title: Comparison of oxidative stress in ASA physical status I patients scheduled for minimally invasive surgery under balanced or intravenous anesthesia.
abstract: 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Anesthesiology, Faculdade de Medicina de Botucatu, UNESP - Univ Estadual Paulista, Botucatu, SP, Brazil - mgbraz@hotmail.com.
authors.forename: M G
authors.initials: MG
authors.lastname: Braz
authors.forename: L G
authors.initials: LG
authors.lastname: Braz
authors.forename: J R
authors.initials: JR
authors.lastname: Braz
authors.forename: D T
authors.initials: DT
authors.lastname: Pierine
authors.forename: C R
authors.initials: CR
authors.lastname: Correa
authors.forename: A L
authors.initials: AL
authors.lastname: Ferreira
authors.forename: L R
authors.initials: LR
authors.lastname: Carvalho
authors.forename: K J
authors.initials: KJ
authors.lastname: Yeum
authors.forename: D M
authors.initials: DM
authors.lastname: Salvadori
mesh_terms: D000328:Adult; D000758:Anesthesia / Q000379:methods*; D000768:Anesthesia, General; D000771:Anesthesia, Intravenous / Q000379:methods*; D017558:Elective Surgical Procedures; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D050356:Lipid Metabolism / Q000502:physiology; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D009696:Nucleic Acids / Q000378:metabolism; D018384:Oxidative Stress / Q000502:physiology*; D055815:Young Adult
chemical_list: D015850:Interleukin-6; D009696:Nucleic Acids