Sevoflurane and Desflurane; Different Effects on Oxidative Parameters in Ischemia-reperfusion Injury.


Karakaş Erkılıç E., Sepici Dinçel A. , Gümüş T., Kosova F., Kanbak O.

Oxidation Communications, cilt.33, sa.4, ss.956-964, 2010 (SCI Expanded İndekslerine Giren Dergi)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 33 Konu: 4
  • Basım Tarihi: 2010
  • Dergi Adı: Oxidation Communications
  • Sayfa Sayıları: ss.956-964

Özet

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.