Laboratory investigation: effects of propofol on the systemic inflammatory response during aortic surgery.
OBJECTIVE
A laboratory investigation was undertaken to assess the effects of propofol on renal function, through modulation of the systemic inflammatory response, in an in vivo experimental model of aortic surgery in comparison with sevoflurane.


METHODS
Twenty young male piglets were anesthetized with either propofol 4 mg.kg(-1).hr(-1) (n = 10) or sevoflurane 1.5% end-tidal concentration (n = 10). Animals were subjected to aorta-aortic bypass with suprarenal aortic clamping for 30 min. At specific intervals (basal -before the start of surgery; reperfusion 15 min after unclamping the aorta; at 24, 48 and 72 hr after surgery, and on the seventh day after surgery) the levels of the following were determined: plasma creatinine, renal myeloperoxidase, tumour necrosis factor-alpha, interleukin 1-ss, and interferon-gamma; kidney superoxide anion and its detoxifying enzyme superoxidase dismutase, kidney malondialdehyde and the activity of inducible nitric oxide synthase. Seven days after surgery, the animals were anesthetized using the described techniques, and after blood withdrawal and kidney sampling they were sacrificed.


RESULTS
In comparison with sevoflurane, propofol was associated with a lower concentration of plasma creatinine (P < 0.05) together with lower concentrations of myeloperoxidase, tumour necrosis factor-alpha, interleukin 1-ss, interferon-gamma, superoxide anion and superoxidase dismutase, malondialdehyde and inducible nitric oxide synthase (P < 0.05).


CONCLUSIONS
In an experimental model of aortic reconstructive surgery, and compared with sevoflurane, propofol anesthesia is associated with less neutrophil infiltration, lower plasma proinflammatory cytokine levels, lower production of oxygen free radicals, less lipid peroxidation, and reduced inducible nitric oxide synthase activity. These observations suggest a possible renal protective effect of propofol in this surgical setting.
Rodríguez-López
José M
JM
Department of Anesthesiology, Rodríguez-Chamorro Hospital, Zamora, Spain. jmrodlop@terra.es
Sánchez-Conde
Pilar
P
Lozano
Francisco S
FS
Nicolás
Juan L
JL
García-Criado
Francisco J
FJ
Cascajo
Carlos
C
Muriel
Clemente
C
D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D000818:Animals; D001011:Aorta / Q000601:surgery*; D003404:Creatinine / Q000097:blood; D004195:Disease Models, Animal; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D007371:Interferon-gamma / Q000097:blood / Q000187:drug effects; D053583:Interleukin-1beta / Q000097:blood / Q000187:drug effects; D008297:Male; D008315:Malondialdehyde / Q000378:metabolism; D008738:Methyl Ethers / Q000008:administration & dosage; D019001:Nitric Oxide Synthase / Q000187:drug effects / Q000378:metabolism; D009195:Peroxidase / Q000187:drug effects / Q000378:metabolism; D015742:Propofol / Q000494:pharmacology*; D000077149:Sevoflurane; D013482:Superoxide Dismutase / Q000187:drug effects / Q000378:metabolism; D013481:Superoxides / Q000378:metabolism; D013552:Swine; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000378:metabolism* / Q000517:prevention & control*; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood / Q000187:drug effects
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D053583:Interleukin-1beta; D008738:Methyl Ethers; D014409:Tumor Necrosis Factor-alpha; D013481:Superoxides; D000077149:Sevoflurane; D008315:Malondialdehyde; D007371:Interferon-gamma; D003404:Creatinine; D009195:Peroxidase; D019001:Nitric Oxide Synthase; D013482:Superoxide Dismutase; D015742:Propofol