EFFECTS OF ANESTHESIA AND SURGERY ON INFLAMMATORY AND OXIDATIVE STRESS
PARAMETERS IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA SYNDROME
Abstract
Introduction: Obstructive sleep apnea syndrome (OSAS) is a clinical
presentation characterized with continuous obstruction of the upper
respiratory tract during sleep. The aim of our study was to investigate
the levels of inflammation and oxidative stress parameters in patients
grouped according to the apnea hypopnea index (AHI) as those with mild,
moderate and severe OSAS and those without OSAS, and to investigate the
effect of surgery on these parameters. Materials and Method: The groups
included 18 patients with an AHI below 5 (Group 1), 28 patients with an
AHI between 5 and 15 (Group 2), 25 patients with an AHI between 15 and
30 (Group 3), and 30 patients with an AHI of over 30 (Group 4). Blood
samples were collected from patients following the induction of
anesthesia (1st measurement), after the operation (2nd measurement), on
the postoperative 3rd day (3rd measurement) and at the postoperative 2nd
month (4th measurement). Arylesterase (ARE), paraoxonase (PON),
nitrotyrosine (NT), leukocyte, CRP, HDL and LDL were measured. The
ARE/HDL and PON1/HDL ratios were calculated. Results: The inter-group
comparisons revealed differences in the 3rd measurement of leukocyte
count and CRP value, in the 3rd and 4th measurements of HDL, and in the
4th measurement of LDL (p<0.05). Although the CRP level was
higher in all measurements in groups with OSAS compared to the non-OSAS
group, statistical significance was not reached (p>0.05).
No significant difference was observed in the inter-group or intra-group
comparisons for ARE, PON and NT values (p>0.05). No
difference was observed in the ARE/HDL and PON1/HDL ratios between the
groups, whereas they were found to be different between the measurements
in patients with OSAS. Conclusion: We observed that CRP,PON, ARE and NT
levels, and the leukocyte count were not related to the severity of OSAS
in patients with OSAS. The difference observed in CRP and leukocyte
count may be due to the continuous effect of the inflammatory effect of
surgery in the early post-operative period. We believe that HDL, LDL and
the ARE/HDL and PON1/HDL ratios may be used as indicators in the
follow-up and treatment of patients with OSAS