Comparison of thiol disulfide values in the cord blood of patients undergoing cesarean section under spinal or general anesthesia

Effects of anesthesia on thiol disulfide levels in cord blood

Authors

Keywords:

Thiol disulfide, Ischemia modified albumin, Cesarean section, Anesthesia

Abstract

Background/Aim: Oxidative stress is known to increase in patients receiving anesthesia before undergoing surgery. Since newborns are more sensitive to oxygen-free radicals, the effects and characteristics of anesthesia methods that are used for pregnant women require analysis. This study aimed to evaluate the effects of spinal and general anesthesia on oxidative stress by investigating thiol disulfide and ischemia modified albumin (IMA) concentrations in the cord blood of patients undergoing cesarean section (C-section) via spinal or general anesthesia.

Methods: This cross-sectional prospective study included 60 patients who were indicated for elective cesarean section. Patients with chronic disease, pregnancy complications and/or required emergency cesareans were not included. Group 1 (n = 30) underwent general anesthesia, and Group 2 (n = 30) underwent spinal anesthesia during their C-sections. Thiol–disulfide levels were evaluated concurrently in all blood samples taken from the umbilical artery remaining on the placental side.

Results: The mean age (SD) of the mothers was 30.6 (4.4) years and the mean gestational age (SD) was 39.0 (0.9) weeks. Gestational age, birth weight, and first and fifth min Apgar scores of the two groups were similar. The mean (SD) native thiol (362.4 [63.8]; 323.2 [45.8]), total thiol (409.6 [70.2]; 363.5 [46.1]), and disulfide values (23.6 (5.4); 20.2 (4.3)) were significantly higher in group 1 than group 2, while the median (interquartile range [IQR]) values of IMA (0.89 (0.85-max 0.92); 0.85 (min 0.82-max 0.879) were significantly higher in group 2 than group 1 (P < 0.05).

Conclusions: As general anesthesia may cause a higher degree of oxidative stress, selecting the appropriate anesthetic technique may be especially important for risky pregnancies in which increased oxidative stress in the mother and baby may be critical for the outcome.

Downloads

Download data is not yet available.

References

Sies H. Oxidative stress: oxidants and antioxidants. Experimental Physiology: Translation and Integration. 1997;82(2):291-5. DOI: https://doi.org/10.1113/expphysiol.1997.sp004024

Cremers CM, Jakob U. Oxidant sensing by reversible disulfide bond formation. The Journal of Biological Chemistry. 2013;288(37):26489-96. DOI: https://doi.org/10.1074/jbc.R113.462929

Jones DP, Liang Y. Measuring the poise of thiol/disulfide couples in vivo. Free Radical Biology & Medicine. 2009;47(10):1329-38. DOI: https://doi.org/10.1016/j.freeradbiomed.2009.08.021

Coverdale JP, Katundu KG, Sobczak AI, Arya S, Blindauer CA, Stewart AJ. Ischemia-modified albumin: Crosstalk between fatty acid and cobalt binding. Prostaglandins, Leukotrienes and Essential Fatty Acids. 2018;135:147-57 DOI: https://doi.org/10.1016/j.plefa.2018.07.014

Bahinipati J, Mohapatra PC. Ischemia modified albumin as a marker of oxidative stress in normal pregnancy. JCDR. 2016;10(9):BC15. DOI: https://doi.org/10.7860/JCDR/2016/21609.8454

Lee YM, Song BC, Yeum KJ. Impact of Volatile Anesthetics on Oxidative Stress and Inflammation. BioMed Research International. 2015;2015:242709. DOI: https://doi.org/10.1155/2015/242709

Aktun LH, Aykanat Y, Erel O, Neselioglu S, Olmuscelik O. A Study Over Thiol Disulfide Homeostasis in Cord Blood in Women With Gestational Diabetes. Journal of Family & Reproductive Health. 2018;12(4):217-22.

Akin F, Kozanhan B, Deniz CD, Sahin O, Goktepe H, Neselioglu S, et al. Effects of the anesthesia technique used during cesarean section on maternal-neonatal thiol disulfide homeostasis. Minerva Anestesiologica. 2019;85(11):1175-83. DOI: https://doi.org/10.23736/S0375-9393.19.13598-5

Erel O, Neselioglu S. A novel and automated assay for thiol/disulphide homeostasis. Clinical Biochemistry. 2014;47(18):326-32. DOI: https://doi.org/10.1016/j.clinbiochem.2014.09.026

Mungli P, Shetty MS, Tilak P, Anwar N. Total thiols: biomedical importance and their alteration in various disorders. Online Journal of Health and Allied Sciences. 2009;8(2).

Erkus ME, Altiparmak IH, Akyuz AR, Demirbag R, Sezen Y, Gunebakmaz O, et al. The association between plasma thiol levels and left ventricular diastolic dysfunction in patient with hypertension. Scandinavian Journal of Clinical and Laboratory Investigation. 2015;75(8):667-73.

Karabayirli S, Keskin EA, Kaya A, Koca C, Erel O, Demircioglu RI, et al. Assessment of fetal antioxidant and oxidant status during different anesthesia techniques for elective cesarean sections. Journal of Research in Medical Sciences. 2015;20(8):739-44. DOI: https://doi.org/10.4103/1735-1995.168373

Ulubas Isik D, Akdas Reis Y, Bas AY, Unal S, Ozcan B, Mollamahmutoglu L, et al. The effect of the modes of delivery on the maternal and neonatal dynamic thiol-disulfide homeostasis. The Journal of Maternal-Fetal & Neonatal Medicine. 2019;32(23):3993-7. DOI: https://doi.org/10.1080/14767058.2018.1481028

Kulacoglu H, Ozdogan M, Gurer A, Ersoy EP, Onder Devay A, Duygulu Devay S, et al. Prospective comparison of local, spinal, and general types of anaesthesia regarding oxidative stress following Lichtenstein hernia repair. Bratislavske lekarske listy 2007;108(8):335-9.

Bravo-Cuellar A, Romero-Ramos JE, Hernandez-Flores G, Romo-Perez Fde J, Bravo-Cuellar L, Lerma-Diaz JM. [Comparison of two types of anesthesia on plasma levels of inflammatory markers]. Cirugia y Cirujanos. 2007;75(2):99-105.

Sinha MK, Gaze DC, Tippins JR, Collinson PO, Kaski JC. Ischemia modified albumin is a sensitive marker of myocardial ischemia after percutaneous coronary intervention. Circulation. 2003;107(19):2403-5. DOI: https://doi.org/10.1161/01.CIR.0000072764.18315.6B

Zapico-Muniz E, Santalo-Bel M, Merce-Muntanola J, Montiel JA, Martinez-Rubio A, Ordonez-Llanos J. Ischemia-modified albumin during skeletal muscle ischemia. Clinical Chemistry. 2004 Jun;50(6):1063-5. DOI: https://doi.org/10.1373/clinchem.2003.027789

Bar-Or D, Winkler JV, Vanbenthuysen K, Harris L, Lau E, Hetzel FW. Reduced albumin-cobalt binding with transient myocardial ischemia after elective percutaneous transluminal coronary angioplasty: a preliminary comparison to creatine kinase-MB, myoglobin, and troponin I. American Heart Journal. 2001;141(6):985-91. DOI: https://doi.org/10.1067/mhj.2001.114800

Iacovidou N, Briana DD, Boutsikou M, Liosi S, Baka S, Boutsikou T, et al. Cord blood ischemia-modified albumin levels in normal and intrauterine growth restricted pregnancies. Mediators of inflammation 2008;2008:523081. DOI: https://doi.org/10.1155/2008/523081

Omur D, Hacivelioglu SO, Oguzalp H, Uyan B, Kiraz HA, Duman C, et al. The effect of anaesthesia technique on maternal and cord blood ischaemia-modified albumin levels during caesarean section: a randomized controlled study. The Journal of International Medical Research. 2013;41(4):1111-9. DOI: https://doi.org/10.1177/0300060512474133

Noh EJ, Kim YH, Cho MK, Kim JW, Kim JW, Byun YJ, et al. Comparison of oxidative stress markers in umbilical cord blood after vaginal and cesarean delivery. Obstet Gynecol Sci. 2014;57(2):109-14. DOI: https://doi.org/10.5468/ogs.2014.57.2.109

Downloads

Published

2022-07-29

Issue

Section

Research Article

How to Cite

1.
Soysal Çağanay, Soysal Y, Döğer C, Yılmaz E, Özdemir O, Küçüközkan T, Erel Özcan. Comparison of thiol disulfide values in the cord blood of patients undergoing cesarean section under spinal or general anesthesia: Effects of anesthesia on thiol disulfide levels in cord blood. J Surg Med [Internet]. 2022 Jul. 29 [cited 2022 Aug. 8];6(7):700-4. Available from: https://jsurgmed.com/article/view/1000340