The effects of sevoflurane and desflurane on lipid peroxidation during laparoscopic cholecystectomy.
OBJECTIVE
To compare the effects of sevoflurane and desflurane anaesthesia on lipid peroxidation.


METHODS
We studied 40 healthy patients undergoing elective laparoscopic cholecystectomy. Patients were randomly allocated to be anaesthetized either with sevoflurane (n = 20) or desflurane (n = 20). Anaesthesia was maintained with inspiratory concentrations of sevoflurane 1-1.5 MAC (n = 20) or desflurane (n = 20). Samples were taken for plasma malondialdehyde and superoxide dismutase assays before induction of anaesthesia, before skin incision and at the end of surgery. Alveolar cell samples were obtained from the lungs using the technique of protective blind bronchoalveolar lavage, after induction of anaesthesia and at the end of surgery for malondialdehyde and superoxide dismutase concentrations.


RESULTS
Plasma malondialdehyde increased more after the administration of desflurane than after sevoflurane: after induction 5.9 +/- 0.6 nmol mL(-1) for desflurane vs. 3.8 +/- 0.5 nmol L(-1) for sevoflurane (P < 0.001); at the end of the surgery: 6.7 +/- 0.4 nmol mL(-1) for desflurane vs. 4.2 +/- 0.3 nmol mL(-1) for sevoflurane (P < 0.001). There was a small but significant increase in plasma superoxide dismutase concentration after desflurane--from 24.2 +/- 1.2 to 24.9 +/- 0.9 U mL(-1) after induction and 25 +/- 1 U mL(-1) at the end of the surgery (P < 0.01)--but no increase with sevoflurane. Malondialdehyde concentrations increased significantly in the cells obtained by protective blind bronchoalveolar lavage at the end of surgery in the desflurane group (from 0.3 +/- 0.1 to 1.7 +/- 0.2 nmol mL(-1) (P < 0.001)), but not in the sevoflurane group. There were no significant differences between the two anaesthetics in the amounts of superoxide dismutase in the samples obtained by protective blind bronchoalveolar lavage.


CONCLUSIONS
Desflurane may cause more systemic and regional lipid peroxidation than sevoflurane during laparoscopic cholecystectomy in healthy human beings.
Koksal
G M
GM
Istanbul University Cerrahpasa Medical Faculty, Department of Anaesthesiology, Istanbul, Turkey. gunizkoksal@hotmail.com
Sayilgan
C
C
Aydin
S
S
Uzun
H
H
Oz
H
H
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry / Q000166:cytology; D017081:Cholecystectomy, Laparoscopic; D000077335:Desflurane; D017558:Elective Surgical Procedures; D006801:Humans; D007530:Isoflurane / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D015227:Lipid Peroxidation / Q000187:drug effects*; D008315:Malondialdehyde / Q000032:analysis / Q000097:blood; D008738:Methyl Ethers / Q000008:administration & dosage*; D008875:Middle Aged; D011650:Pulmonary Alveoli / Q000187:drug effects / Q000473:pathology; D000077149:Sevoflurane; D013482:Superoxide Dismutase / Q000032:analysis / Q000097:blood
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D008315:Malondialdehyde; D000077335:Desflurane; D007530:Isoflurane; D013482:Superoxide Dismutase