Study of the systemic and pulmonary oxidative stress status during exposure to propofol and sevoflurane anaesthesia during thoracic surgery.
OBJECTIVE
General anaesthesia during mechanical ventilation can induce variable systemic and pulmonary immune effects that may affect postoperative outcome. The aim of the present study was to evaluate evidence of oxidative stress in the blood and bronchoalveolar lavage (BAL) fluid of patients exposed to propofol or sevoflurane anaesthesia during thoracic surgery.


METHODS
Sixty adult patients undergoing thoracic surgery were randomly allocated to receive propofol (n = 30) or sevoflurane (n = 30) anaesthesia. Blood samples and bronchoscopic BAL specimens were evaluated for oxidative activity measurements: malondialdehyde, glutathione peroxidase and superoxide dismutase. Also BAL specimens were evaluated for numbers of cells, albumin concentrations, proinflammatory cytokines (tumour necrosis factor-alpha, interleukin-8) and proteinases (polymorphonuclear elastase).


RESULTS
We found a significant decrease for malondialdehyde and higher values of glutathione peroxidase measurements in the plasma and BAL during propofol anaesthesia. Significantly higher levels of malondialdehyde and lower concentrations of glutathione peroxidase in plasma and BAL were found during sevoflurane anaesthesia. Superoxide dismutase showed no significant changes during exposure to either anaesthetic.In both groups, intraalveolar cell numbers, albumin concentrations as well as interleukin-8, tumour necrosis factor and polymorphonuclear elastase concentrations increased over time. However, they were significantly higher in the sevoflurane than in the propofol group.


CONCLUSIONS
Sevoflurane seemed to induce a local and systemic oxidative stress, whereas propofol is more likely to have antioxidant properties. Sevoflurane appears to cause a greater intrapulmonary proinflammatory response than propofol during thoracic surgery.
Abou-Elenain
Khaled
K
Department of Anaesthesiology, Minoufiya Faculty of Medicine, Minoufiya University, Damanhour, Beheira, Egypt. kh69193@yahoo.com
D000328:Adult; D000368:Aged; D000768:Anesthesia, General / Q000379:methods; D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects; D000077463:Carbamide Peroxide; D005260:Female; D005979:Glutathione Peroxidase / Q000032:analysis; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007962:Leukocytes / Q000187:drug effects; D008297:Male; D008315:Malondialdehyde / Q000032:analysis; D008738:Methyl Ethers / Q000494:pharmacology*; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects*; D010545:Peroxides / Q000032:analysis; D015742:Propofol / Q000494:pharmacology*; D000077149:Sevoflurane; D013482:Superoxide Dismutase / Q000032:analysis; D019616:Thoracic Surgical Procedures; D014508:Urea / Q000031:analogs & derivatives / Q000032:analysis
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D010545:Peroxides; D000077463:Carbamide Peroxide; D000077149:Sevoflurane; D008315:Malondialdehyde; D014508:Urea; D005979:Glutathione Peroxidase; D013482:Superoxide Dismutase; D015742:Propofol