title: Enoxaparin effect on malondialdehyde levels in laparoscopic cholecystectomy.
abstract: BACKGROUND
  This study was established to assess the effects of low dose enoxaparin on plasma malondialdehyde levels during laparoscopic cholecystectomy as a model of ischemia-reperfusion.
  
  
  METHODS
  Fifty patients, scheduled for laparoscopic cholecystectomy, were randomized into two groups of 25 patients in each. In enoxaparin group, patients had 20 mg/0.2 ml subcutaneous (sc) enoxaparin 2 hr before surgery. Blood samples were obtained for malondialdehyde, alanine transferase, aspartate transferase, measurements before the insufflation, 1 min before deflation, and 20 min after deflation.
  
  
  RESULTS
  Plasma malondialdehyde concentrations were insignificant between enoxaparin and control groups before insufflation (1.64 ± 2.66 vs. 2.45 ± 4.42 μmol l(-1); p = 0.44) and 1 min before deflation (1.55 ± 2.61 vs. 3.66 ± 5.68 μmol l(-1); p = 0.38). Malondialdehyde levels significantly increased in control group 20 min after deflation in respect to enoxaparin group (1.52 ± 2.67 vs. 6.04 ± 7.85 μmol l(-1)), (p = 0.049). In control group, plasma malondialdehyde concentrations increased significantly compared with initial level throughout the study (p = 0.001). Within enoxaparin group, no statistically significant change was observed (p = 0.28). Plasma alanine transferase and aspartate transferase levels increased similarly in both groups during the study (p > 0.05). Alanine transferase and aspartate transferase increases within each group were statistically significant for all times (p < 0.05).
  
  
  CONCLUSIONS
  As a conclusion, mini dose of enoxaparin used sc'ly 2 hr before the operation, prevented the malondialdehyde increase during reperfusion period after laparoscopic cholecystectomy without causing any bleeding disorder while having no effect on serum alanine transferase, aspartate transferase increase.
authors.affiliation: Department of General Surgery, Ankara Training and Research Hospital, Turkey. turgutcavusoglu@gmail.com
authors.forename: Turgut
authors.initials: T
authors.lastname: Cavusoglu
authors.forename: Namik
authors.initials: N
authors.lastname: Ozcan
authors.forename: Elmas
authors.initials: E
authors.lastname: Ogus
authors.forename: Ayse
authors.initials: A
authors.lastname: Ozcan
authors.forename: Cetin
authors.initials: C
authors.lastname: Kaymak
authors.forename: Serdar
authors.initials: S
authors.lastname: Sahin
authors.forename: Fatma Meric
authors.initials: FM
authors.lastname: Yilmaz
authors.forename: Savas
authors.initials: S
authors.lastname: Tezel
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D017081:Cholecystectomy, Laparoscopic / Q000379:methods; D017984:Enoxaparin / Q000627:therapeutic use*; D006801:Humans; D008315:Malondialdehyde / Q000097:blood*; D008875:Middle Aged; D015427:Reperfusion Injury / Q000517:prevention & control*
chemical_list: D017984:Enoxaparin; D008315:Malondialdehyde; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase