The effects of dexmedetomidine on thiol/disulphide homeostasis in coronary artery bypass surgery: a randomized controlled trial

Abstract Background Thiol-disulfide homeostasis (TDH) plays a pivotal role in various physiological mechanisms, including antioxidant defence, detoxification, apoptosis, regulation of enzyme activities and cellular signal transduction. TDH can be used as a biomarker to detect oxidative stress (OS) l...

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Main Authors: Yusuf Ozguner, Savaş Altınsoy, Gökçen Kültüroğlu, Dilek Unal, Julide Ergil, Salim Neşelioğlu, Özcan Erel
Format: Article
Language:English
Published: BMC 2024-11-01
Series:BMC Anesthesiology
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Online Access:https://doi.org/10.1186/s12871-024-02794-1
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author Yusuf Ozguner
Savaş Altınsoy
Gökçen Kültüroğlu
Dilek Unal
Julide Ergil
Salim Neşelioğlu
Özcan Erel
author_facet Yusuf Ozguner
Savaş Altınsoy
Gökçen Kültüroğlu
Dilek Unal
Julide Ergil
Salim Neşelioğlu
Özcan Erel
author_sort Yusuf Ozguner
collection DOAJ
description Abstract Background Thiol-disulfide homeostasis (TDH) plays a pivotal role in various physiological mechanisms, including antioxidant defence, detoxification, apoptosis, regulation of enzyme activities and cellular signal transduction. TDH can be used as a biomarker to detect oxidative stress (OS) levels and ischemia status in the tissues. Coronary artery bypass grafting (CABG) surgery is a procedure associated with high oxidative stress. Dexmedetomidine, an alpha-2 agonist anaesthetic agent, has antioxidant effects. In this study, the effects of dexmedetomidine on oxidative stress in CABG surgery were investigated. Methods Patients who underwent on-pump CABG surgery were divided into two groups: those receiving dexmedetomidine (Group D) and those not receiving dexmedetomidine (Group C). From anesthesia induction to the end of surgery, patients in Group D received intravenous infusions of 0.05–0.2 mcg/kg/min remifentanil and 0.2–0.7 mcg/kg/h dexmedetomidine. Patients in Group C received intravenous infusion of 0.05–0.2 mcg/kg/min remifentanil. Blood samples were collected from the patients 30 min before induction of anesthesia (T1), 30 min after removal of the aortic cross-clamp (T2), and at the end of the surgery (T3). Thiol-disulfide homeostasis (TDH) was assessed using a novel method. A novel automated method enables the determination of native thiols, total thiols and disulfides levels in plasma, allowing the calculation of their respective ratios. Results In patients receiving dexmedetomidine, lower postoperative levels of disulfide, disulfide/native thiol, and disulfide/total thiol, along with higher native thiol/total thiol, were observed compared to the control group. (p < 0.05) Postoperative native thiol and total thiol levels were similar for both groups. (p > 0.05) Conclusions In our study, through dynamic thiol-disulfide measurements, we found that levels of oxidative stress (OS) were lower in patients who received dexmedetomidine. We believe that the positive effects of dexmedetomidine on OS could be beneficial in CABG surgery. Furthermore, we anticipate that with further studies conducted in larger patient cohorts, the clinical utilization of dexmedetomidine will become more widespread. Trial registration number NCT05895331 / 06.07.2023.
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spelling doaj-art-af1a17a76b1343b0bb4fa184eb32d1462025-08-20T02:13:26ZengBMCBMC Anesthesiology1471-22532024-11-012411810.1186/s12871-024-02794-1The effects of dexmedetomidine on thiol/disulphide homeostasis in coronary artery bypass surgery: a randomized controlled trialYusuf Ozguner0Savaş Altınsoy1Gökçen Kültüroğlu2Dilek Unal3Julide Ergil4Salim Neşelioğlu5Özcan Erel6Department of Anesthesiology and Reanimation, Ankara Etlik City HospitalDepartment of Anesthesiology and Reanimation, Ankara Etlik City HospitalDepartment of Anesthesiology and Reanimation, Ankara Etlik City HospitalDepartment of Anesthesiology and Reanimation, Ankara Etlik City HospitalDepartment of Anesthesiology and Reanimation, Ankara Etlik City HospitalDepartment of Clinical Biochemistry, Faculty of Medicine, Yildirim Beyazit UniversityDepartment of Clinical Biochemistry, Faculty of Medicine, Yildirim Beyazit UniversityAbstract Background Thiol-disulfide homeostasis (TDH) plays a pivotal role in various physiological mechanisms, including antioxidant defence, detoxification, apoptosis, regulation of enzyme activities and cellular signal transduction. TDH can be used as a biomarker to detect oxidative stress (OS) levels and ischemia status in the tissues. Coronary artery bypass grafting (CABG) surgery is a procedure associated with high oxidative stress. Dexmedetomidine, an alpha-2 agonist anaesthetic agent, has antioxidant effects. In this study, the effects of dexmedetomidine on oxidative stress in CABG surgery were investigated. Methods Patients who underwent on-pump CABG surgery were divided into two groups: those receiving dexmedetomidine (Group D) and those not receiving dexmedetomidine (Group C). From anesthesia induction to the end of surgery, patients in Group D received intravenous infusions of 0.05–0.2 mcg/kg/min remifentanil and 0.2–0.7 mcg/kg/h dexmedetomidine. Patients in Group C received intravenous infusion of 0.05–0.2 mcg/kg/min remifentanil. Blood samples were collected from the patients 30 min before induction of anesthesia (T1), 30 min after removal of the aortic cross-clamp (T2), and at the end of the surgery (T3). Thiol-disulfide homeostasis (TDH) was assessed using a novel method. A novel automated method enables the determination of native thiols, total thiols and disulfides levels in plasma, allowing the calculation of their respective ratios. Results In patients receiving dexmedetomidine, lower postoperative levels of disulfide, disulfide/native thiol, and disulfide/total thiol, along with higher native thiol/total thiol, were observed compared to the control group. (p < 0.05) Postoperative native thiol and total thiol levels were similar for both groups. (p > 0.05) Conclusions In our study, through dynamic thiol-disulfide measurements, we found that levels of oxidative stress (OS) were lower in patients who received dexmedetomidine. We believe that the positive effects of dexmedetomidine on OS could be beneficial in CABG surgery. Furthermore, we anticipate that with further studies conducted in larger patient cohorts, the clinical utilization of dexmedetomidine will become more widespread. Trial registration number NCT05895331 / 06.07.2023.https://doi.org/10.1186/s12871-024-02794-1Coronary artery bypassDexmedetomidineOxidative stressThiol-disulfide homeostasis
spellingShingle Yusuf Ozguner
Savaş Altınsoy
Gökçen Kültüroğlu
Dilek Unal
Julide Ergil
Salim Neşelioğlu
Özcan Erel
The effects of dexmedetomidine on thiol/disulphide homeostasis in coronary artery bypass surgery: a randomized controlled trial
BMC Anesthesiology
Coronary artery bypass
Dexmedetomidine
Oxidative stress
Thiol-disulfide homeostasis
title The effects of dexmedetomidine on thiol/disulphide homeostasis in coronary artery bypass surgery: a randomized controlled trial
title_full The effects of dexmedetomidine on thiol/disulphide homeostasis in coronary artery bypass surgery: a randomized controlled trial
title_fullStr The effects of dexmedetomidine on thiol/disulphide homeostasis in coronary artery bypass surgery: a randomized controlled trial
title_full_unstemmed The effects of dexmedetomidine on thiol/disulphide homeostasis in coronary artery bypass surgery: a randomized controlled trial
title_short The effects of dexmedetomidine on thiol/disulphide homeostasis in coronary artery bypass surgery: a randomized controlled trial
title_sort effects of dexmedetomidine on thiol disulphide homeostasis in coronary artery bypass surgery a randomized controlled trial
topic Coronary artery bypass
Dexmedetomidine
Oxidative stress
Thiol-disulfide homeostasis
url https://doi.org/10.1186/s12871-024-02794-1
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