Oxidation Communications, cilt.33, sa.4, ss.956-964, 2010 (SCI Expanded İndekslerine Giren Dergi)
In this study were investigated the effects of sevoflurane and desflurane on the serum
oxidative stress parameters. The model consisted in verifying the oxidative stress
difference between sevoflurane and desflurane anaesthetics in ischemia/reperfusion
of human skeletal muscle in which sevoflurane, used during the orthopaedic surgery
with tourniquet, might be more protective to the reperfusion injury of tissues. Reactive
oxygen species are considered to be important components involved in the pathophysiological
tissue alterations observed during ischemia and reperfusion. In this study
the time-dependent differences in antioxidant enzyme activities and free radicals in
ischemia/reperfusion injury model were discussed using tourniquet during the elective
unilateral knee arthroplasty. Twenty-eight patients, ASAI-II, were included in
the study. The anaesthesia induction was achieved with lidocaine, thiopental sodium,
cisatracurium besylate and 1 μg/kg fentanyl following pre-oxygenisation for 3 min.
The anaesthesia maintenance was provided with 50% N2O, 50% O2 and 1 minimum
alveolar concentration of sevoflurane or desflurane by controlled ventilation. Pneumatic
tourniquet was applied after blood samples were taken from the femoral vein
and following placement of total knee prothesis, reperfusion was provided by getting
down the tourniquet and blood samples were also obtained at 5, 20, 60 min and in
24 h. In the desflurane group, malondialdhyde levels increased (p<0.05) during 24 h
and superoxide dismutase levels were decreased during the first 20 min of reperfusion
while there were no differences in the sevoflurane group. Sixty minutes after initiation
of reperfusion, total antioxidant status decreased in the sevoflurane group (p<0.05).
Both inhalation anaesthetics had advantages and disadvantages depending on their
antioxidant capacities and free radical scavenging abilities. While deciding on the
anaesthesia protocol, needs and potential side effects affecting the postoperative period
and wellness of the patients could be the priority.
Keywords: general anaesthesia, sevoflurane, desflurane, ischemia-reperfusion lipid
peroxidation, antioxidant enzymes.