ABSTRACT
Propofol (2, 6-diisopropylphenol) is a widely used intravenous sedative-hypnotic agent for both induction/maintenance of anesthesia and sedation of critically ill patients. The present study aimed to evaluate oxidative stress biomarkers in individuals undergoing surgery with propofol and ketamine at doses used to induce anesthesia. The plasma oxidative stress biomarkers such as total antioxidant capacity (TAC), lipid peroxidation (LPO), total thiol molecules (TTM) and antioxidant enzymes activity such as glutathione peroxidase (GPx), superoxidedismutase (SOD) and catalase (CAT) were studied in blood samples obtained from 40 patients with propofol, and compared to samples from 40 patients with ketamine aged 11 - 50 years. The results showed that the ketamine group had significantly higher blood LPO level, GPx and SOD activity while having lower blood TAC and TTM concentrations in comparison to the propofol group. In conclusion, our findings showed that propofol has antioxidant effects in human. Further studies need to be conducted to demonstrate the exact mechanism of oxidative stress caused by anesthesia in surgery patients.
Subject(s)
Anesthetics, Intravenous/pharmacology , Antioxidants , Catalase/drug effects , Glutathione Peroxidase/drug effects , Ketamine/pharmacology , Lipid Peroxidation/drug effects , Oxidative Stress/drug effects , Propofol/pharmacology , Superoxide Dismutase/drug effects , Adolescent , Adult , Anesthesia/methods , Anesthetics, Intravenous/therapeutic use , Catalase/blood , Child , Female , Glutathione Peroxidase/blood , Humans , Ketamine/therapeutic use , Male , Middle Aged , Propofol/therapeutic use , Sulfhydryl Compounds/blood , Superoxide Dismutase/blood , Young AdultABSTRACT
The aim of this study was to assess the effect of spinal block with low dose of bupivacaine and sufentanil on patients with low cardiac output who underwent lower limb surgery. Fifteen patients who had ejection fraction less than 40% (group 1) were compared with 65 cases with ejection fraction more than 40% (group 2) in our study. Our subjects underwent spinal block with 7.5 mg hyperbaric bupivacaine 0.5% and 5 µg sufentanil. We recorded early events such as hypotension, bradycardia, vasopressor need and ST segment change in our cases. The average mean arterial pressure decreased 13% (110 mmHg to 95.7 mmHg) in group 1 and 20% (160 mmHg to 128 mmHg) in group 2 (P<0.001). Hypotension due to spinal anesthesia was observed in none of our subjects in both groups and none of our cases need to vasopressor support. All patients remained alert, and no ST segment changes were observed in two groups. In our study none of subjects complained of pain intraoperatively. The subjects were without complaints during the spinal anesthetic in both groups. Spinal block with low dose local anesthetic and sufentanil was a safe and effective method for lower limb surgery in patients with low ejection fraction.
Subject(s)
Analgesics, Opioid/pharmacology , Anesthesia, Spinal/methods , Anesthetics, Local/pharmacology , Blood Pressure/drug effects , Bupivacaine/pharmacology , Stroke Volume , Sufentanil/pharmacology , Aged , Aged, 80 and over , Case-Control Studies , Humans , Lower Extremity/surgery , Middle AgedABSTRACT
The quality of subarachnoid block can be improved by adding opioids to the local anesthetics. We compared the analgesic effects of different doses of intrathecal sufentanil added to lidocaine %5 for elective cesarean section. This study was a prospective, randomized, double-blind, controlled trial. 90 pregnant women with ASA class I-II, scheduled for elective cesarean section under spinal anesthesia were enrolled in this study. Three groups were made of them by random; Group 1 (control group) was given lidocaine 5% (75 mg) and 2 ml of normal saline. Patients in Group 2 received lidocaine 5% (75 mg) and 5 micrograms sufentanil plus 1ml normal saline. Group 3 patients received lidocaine 5% (75 mg) and 10 micrograms sufentanil. Duration of sensory block and effective analgesia (need to analgesic) were measured. Opioid related side effects were recorded. Duration of sensory block and effective analgesia were prolonged in sufentanil groups in comparison of control group(50.3±4) that was significantly more in group 3 (128 ± 4) versus group 2 (58.3 ± 10)(P < 0.001) . There was mild to moderate respiratory depression in sufentanil groups which was more noted in group 3 (p < 0.001). No differences were detected in other side effects such as hypotension, nausea & vomiting. The addition of sufentanil 10 versus 5 micrograms to lidocaine 5% provided more duration of analgesia for cesarean delivery. So, the adding of 10 micrograms sufentanil to lidocaine 5% for cesarean section has more effective analgesia with minimum side effects.
