Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2014.05.004
Brazilian Journal of Anesthesiology
Scientific Article

Comparison of effects on the oxidant/antioxidant system of sevoflurane, desflurane and propofol infusion during general anesthesia

Comparação dos efeitos da perfusão de sevoflurano, desflurano e propofol sobre o sistema oxidante/antioxidante durante anestesia geral

Mesut Erbas; Yavuz Demiraran; Hayriye Ak Yildirim; Gulbin Sezen; Abdulkadir Iskender; Ibrahim Karagoz; Hayati Kandis

http://dx.doi.org/10.1016/j.bjane.2014.05.004 Braz J Anesthesiol, vol.65, n1, p.68-72, 2015
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Abstract

BACKGROUND AND OBJECTIVES: Desflurane and sevoflurane are frequently used for maintenance of anesthesia and studies have shown that these anesthetics cause a variety of changes to the oxidative stress and antioxidative defense mechanisms. This study aims to compare the effects of sevoflurane, desflurane and propofol infusion anesthesia on the oxidant and antioxidant systems of patients undergoing laparoscopic cholecystectomy. METHODS: 45 patients between 18 and 50 years with planned laparoscopic cholecystectomy under general anesthetic were included in the study. Patients were divided into three groups on the way to surgery: propofol (group P n: 15), sevoflurane (group S n: 15) and desflurane (group D n: 15). All groups were given hypnotic 2 mg/kg propofol IV, 1 mcg/kg fentanyl IV and 0.1 mg/kg vecuronium IV for induction. For maintenance of anesthesia group S were ventilated with 2% sevoflurane, group D cases were given 6% desflurane and group P were given propofol infusions of 12 mg/kg/h for the first 10 min, 9 mg/kg/h for the second 10 min and 6 mg/kg/h after that. Before induction and after the operation venous blood samples were taken to evaluate the levels of glutation peroxidase, total oxidants and antioxidants. RESULTS AND CONCLUSIONS: The 45 patients included in the study were 22 male and 23 female patients. The demographic characteristics of the groups were similar. In the postoperative period we observed that while sevoflurane and propofol increased antioxidants by a statistically significant level, desflurane increased the total oxidants level by a significant amount compared to levels before the operation.

Keywords

Oxidant, Antioxidant, Propofol, General anesthesia

Resumo

JUSTIFICATIVA E OBJETIVOS: Desflurano e sevoflurano são usados com frequência para a manutenção da anestesia e estudos mostraram que esses anestésicos causam alterações variadas nos mecanismos de defesa antioxidante contra o estresse oxidativo. Este estudo teve como objetivo comparar os efeitos de anestesias com perfusão de sevoflurano, desflurano e propofol sobre os sistemas oxidante/antioxidante de pacientes submetidos à colecistectomia laparoscópica. MÉTODOS: Foram incluídos no estudo 45 pacientes entre 18 e 50 anos, agendados para colecistectomia laparoscópica sob anestesia geral. Os pacientes foram divididos em três grupos para receberem propofol (Grupo P, n = 15), sevoflurano (Grupo S, n = 15) e desflurano (Grupo D, n = 15). Todos os grupos receberam 2 mg/kg de propofol IV, 1 mcg/kg de fentanil IV e 0,1 mg/kg de vecurônio IV para indução. Para manutenção da anestesia, o Grupo S recebeu ventilação com sevoflurano a 2%, o Grupo D recebeu desflurano a 6% e o Grupo P recebeu propofol em perfusões de 12 mg/kg/h nos primeiros 10 minutos, 9 mg/kg/h nos 10 minutos seguintes e 6 mg/kg/h subsequentemente. Antes da indução e depois da cirurgia, amostras de sangue venoso foram colhidas para avaliar os níveis de glutationa peroxidase e o total de oxidantes e antioxidantes. RESULTADOS E CONCLUSÕES: Dos 45 pacientes incluídos no estudo, 22 eram do sexo masculino e 23 do feminino. As características demográficas dos grupos eram semelhantes. No período pós-operatório, observamos que enquanto sevoflurano e propofol aumentaram os antioxidantes a um nível de significância estatística, desflurano aumentou o nível total de oxidantes em quantidade significativa, em comparação com os níveis pré-operação.

Palavras-chave

Oxidante, Antioxidante, Propofol, Anestesia geral

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