Bronkoalveolar lavaj (Bal) sıvısındaki nötrofillerin kemotaktik fonksiyonları üzerine sevofluran, desfluran ve propofal anestezisinin etkileri
Küçük Resim Yok
Tarih
2007
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Desfluran, sevofluran veya propofol ile gerçekleştirilen anestezi uygulamasının, bronkoalveolar lavaj (BAL) materyalindeki nötrofillerin kemotaktik fonksiyonları üzerine olan etkilerini akımsitometri yöntemi ile değerlendirmeyi amaçladık. Gereç ve Yöntem: ASA I grubu, 18-40 yaş arasında, 30 hasta rasgele üç gruba (Grup DDesfluran, Grup SSevofluran, Grup PPropofol) ayrıldı. Hastalar diazepam ve atropin ile premedike edildi. Hastaların sistolik ve diastolik arter basıncı, oksijen saturasyonu ve end-tidal CO2 değerleri ile desfluran ve sevofluranın minimum alveoler konsantrasyon ve % değerleri kaydedildi. Anestezi indüksiyonunda tüm hastalara 2-3 mg kg-1 propofol 1 mcg kg-1 fentanil ve 0.6 mg kg-1 rokuronyum bromür uygulandı. Anestezi idamesinde inhalasyon ajanları 1-1,5 MAC olacak şekilde, propofol infüzyonu ise, 12 mg kg-1 dozunda başlanıp 9, 6 ve sonunda 4 mg kg-1 dozuna düşürülerek uygulandı. Fiberoptik bronkoskopla indüksiyondan ve operasyon bitiminden hemen sonra bronkoalveolar lavaj yapıldı. Elde edilen BAL örneklerindeki nötrofillerin, bazal (BAHO) ve N-formil-met-leu-phe (fMLP) ile uyarılmış (UAHO) aktive hücre oranları akım sitometrik yöntemle ölçüldü. Bulgular: Hastaların demografik özellikleri, anestezi/cerrahi süreleri ve hemodinamik bulgular gruplar arasında benzerdi. Grup P’de propofol verilmeden önceki bazal aktive hücre oranları (BAHO), propofol uygulaması sonrası BAHO ile karşılaştırıldığında istatistiksel olarak anlamlı düzeyde yüksekti. Propofol anestezisi sonrasında N-formil-met-leu-phe (fMLP) ile uyarılmış aktive hücre oranları (UAHO), BAHO’na göre anlamlı olarak daha yüksekti. Grup D’de desfluran anestezisi sonrasında UAHO’ları, BAHO’larına göre anlamlı olarak daha yüksekti. Grup S’de sevofluran verilmesinden önce ve sonra, BAHO ve UAHO arasında istatistiksel olarak anlamlı fark yoktu. Sonuç: Bu çalışmanın sonuçları BAL nötrofillerinin kemotaksi fonksiyonu üzerine en az etkili ajanın sevofluran olduğunu göstermiştir.
Aim: We aimed to investigate the effects of anesthesia with desflurane, sevoflurane or propofol on chemotactic activity of neutrophils in bronchoalveolar lavage (BAL) material using with flow cytometry. Materials and Methods: The study includes thirty patients ages ranging from 18 to 40 with ASA class I. The patients were divided into three group (Group DDesflurane, Group SSevoflurane, Group PPropofol). All patients were premedicated with diazepam and atropin. Systolic and diastolic blood pressure, oxygen saturation, end-tidal CO2 values and minimum alveolar concentration of desflurane and sevoflurane were recorded. 2-3 mg kg-1 propofol, 1 mcg kg-1 fentanyl and 0,6 mg kg-1 rocuronium bromur were administered to all patients in the induction of anesthesia. The anesthesia was maintained with inhalation agent (1-1,5 MAC) or propofol (the starting dose 12 mg kg-1 of propofol infusion was reduced to 9, 6 and a final 4 mg kg-1). Bronchoalveolar lavage was performed immediately after induction of anesthesia and surgical procedure by fiberoptic bronchoscop. The basal active cell ratios (BACR) and N-formyl-met-leu-phe (fMLP)-stimulated active cell ratios before and after anesthesia were determined by flow cytometry in BAL neutrophils. Results: Demografic properties, durations of anesthesia and surgery and hemodynamic parameters were similar between the groups. In group P, the basal active cell ratios (BACR) before administration of propofol compared to the BACR after administration of propofol were high. After propofol anesthesia, the fMLP-stimulated active cell ratios (SACR) were significantly higher than the BACR. In group D, after desflurane anesthesia the SACR were significantly higher than the BACR. In group S before and after administration of sevoflurane, there were no statistically significant difference between BACR and SACR. Conclusion: This study showed that sevoflurane was the least effective agent on chemotaxis of BAL neutrofils.
Aim: We aimed to investigate the effects of anesthesia with desflurane, sevoflurane or propofol on chemotactic activity of neutrophils in bronchoalveolar lavage (BAL) material using with flow cytometry. Materials and Methods: The study includes thirty patients ages ranging from 18 to 40 with ASA class I. The patients were divided into three group (Group DDesflurane, Group SSevoflurane, Group PPropofol). All patients were premedicated with diazepam and atropin. Systolic and diastolic blood pressure, oxygen saturation, end-tidal CO2 values and minimum alveolar concentration of desflurane and sevoflurane were recorded. 2-3 mg kg-1 propofol, 1 mcg kg-1 fentanyl and 0,6 mg kg-1 rocuronium bromur were administered to all patients in the induction of anesthesia. The anesthesia was maintained with inhalation agent (1-1,5 MAC) or propofol (the starting dose 12 mg kg-1 of propofol infusion was reduced to 9, 6 and a final 4 mg kg-1). Bronchoalveolar lavage was performed immediately after induction of anesthesia and surgical procedure by fiberoptic bronchoscop. The basal active cell ratios (BACR) and N-formyl-met-leu-phe (fMLP)-stimulated active cell ratios before and after anesthesia were determined by flow cytometry in BAL neutrophils. Results: Demografic properties, durations of anesthesia and surgery and hemodynamic parameters were similar between the groups. In group P, the basal active cell ratios (BACR) before administration of propofol compared to the BACR after administration of propofol were high. After propofol anesthesia, the fMLP-stimulated active cell ratios (SACR) were significantly higher than the BACR. In group D, after desflurane anesthesia the SACR were significantly higher than the BACR. In group S before and after administration of sevoflurane, there were no statistically significant difference between BACR and SACR. Conclusion: This study showed that sevoflurane was the least effective agent on chemotaxis of BAL neutrofils.
Açıklama
Anahtar Kelimeler
Cerrahi
Kaynak
Türk Anestezi ve Reanimasyon Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
35
Sayı
6
