Rinoplasti olgularında TİVA (total intravenöz anestezi) ve inhalasyon anestezisinin tiyol/disülfit dengesi üzerine etkisinin araştırılması / Investigation of the effect of TİVA (total intravenous anesthesia) and inhalation anesthesia on the thiol / disulphite balance in rhinoplasty cases

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İncekara, Zeynep Nur
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Bezmialem Vakıf University
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Introduction: Total intravenous anesthesia (TIVA) and inhalation anesthesia are two anesthesia methods that can be preferred for the maintenance of anesthesia. Sevoflurane and propofol are drugs used frequently in these methods. This study aims to investigate and compare the effects of inhalation anesthesia using sevoflurane and TIVA using propofol on oxidative stress in patients undergoing controlled hypotensive anesthesia. Methods: Our study was planned as a randomized controlled prospective study to be performed in patients between the ages of 18-55 who will undergo elective rhinoplasty, with an ASA score of 1. 62 patients were included in our study. Patients with a history of smoking, alcohol, and drug use, who had a Body Mass Index (BMI)> 30, and those whose blood pressure values were out of the targets determined in 3 consecutive measurements were excluded from the study. Bispectral Index (BIS) and Train of Four (TOF) monitoring were performed in all patients undergoing standard anesthesia induction. While anesthesia was maintained with TIVA (Group 1, n = 30) in one group of patients who were divided into two groups with closed envelope method, inhalation anesthesia (Group 2, n = 32) method was used in the other group. In both groups, the blood pressure target was determined to be in the range of MAP 50-65 mmHg. Blood was collected and stored to measure TAS, TOS, Catalase, Myeloperoxidase, Total Thiol, Native Thiol and Disulfide parameters before and after induction at 5, 30, 60 and 120 minutes. Hemodynamic data (HR, SBP, DBP, MAP, SpO2) and BIS values of the patients were recorded at 5-minute intervals. The time from the end of surgery to extubation was recorded as the extubation time. At the end of the surgery, the surgical field opinion and satisfaction assessment were made by Boezaart Scoring and the survey presented to the surgeon, respectively. The patients were followed up in the recovery unit for 30 minutes; numerical pain scores and nausea-vomiting scores were recorded. Results: There was no remerkable difference between demographic data (age, gender, BMI), duration of surgery and anesthesia, BIS values and hemodynamic and biochemical parameters before induction of both groups. The extubation time and need for additional opioid use in Group 2 were statistically significantly higher than Group 1. There was no significant difference between the Boezaart Scoring and the surgical satisfaction values of the groups. TAS, TOS, OSİ, Catalase, Myeloperoxidase, Total Thiol, Native Thiol, Disulfide, Disulfide / Total Thiol, Disulfide / Native Thiol values decreased in both groups compared to initial values. There was no significant difference between the two groups in the evaluated parameters at all times. Conclusion: We concluded that TIVA using propofol and inhalation anesthesia using sevoflurane had a protective effect from the oxidative stress caused by surgery and there was no significant difference between the two methods in cases with rhinoplasty which underwent controlled hypotension. However, there is a need for randomized controlled studies in larger patient groups. Key Words: TIVA, inhalation, propofol, sevoflurane, oxidative stress, thiol-disulphide
Thesis (Medical)--Bezmialem Vakıf University, Faculty of Medicine, Department of Anesthesiology and Reanimation, Istanbul, 2020
Anestezi ve Reanimasyon = Anesthesiology and Reanimation
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