Pathogenetic role of oxidative stress in the formation of postoperative cognitive dysfunction in otolaryngologic patients after general anaesthesia with controlled hypotension

Authors

  • O.I. Datsyuk Vinnytsia Regional Clinical Hospital named after M.I. Pyrogov, Vinnytsia, Ukraine National Pyrogov Memorial Medical University, Vinnytsia, Ukraine
  • R.A. Bondar Vinnytsia Regional Clinical Hospital named after M.I. Pyrogov, Vinnytsia, Ukraine National Pyrogov Memorial Medical University, Vinnytsia, Ukraine
  • A.V. Kostiuchenko Vinnytsia Regional Clinical Hospital named after M.I. Pyrogov, Vinnytsia, Ukraine National Pyrogov Memorial Medical University, Vinnytsia, Ukraine
  • N.V. Titarenko Vinnytsia Regional Clinical Hospital named after M.I. Pyrogov, Vinnytsia, Ukraine National Pyrogov Memorial Medical University, Vinnytsia, Ukraine

DOI:

https://doi.org/10.22141/2224-0586.6.101.2019.179601

Keywords:

general anaesthesia, controlled hypotension, oxidative stress, postoperative cognitive dysfunction

Abstract

Background. Despite a large number of studies devoted to the problem of postoperative cognitive dysfunction that occurs in patients after general anaesthesia, the question of the pathogenetically based choice of methods for correction of cognitive dysfunctions in the perioperative period remains controversial. The purpose of the study was to investigate the peculiarities of free radical processes in otolaryngologic patients undergoing surgical intervention under conditions of general anaesthesia with controlled hypotension and to analyse their significance in the pathogenesis of postoperative cognitive dysfunction. Materials and methods. A prospective study was conducted on 33 otolaryngologic patients (19 men and 14 women) undergoing surgical intervention under general anaesthesia using controlled hypotension. The mean age of the patients was 45.24 ± 15.46 years old. A clinical study was conducted using a battery of neurophysiological tests (Pieron-Ruzer technique, Bourdon proof-reading test, Luriy test, Raven test). The progress of oxidation was evaluated by determining serum levels of protein carbonyl groups, diene conjugates, malondialdehyde, protein SH-groups and superoxide dismutase activity. The serum level of interleukin-18 and the content of neuron-specific enolase were determined by the enzyme immunoassay. Statistical analysis of the received data was performed in the statistical package SPSS 20 (SPSS Inc.). Results. General anaesthesia in combination with medication hypotension promotes the development of postoperative cognitive dysfunction, manifested with decreased concentrations and performance of attention (according to the results of the Pierron-Ruzer technique and proof-reading test), by decreased rate and volume of short-term memory with a decrease in the Luriy test in the early postoperative period as well as by a significant increase of the serum level of the neuron-specific enolase in the postoperative period (p < 0.05). There is a disturbance of oxidative balance in patients that undergo general anaesthesia under conditions of controlled hypotension, which is characterized by an increase in the synthesis of free radicals, in particular, carbonyl groups of proteins, diene conjugates, malonic dialdehyde (p < 0.001) and violations of the antioxidant potential with a decreased activity of superoxide dismutase and levels of SH-protein groups. The patients with postoperative cognitive dysfunction presented with the most negative differences in the oxidative status: the level of carbonyl groups of proteins, diene conjugates and malonic dialdehyde in the blood was higher by 20.7, 16.2 and 30.2 %, respectively, while antioxidant protection levels were significantly lower by 33.2 % and by 6.7% for SH-protein groups compared to patients without postoperative cognitive dysfunction. Conclusions. Changes in oxidative status are one of the pathogenetic links in the development of postoperative cognitive dysfunction in otolaryngologic patients undergoing general anaesthesia with controlled hypotension.

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Published

2019-10-30

How to Cite

Datsyuk, O., Bondar, R., Kostiuchenko, A., & Titarenko, N. (2019). Pathogenetic role of oxidative stress in the formation of postoperative cognitive dysfunction in otolaryngologic patients after general anaesthesia with controlled hypotension. EMERGENCY MEDICINE, (6.101), 72–77. https://doi.org/10.22141/2224-0586.6.101.2019.179601

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Original Researches

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