Recovery of Endothelial Function after Minor-to-Moderate Surgery Is Impaired by Diabetes Mellitus, Obesity, Hyperuricemia and Sevoflurane-Based Anesthesia
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- Ohno Sachi
- Department of Dental Anesthesiology, Graduate School of Medical and Dental Sciences, Kagoshima University
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- Kohjitani Atsushi
- Department of Dental Anesthesiology, Graduate School of Medical and Dental Sciences, Kagoshima University
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- Miyata Masaaki
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
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- Tohya Akina
- Department of Dental Anesthesiology, Graduate School of Medical and Dental Sciences, Kagoshima University
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- Yamashita Kaoru
- Department of Dental Anesthesiology, Graduate School of Medical and Dental Sciences, Kagoshima University
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- Hashiguchi Teruto
- Department of Laboratory and Vascular Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University
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- Ohishi Mitsuru
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
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- Sugimura Mitsutaka
- Department of Dental Anesthesiology, Graduate School of Medical and Dental Sciences, Kagoshima University
書誌事項
- 公開日
- 2018-05-31
- 資源種別
- journal article
- DOI
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- 10.1536/ihj.17-143
- 公開者
- 一般社団法人 インターナショナル・ハート・ジャーナル刊行会
この論文をさがす
説明
<p>Endothelial dysfunction is observed in several cardiovascular diseases, where endothelium-dependent vasodilation is impaired by oxidative stress. However, the time course of endothelial function during the perioperative period of a minor-to-moderate surgery, and the effects of atherosclerotic risk factors and employed general anesthetics on recovery of endothelial function, are unknown. Endothelial function of 30 patients was evaluated as the reactive hyperemia index (RHI) of reactive hyperemia peripheral arterial tonometry. RHI was measured on day before surgery (control), immediately after surgery (Day 0), day after surgery (Day 1), and day 4 after surgery (Day 4) in patients with no functional limitations who were scheduled for oral and maxillofacial surgery of around 3 hours. Sevoflurane- or propofol-based anesthesia supplemented with an opioid analgesic remifentanil was employed. The control RHI was 2.26 ± 0.64. The RHI significantly decreased to the lowest level on Day 0 (1.52 ± 0.28), recovered on Day 1 (2.07 ± 0.58), and improved further on Day 4 (2.55 ± 0.83). Multiple linear regression analysis revealed that recovery of the RHI from Day 0 to Day 4 was impaired by diabetes mellitus (P = 0.0313), obesity (BMI ≥ 25; P = 0.0166), hyperuricemia (uric acid ≥ 6.0 mg/dL; P = 0.0416) and sevoflurane-based anesthesia (P = 0.0308). These findings suggest that endothelial function as evaluated by the RHI is severely suppressed on the day of a minor-to-moderate surgery, and that it improves until the 4th postoperative day on average. Recovery of endothelial function is impaired by diabetes mellitus, obesity, hyperuricemia, and sevoflurane-based anesthesia.</p>
収録刊行物
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- International Heart Journal
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International Heart Journal 59 (3), 559-565, 2018-05-31
一般社団法人 インターナショナル・ハート・ジャーナル刊行会