ESRA19-0229 The evaluation of the effects of three different postoperative analgesic methods on thiol/disulphide homeostasis

Background and aims Trauma leads to an increase in oxidative stress at the cellular level. the thiol/disulfide homeostasis is a direct indicator of the oxidative state in the cell. Oxidative stress causes an increase in disulfide with a decrease in thiol. We planned to examine the correlation between total thiol, native thiol/disulfide values and pain scores by three different analgesia methods. Methods Sixty patients with ASA I-III who underwent proximal femoral nailing under hypobaric spinal anesthesia were divided into three groups with closed envelope method. Postoperative analgesia was provided with intravenous PCA in Group I, with epidural PCA in Group II, with USG-guided-femoral+sciatic nerve block in group III. VAS at postoperative 3rd,6th,24th hours were recorded. Paracetamol 1gr iv infusion was given when VAS> 3. Total thiol, native thiol and disulfide values were determined at preoperative, perioperative 30th minute and postoperative 3rd, 6th,24th hours. Results Total thiol and native thiol increased while disulfide values decreased in all groups. Thiol increased while disulfide decreased after spinal anesthesia. No significant difference was found between the groups in terms of thiol and disulfid levels. VAS values showed no difference between groups. Conclusions There were no significant differences between the three different methods for postoperative analgesia in the basis of basal thiol, native thiol and disulfide values. VAS values were also similar in all three groups. Spinal anesthesia decreased oxidative stress. Intravenous PCA, epidural PCA and femoral+sciatic block provided efficient analgesia and oxidative stress control following proximal femoral nailing.