腹腔鏡下胆嚢摘出術中における酸化ストレス指標としての尿中８‐ヒドロキシデオキシグアニジン（８‐ＯＨ‐ｄＧ）の推移

• Published in: 蘇生 Vol. 25; no. 1; pp. 12 - 16
• Main Authors: Kaneda Toru, Seki Hiroyuki, Katsumata Kiyoshi
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society of Reanimatology 2006; 日本蘇生学会
• Subjects: 8-hydroxydeoxyguanoshine; 8-ヒドロキシデオキシグアニジン (8-OH-dG); laparoscopic cholecystectomy; oxidative DNA damage; surgical stress; 手術侵襲; 腹腔鏡下胆嚢摘出術; 酸化的DNA損傷
• ISSN: 0288-4348; 1884-748X
• DOI: 10.11414/jjreanimatology1983.25.12

8-hydroxydeoxyguanosine (8-OH-dG) which is producted by oxidative DNA damage is one of the predominant forms of radical-induced lesion to DNA, and has been widely used as a biomarker for oxidative stress. To determine the relationship between oxidative DNA damage and surgical stress undergoing laparoscopic cholecystectomy (Lap-C) with Propofol (Target controlled infusion) and epidural anesthesia, we measured urinary 8-OH-dG using CoulArray Medical System (ESA Inc., USA) in 5 patients. The measurement points of 8-OH-dG were after induction of anesthesia, 5 min. after pneumoperitoneum, 30 min. after pneumoperitoneum, at the end of operation and next morning.Our results showed large intra-individual variation of urinary 8-OH-dG. Under influence of intraperitoneal infusion of CO2, there is no change in urinary 8-OH-dG value. In our 5 cases, changes of urinary 8-OH-dG showed almost same pattern in all of the measurement point. From these results, it is thought that oxidative DNA damage during Lap-C is small or not. Still more, adequate depth of anesthesia may decrease oxidative stress caused by surgical stress during Lap-C. We suggest that adequate depth of anesthesia may have anti-oxidative effects. 8-ヒドロキシデオキシグアニジン (B-OH-dG) は活性酸素によるDNA損傷のマーカーとして考えられている。今回手術侵襲, 麻酔と酸化ストレスとの関連を検討するため硬膜外麻酔併用プロポフォールTCI麻酔下腹腔鏡下胆嚢摘出術 (Lap-C) 5症例の尿中8つH-dGをクーロアレイメディカルシステムを用いて測定した。採尿は導入直後, 気腹5分, 30分後, 手術終了時, 手術翌朝とした。8-OH-dG値は5症例でばらつきが大きく, 気腹に伴う大きな変動はなく経時的にはおおむね同様に推移した。Lap-C中の酸化ストレスはさほど大きくないと考えられ, 適切な深度の麻酔が手術侵襲による酸化ストレスを抑制させた可能性が考えられた。すなわち十分な深度の麻酔は抗酸化作用を持つ事が示唆された。