The effects of dexmedetomidine on thiol/disulphide homeostasis in coronary artery bypass surgery: a randomized controlled trial.

IF 2.3 3区 医学 Q2 ANESTHESIOLOGY
Yusuf Ozguner, Savaş Altınsoy, Gökçen Kültüroğlu, Dilek Unal, Julide Ergil, Salim Neşelioğlu, Özcan Erel
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引用次数: 0

Abstract

Background: Thiol-disulfide homeostasis (TDH) plays a pivotal role in various physiological mechanisms, including antioxidant defence, detoxification, apoptosis, regulation of enzyme activities and cellular signal transduction. TDH can be used as a biomarker to detect oxidative stress (OS) levels and ischemia status in the tissues. Coronary artery bypass grafting (CABG) surgery is a procedure associated with high oxidative stress. Dexmedetomidine, an alpha-2 agonist anaesthetic agent, has antioxidant effects. In this study, the effects of dexmedetomidine on oxidative stress in CABG surgery were investigated.

Methods: Patients who underwent on-pump CABG surgery were divided into two groups: those receiving dexmedetomidine (Group D) and those not receiving dexmedetomidine (Group C). From anesthesia induction to the end of surgery, patients in Group D received intravenous infusions of 0.05-0.2 mcg/kg/min remifentanil and 0.2-0.7 mcg/kg/h dexmedetomidine. Patients in Group C received intravenous infusion of 0.05-0.2 mcg/kg/min remifentanil. Blood samples were collected from the patients 30 min before induction of anesthesia (T1), 30 min after removal of the aortic cross-clamp (T2), and at the end of the surgery (T3). Thiol-disulfide homeostasis (TDH) was assessed using a novel method. A novel automated method enables the determination of native thiols, total thiols and disulfides levels in plasma, allowing the calculation of their respective ratios.

Results: In patients receiving dexmedetomidine, lower postoperative levels of disulfide, disulfide/native thiol, and disulfide/total thiol, along with higher native thiol/total thiol, were observed compared to the control group. (p < 0.05) Postoperative native thiol and total thiol levels were similar for both groups. (p > 0.05) CONCLUSIONS: In our study, through dynamic thiol-disulfide measurements, we found that levels of oxidative stress (OS) were lower in patients who received dexmedetomidine. We believe that the positive effects of dexmedetomidine on OS could be beneficial in CABG surgery. Furthermore, we anticipate that with further studies conducted in larger patient cohorts, the clinical utilization of dexmedetomidine will become more widespread.

Trial registration number: NCT05895331 / 06.07.2023.

右美托咪定对冠状动脉搭桥手术中硫醇/二硫化物平衡的影响:随机对照试验。
背景:硫醇-二硫平衡(TDH)在多种生理机制中发挥着关键作用,包括抗氧化防御、解毒、细胞凋亡、酶活性调节和细胞信号传导。TDH 可作为一种生物标记物来检测组织中的氧化应激(OS)水平和缺血状态。冠状动脉旁路移植(CABG)手术是一种与高氧化应激相关的手术。右美托咪定是α-2激动剂麻醉剂,具有抗氧化作用。本研究调查了右美托咪定对 CABG 手术中氧化应激的影响:方法:将接受体外循环 CABG 手术的患者分为两组:接受右美托咪定的患者(D 组)和未接受右美托咪定的患者(C 组)。从麻醉诱导到手术结束,D 组患者接受 0.05-0.2 mcg/kg/min 瑞芬太尼和 0.2-0.7 mcg/kg/h 右美托咪定的静脉注射。C 组患者静脉注射 0.05-0.2 微克/千克/分钟的瑞芬太尼。分别在麻醉诱导前 30 分钟(T1)、去除主动脉交叉夹钳后 30 分钟(T2)和手术结束时(T3)采集患者的血样。采用一种新型方法对硫醇-二硫平衡(TDH)进行了评估。这种新型自动方法可测定血浆中的原生硫醇、总硫醇和二硫化物水平,并计算出它们各自的比率:结果:与对照组相比,接受右美托咪定治疗的患者术后二硫化物、二硫化物/原生硫醇、二硫化物/总硫醇水平较低,而原生硫醇/总硫醇水平较高。(p 0.05)结论:在我们的研究中,通过动态硫醇-二硫化物测量,我们发现接受右美托咪定治疗的患者氧化应激(OS)水平较低。我们认为右美托咪定对氧化应激水平的积极影响可能有益于 CABG 手术。此外,我们预计随着在更大的患者群体中开展进一步研究,右美托咪定的临床应用将更加广泛:NCT05895331 / 06.07.2023。
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来源期刊
BMC Anesthesiology
BMC Anesthesiology ANESTHESIOLOGY-
CiteScore
3.50
自引率
4.50%
发文量
349
审稿时长
>12 weeks
期刊介绍: BMC Anesthesiology is an open access, peer-reviewed journal that considers articles on all aspects of anesthesiology, critical care, perioperative care and pain management, including clinical and experimental research into anesthetic mechanisms, administration and efficacy, technology and monitoring, and associated economic issues.
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