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Neuraxial anesthesia is less harmful to the endothelial glycocalyx during elective joint surgery compared to general anesthesia

The result's identifiers

  • Result code in IS VaVaI

    <a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F44555601%3A13450%2F19%3A43895418" target="_blank" >RIV/44555601:13450/19:43895418 - isvavai.cz</a>

  • Alternative codes found

    RIV/00216208:11140/19:10385669 RIV/00216208:11150/19:10385669 RIV/00179906:_____/19:10385669 RIV/00669806:_____/19:10385669

  • Result on the web

    <a href="https://content.iospress.com/articles/clinical-hemorheology-and-microcirculation/ch180428" target="_blank" >https://content.iospress.com/articles/clinical-hemorheology-and-microcirculation/ch180428</a>

  • DOI - Digital Object Identifier

    <a href="http://dx.doi.org/10.3233/CH-180428" target="_blank" >10.3233/CH-180428</a>

Alternative languages

  • Result language

    angličtina

  • Original language name

    Neuraxial anesthesia is less harmful to the endothelial glycocalyx during elective joint surgery compared to general anesthesia

  • Original language description

    BACKGROUND: Damage of the endothelial glycocalyx (EG) has been described during surgery, but the effect of different anesthesia techniques remains unknown. Perfused boundary region (PBR) evaluated by side-stream dark field (SDF) imaging of the sublingual microcirculation enables in vivo EG assessment. PBR values are inversely related to the EG thickness. OBJECTIVE: The aim of the observational study was to evaluate the changes of PBR in patients undergoing elective joint surgery under general (GA) vs. neuraxial anesthesia (NA). Our hypothesis was that PBR will be lower in patients in NA. METHODS: Sixty consecutive patients (ASA 1-3) undergoing elective total knee or hip replacement under GA or NA were included in this prospective observational cohort study. PBR in the sublingual microcirculation was recorded in each patient using SDF at two time points - before surgery and 2 hours after surgery. RESULTS: Before surgery, there was no significant difference in baseline PBR between groups (NA: 1.95 mu m (+/- 0.24); GA: 2.02 mu m (+/- 0.26); p = 0.098). Postoperatively (2 hours after surgery) PBR was significantly increased in both groups with respect to baseline values (NA: 2.09 mu m (+/- 0.19), GA: 2.20 mu m (+/- 0.25); p &lt; 0.001). In the GA group, postoperative PBR values were significantly higher than in the NA group (p = 0.006). CONCLUSION: Joint surgery led to significant increases of PBR. Patients in the GA group had significantly higher PBR values 2 hours after surgery compared to NA group. This might implicate that NA is associated with less EG damage then GA in elective hip/knee surgery.

  • Czech name

  • Czech description

Classification

  • Type

    J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database

  • CEP classification

  • OECD FORD branch

    30205 - Hematology

Result continuities

  • Project

    <a href="/en/project/NV15-31881A" target="_blank" >NV15-31881A: Alterations of glycocalyx in critical illness and during major surgery and approaches for glycocalyx protection</a><br>

  • Continuities

    V - Vyzkumna aktivita podporovana z jinych verejnych zdroju

Others

  • Publication year

    2019

  • Confidentiality

    S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Data specific for result type

  • Name of the periodical

    Clinical Hemorheology and Microcirculation

  • ISSN

    1386-0291

  • e-ISSN

  • Volume of the periodical

    72

  • Issue of the periodical within the volume

    1

  • Country of publishing house

    NL - THE KINGDOM OF THE NETHERLANDS

  • Number of pages

    11

  • Pages from-to

    11-21

  • UT code for WoS article

    000476864200002

  • EID of the result in the Scopus database

    2-s2.0-85069708984