Document Detail

Epidural anesthesia may attenuate lipid peroxidation during aorto-femoral surgery.
MedLine Citation:
PMID:  15128632     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To determine the effect of epidural anesthesia (EP) on oxygenation of the chronically ischemic limb in patients undergoing aorto-femoral bypass grafting and to assess whether it produces an alteration of lipid peroxidation and antioxidant status following revascularization. METHODS: In this prospective, randomized, single-blinded study 40 ASA II or III patients undergoing elective aorto-femoral bypass grafting were allocated to receive general anesthesia (group GA, n = 20), or epidural + GA (group EP, n = 20) during surgery. Femoral venous blood-gas status, activities of the protecting antioxidant enzymes superoxide dismutase (SOD), glutathione peroxidase (GSH-px), glutathione reductase (GSH-rd), glutathione (GSH) and thiobarbituric acid-reactive substances (TBARS) as a marker of lipid peroxidation were determined in blood samples taken from the femoral vein at different intervals before and after revascularization. RESULTS: Before the induction of anesthesia in group EP, femoral venous PO(2) [mean (standard deviation), 95% confidence interval] increased after achieving an adequate level of blockade by EP extending to the dermatomal level of T6-8 [29.32 (4.6), 26.34-32.30 to 36.29 (4.6), 33.37-39.22 mmHg, P < 0.05]. Femoral venous PO(2) was similar in both groups thereafter. In the GA group a significant increase in erythrocyte TBARS was observed immediately after restoration of blood flow when compared with baseline values [221.32 (102), 148.35-294-29 to 337.26 (123) 248.99-425.53 nmol*g(-1) hemoglobin, P < 0.01] but not at any other moment. In the EP group TBARS did not increase throughout the study. Within group comparisons revealed no significant differences in GSH, GSH-px, GSH-rd and SOD. CONCLUSION: In patients with atherosclerotic aorto-iliac occlusive disease EP may possibly attenuate lipid peroxidation following revascularization but has no effect on antioxidant enzyme activities.
Lale Yüceyar; Hülya Erolçay; Dildar Konukoglu; A Kürsat Bozkurt; Bora Aykaç
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Canadian journal of anaesthesia = Journal canadien d'anesthésie     Volume:  51     ISSN:  0832-610X     ISO Abbreviation:  Can J Anaesth     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-05-06     Completed Date:  2004-09-07     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8701709     Medline TA:  Can J Anaesth     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  465-71     Citation Subset:  IM    
Department of Anesthesiology, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey.
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MeSH Terms
Anesthesia, Epidural*
Anesthesia, General
Antioxidants / metabolism
Arterial Occlusive Diseases / surgery*
Arteriosclerosis / surgery*
Blood Gas Analysis
Erythrocytes / enzymology,  metabolism
Femoral Vein / surgery*
Glutathione Peroxidase / blood
Glutathione Reductase / blood
Hemodynamics / physiology
Lipid Peroxidation / physiology*
Middle Aged
Myocardial Reperfusion
Myocardial Revascularization*
Superoxide Dismutase / blood
Thiobarbituric Acid Reactive Substances / metabolism
Reg. No./Substance:
0/Antioxidants; 0/Thiobarbituric Acid Reactive Substances; EC Peroxidase; EC Dismutase; EC Reductase

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