The Effects of General Anesthesia and Infraclavicular Block Applications on Oxidative Stress and Endothelial Dysfunction in Upper Extremity Surgeries
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Endothelial Dysfunction
- Sponsor
- Bagcilar Training and Research Hospital
- Enrollment
- 106
- Primary Endpoint
- Effects of Anesthesia Technique on Endothelial Function with using ultrasonographic technique
- Status
- Not Yet Recruiting
- Last Updated
- last year
Overview
Brief Summary
The aim of this study was to compare the effects of two different anesthesia methods, general anesthesia and infraclavicular block, on oxidative stress and endothelial dysfunction in upper extremity forearm operations.This prospective study aims to determine the ideal anesthesia method for patients undergoing upper extremity forearm surgeries under tourniquet by comparing general anesthesia and infraclavicular block applications in terms of oxidative stress and ED related to ischemia-reperfusion injury.
Detailed Description
Pneumatic tourniquets are commonly used in orthopedic extremity surgeries to reduce surgical trauma and blood loss. When the tourniquet is released, it leads to the release of more free oxygen radicals than under physiological conditions, resulting in ischemia-reperfusion injury, oxidative stress, and endothelial dysfunction (ED). Endothelial dysfunction is characterized by the imbalance between vasoactive substances such as nitric oxide (NO) and endothelin, which regulate vascular tone by exerting vasodilatory and vasoconstrictive effects.During ischemia, xanthine oxidase (XO) derived from xanthine dehydrogenase is the main source of free oxygen radicals (FOR), including superoxide anion (O2-), hydrogen peroxide (H2O2), and hydroxyl anion (OH-). Superoxide anion reacts with NO to produce peroxynitrite (ONOO-), a reactive oxygen derivative. Free radicals affect unsaturated fatty acids in membranes, leading to the production of malondialdehyde (MDA), which exerts cytotoxic effects on endothelial cells. Increased production of FOR due to oxidative stress and dysfunction of antioxidant mechanisms result in protein carbonylation. Protein carbonyl groups (PC) serve as indicators of severe oxidative damage and loss of protein function
Investigators
Sezen Kumaş Solak
Principle Investigator
Bagcilar Training and Research Hospital
Eligibility Criteria
Inclusion Criteria
- •Scheduled for upper extremity surgery using a pneumatic tourniquet
- •American Society of Anesthesiologists (ASA) physical status classification I
Exclusion Criteria
- •Under 18 or over 65 years of age
- •Hypertension
- •Diabetes mellitus
- •Malignancy
- •Cardiovascular disease history (congestive heart failure, myocardial infarction, venous thrombosis)
- •Cerebrovascular disease history
- •Liver/kidney dysfunction
- •Pregnant or breastfeeding women
- •History of substance and tobacco use
- •History of extremity ischemia
Outcomes
Primary Outcomes
Effects of Anesthesia Technique on Endothelial Function with using ultrasonographic technique
Time Frame: Brachial artery FMD measurements will evaluated using ultrasonographic technique from the contralateral Measurements will be taken at three different time points: preoperatively(FMD1), 24hours postoperatively (FMD2), 6th day postoperatively(FMD3)
In this study, investigators aimed to determine the ideal anesthesia method for patients undergoing upper extremity surgeries accompanied by a tourniquet, by comparing general anesthesia and infraclavicular block methods in terms of oxidative stress and endothelial dysfunction (ED) related to ischemia-reperfusion injury. Brachial artery FMD (flow-mediated dilation ) measurements will evaluated using ultrasonographic technique from the contralateral
Evaluation of the Effect of Anesthesia Technique on Endothelial Function with evaluated in the collected blood samples levels
Time Frame: before anesthesia (T0), 1 minute before (T1), 5 minutes after (T2), and 20 minutes after deflation of the tourniquet
During the operation, the dorsal venous cannula in the foot was not utilized for any other purpose. The duration of surgery and tourniquet application was recorded for each group. Tourniquet pressure was set at approximately twice the systolic arterial pressure (SAP). Evaluated in the collected blood samples levels of Protein carbonyl (PC),xanthine oxidase (XO),nitric oxide (NO),malondialdehyde (MDA)
Secondary Outcomes
- Effects of Anesthesia Technique on Endothelial Function(before anesthesia (T0), 1 minute before (T1), 5 minutes after (T2), and 20 minutes after deflation of the tourniquet)