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Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva
Minerva Anestesiologica 2013 September;79(9):1030-8
Comparison of oxidative stress in ASA physical status I patients scheduled for minimally invasive surgery under balanced or intravenous anesthesia
Braz M. G. 1, Braz L. G. 1, Braz J. R. 1, Pierine D. T. 2, Correa C. R. 2, Ferreira A. L. 3, Carvalho L. R. 4, Yeum K. J. 5, 6, Salvadori D. M. 2 ✉
1 Department of Anesthesiology, Faculdade de Medicina de Botucatu, UNESP - Univ Estadual Paulista, Botucatu, SP, Brazil;
2 Department of Pathology, Faculdade de Medicina de Botucatu, UNESP - Univ Estadual Paulista, Botucatu, SP, Brazil;
3 Department of Internal Medicine, Faculdade de Medicina de Botucatu, UNESP - Univ Estadual Paulista, Botucatu, SP, Brazil;
4 Department of Biostatistics, Instituto de Biociências de Botucatu, UNESP - Univ Estadual Paulista, Botucatu, SP, Brazil;
5 Jean Mayer USDA-Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA;
6 College of Biomedical and Health Sciences, Konkuk University, Konkuk, South Korea
Background: The effects of anesthetics on inflammation and oxidative parameters, evaluated in patients without comorbidities undergoing minor surgery, remain unknown. The present study aimed to investigate the inflammatory and oxidative stress status in adult patients undergoing elective minimally invasive surgery, using different anesthetic techniques.
Methods: Thirty patients classified as ASA physical status I, who were scheduled for minor surgeries (tympanoplasty or septoplasty), were randomly allocated into two groups: balanced (BAL) anesthesia maintained with isoflurane or total intravenous anesthesia (TIVA) with propofol. Blood samples were drawn prior to the induction of anesthesia (baseline), 120 min after the beginning of anesthesia and one day after surgery. The proinflammatory cytokine IL-6 was determined by flow cytometry; DNA oxidation was evaluated by the single cell gel electrophoresis assay, and plasma malondialdehyde (lipid peroxidation biomarker) and antioxidant status were determined through fluorometry.
Results: Increased IL-6 was observed one day after surgery in both groups (P=0.0001). Malondialdehyde levels did not change among the time points assessed or between the groups (P>0.05). Whereas BAL anesthesia had no effect on acid nucleic and antioxidant status, TIVA decreased oxidized/alkylated purines (P=0.03) and increased antioxidant status (P=0.002) during anesthesia. The two groups did not differ significantly in DNA oxidation or antioxidant status (P>0.05).
Conclusion: BAL anesthesia maintained with isoflurane and TIVA maintained with propofol are safe by virtue of not causing oxidative stress status in ASA physical status I patients undergoing minimally invasive surgeries. Moreover, even in minor surgeries, TIVA with propofol produces an antioxidant effect in patients.