

Yayıncı:

Cukurova University

Ana Başlıklar:

Anesteziyoloji

Dergi:

Cukurova Medical Journal Vol.49 Issue 4, pp.996-1005

Belge Tipi:

Makale

Yayın Tarihi:

12/2024

Belge Dili:

İngilizce

Document ID (Org No.):

2001329050

pISSN:

2602-3032