Şentürk Bilge, Umuroğlu Tümay, Saraçoğlu Ayten, Eti Zeynep, Göğüş Fevzi Yılmaz
Department of Anaesthesiology and Reanimation, Marmara University Faculty of Medicine, İstanbul, Turkey.
Turk J Anaesthesiol Reanim. 2015 Apr;43(2):68-72. doi: 10.5152/TJAR.2014.66934. Epub 2015 Feb 5.
In this study, we aimed to compare the effects of desflurane and propofol on the release of thyroid hormones in euthyroid patients undergoing single-level lumbar discectomy.
The study group included 21-65-year-old American Society of Anesthesiology (ASA) I-II euthyroid 40 patients undergoing elective single-level lumbar discectomy. They were randomly divided into 2 groups (n=20). In the maintenance of anaesthesia, Group D received desflurane inhalational anaesthesia and remifentanil infusion, and Group P received propofol and remifentanil IV infusions. Four blood samples for the determination of plasma levels of free triiodothyronine (FT3), free thyroxine (FT4) and thyrotropin (TSH) were collected 5 min before and 60 min after the induction of anaesthesia and 60 min and 24 h after the surgery.
Plasma TSH levels in both groups reached the highest levels at the first postoperative hour and returned to the preoperative levels 24 hours after the surgery. Regarding plasma FT3 levels, there were no significant differences within and between groups. There were no significant differences in plasma FT4 levels within the patients of Group P, but in Group D, FT4 levels reached its peak in the first hour of anaesthesia induction and returned back to preoperative levels 24 hours postoperatively (p<0.05).
Further studies are needed to confirm our findings and evaluate patients with thyroid gland pathologies.
在本研究中,我们旨在比较地氟醚和丙泊酚对接受单节段腰椎间盘切除术的甲状腺功能正常患者甲状腺激素释放的影响。
研究组包括40例年龄在21 - 65岁、美国麻醉医师协会(ASA)分级为I - II级的甲状腺功能正常患者,他们接受择期单节段腰椎间盘切除术。将他们随机分为2组(n = 20)。在麻醉维持阶段,D组接受地氟醚吸入麻醉和瑞芬太尼输注,P组接受丙泊酚和瑞芬太尼静脉输注。在麻醉诱导前5分钟、诱导后60分钟、术后60分钟和24小时采集四份血样,用于测定血浆游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)和促甲状腺激素(TSH)水平。
两组患者血浆TSH水平均在术后第1小时达到最高,术后24小时恢复至术前水平。关于血浆FT3水平,组内和组间均无显著差异。P组患者血浆FT4水平无显著差异,但在D组,FT4水平在麻醉诱导后第1小时达到峰值,术后24小时恢复至术前水平(p < 0.05)。
需要进一步研究来证实我们的发现并评估甲状腺疾病患者。