Investigation of the effect of sempatic ganglionectomy on oxidan /antioxidant balance in experimental subarachnoid hemorrhage model in rats

INTRODUCTION: Subarachnoid hemorrhage (SAH) is a major health problem characterized by sudden and severe headaches. It is mostly seen in 20-60 age group. It is slightly more common in women when compared to men population. Although the annual incidence of subarachnoid hemorrhage varies between 10 to 16 per 100,000 population, it is reported that these rates increase with age. The most important cause of mortality and morbidity in patients with SAH is early brain injury occurring in the first 3 days of bleeding. Increased intracranial pressure due to brain damage, decreased cerebral blood flow and cerebral ischemia cause apoptosis and oxidative stress. Oxidative stress plays a main role in vasospasm after SAH. It has been reported that glutathione peroxidase and lipid peroxidase concentrations increase in cerebrospinal fluid and it is responsible for vasospasm in patients with SAH. OBJECTIVE: The sympathetic blockade in patients with SAH, which is the hypothesis of our study, can prevent vasospasm and may increase the quality of life of patients with SAH in the postoperative period by reducing the oxidative enzymes caused by vasospasm and by activating the antioxidant systems. METHODS: A total of 35 male Wistar male rats weighing 150-200 gr were used in our study. Rats were divided into 5 groups: Group 1: Control (n = 7), Group 2: Sham control (n = 7), Group 3: SAH (n = 7), Group 4: SAH + Sympathectomy (n = 7), Group 5: SAK + Sham opere (n = 7). Sympathectomy was performed after experimental experimental SAH model; the effect of this application on oxidant / antioxidant levels was studied in plasma; and in the brain tissue obtained after perfusion, by ELISA method. Oxidant MDA and antioxidant SOD, CAT, GPx molecules and total oxidant (TOS) and total antioxidant (TAS) levels were measured by ELISA method. FINDINGS: Plasma TOS levels were significantly increased in the subarachnoid group compared to sham control (p <0.05). On the other hand, superior cervical sympathectomy significantly reduced the plasma TOS compared to the group treated with SAH (p <0.05). In addition, subarachnoid hemorrhage significantly reduced plasma TAS levels compared to sham control (p <0.005). Sympathectomy significantly increased the TAS levels compared to SAH (p <0.05). The use of subarachnoid hemorrhage in brain tissue significantly increased TOS compared to sham control (p <0.0005), and sympathectomy significantly decreased TOS in the brain compared to SAH (p <0.005). The application of subarachnoid hemorrhage in the brain tissue significantly decreased the TAS compared to the sham control (p <0, 05). On the other hand, sympathectomy increased significantly in the brain compared to SAH (p <0, 05). The application of SAH in the brain tissue decreased the CAT level significantly compared to the Sham Control group (p <0.005). Sympathectomy significantly increased the CAT level of the brain compared to SAH (p <0.05). When the CAT levels of plasma samples were compared, SAH administration was significantly decreased compared to the Sham Control group (p <0.005). When sympathectomy was applied, CAT level was significantly increased compared to SAH group (p <0.05). Administration of SAH in the brain tissue significantly decreased GPx values compared to Sham Control (p <0.05). Sympathectomy performed significantly increased GPx values in brain tissue compared to SAH group (p <0.005). SAH administration significantly decreased GPx values in plasma samples compared to Sham Control group (p <0.005). Sympathectomy significantly increased the GPx value compared to SAH group (p <0.05). For the measurement of brain tissue SOD levels alone, SAH administration was statistically lower than the Sham Control group (p <0.005). SOD levels in brain tissue were significantly lower in the SAH group than in the sympathectomy group (p <0.05). Evaluation of SOD levels studied in plasma samples showed that SAH alone decreased SOD levels compared to Sham Control group (p <0.005). The sympathectomy performed with SAH significantly increased SOD levels compared to SAH alone (p <0.005). CONCLUSION: According to the results of our study, the sympathetic blockade in the postoperative period may prevent cerebral vasospasm and the resulting cerebral ischemia in patients with sub-arachnoid hemorrhage. In this case, the quality of life of the patients may be improved by reducing the damage caused by SAH with cerebral vasospasm and cerebral ischemia due to possible sympathetic blockade.