Relation of catecholamines with oxidative stress in patients undergoing cardiac surgery before and after endotracheal intubation

Abstract

Inroduction
 Endotracheal intubation is used to maintain the airway open so that oxygen, medicine, or anesthesia can be administered. Anesthesia and surgery boost the release of cross-regulating hormones through physiological responses and psychological stress. There is a strong link between psychological stress and oxidative stress, according to research.
 Objective: - The goal of this study was to determine the levels of catecholamines (adrenaline and noradrenaline) and oxidative stress before and after endotracheal intubation in patients undergoing cardiac surgery and to study association between them.
 Material & Methods: - Total 30 patients undergoing cardiac surgery were enrolled. Blood samples were collected before and after endotracheal intubation. Plasma adrenaline and noradrenaline levels were estimated by ELISA. MDA & SOD were estimated by spectrophotometric method.
 Results: - Mean levels of plasma adrenaline (p< 0.01), noradrenaline (p< 0.0001) and Serum MDA (p< 0.0001) were significantly decreased while Serum SOD were significantly increased (p< 0.0001) after endotracheal intubation as compared to before endotracheal intubation by laryngoscopy in patients undergoing cardiac surgery. We found significant positive correlation of MDA with adrenaline and nor-adrenaline before and after intubation. SOD activity was negatively correlated with MDA, adrenaline and noradrenaline before and after intubation
 Conclusion: Elevated levels of adrenaline, noradrenaline, MDA, and lower levels of SOD show that patients are stressed prior to endotracheal intubation, resulting in a stronger stress response and increased oxidative stress. After intubation, the levels of adrenaline and noradrenaline reduced, indicating a reduction of stress. Our study also shows a link between psychological and oxidative stress. For a better outcome and to avoid subsequent complications, it is preferable to evaluate stress levels and oxidative stress in patients undergoing cardiac surgery before and after endotracheal intubation.