title: The effects of adding ischemic preconditioning during desflurane inhalation anesthesia or propofol total intravenous anesthesia on pneumoperitoneum-induced oxidative stress.
abstract: BACKGROUND
  The aim of the study was to explore the differences in oxidative stress during anesthesia with desflurane/N2O or propofol/remifentanil in patients undergoing laparoscopic cholecystectomy and additionally to evaluate the differential effects of desflurane and propofol on ischemic preconditioning (IP).
  
  
  METHODS
  One hundred patients were randomly allocated to four groups. For anesthesia maintenance, the inhalation group (Group I) and the inhalation plus IP group (Group IIP) received desflurane at an end-tidal concentration of 4-6 vol% in oxygen/N2O, and the TIVA group (Group T) and TIVA plus IP group (Group TIP) received infusions of propofol and remifentanil. In Groups IIP and TIP, IP was carried out by 10 min of pneumoperitoneum followed by 10 min of deflation. Preoperative and postoperative plasma total antioxidant status (TAS), total oxidant status (TOS), paraoxonase, stimulated paraoxonase, arylesterase, ceruloplasmin, and myeloperoxidase levels were analyzed; oxidative stress index (OSI) was calculated.
  
  
  RESULTS
  When oxidative stress parameters were compared between groups, myeloperoxidase values in Group I were statistically significantly lower compared to Group TIP (p = .004 with Bonferroni's correction). There were no differences between preoperative and postoperative TAS, paraoxonase, stimulated paraoxonase, arylesterase, or ceruloplasmin levels (p > .05). In intragroup evaluations, postoperative paraoxonase and stimulated paraoxonase levels were found to be lower than preoperative values in Group TIP (p = .021 and .012, respectively).
  
  
  CONCLUSIONS
  In laparoscopic cholecystectomy lasting less than 60 min, there were no differences in the measured oxidative stress parameters between maintenance of anesthesia by desflurane/N2O and propofol/remifentanil/N2O. The addition of 10 min IP administration during both anesthesia techniques did not result in additional changes in the analyzed oxidative stress.
authors: a Department of Anesthesiology , Private Konak Hospital , Kocaeli , Turkey.
authors: Safinaz
authors: S
authors: Karabayirli
authors: b Department of General Surgery , Medicana International Ankara Hospital , Ankara , Turkey.
authors: Onder
authors: O
authors: Surgit
authors: c Department of Anesthesiology Ataturk Training and Research Hospital , Ankara , Turkey.
authors: Hulya
authors: H
authors: Kasikara
authors: d Department of Clinical Biochemistry , Faculty of Medicine, Yildirim Beyazit University , Ankara , Turkey.
authors: Cemile
authors: C
authors: Koca Bicer
authors: e Department of Clinical Biochemistry , December 25 State Hospital , Gaziantep , Turkey.
authors: Merve
authors: M
authors: Ergin
authors: f Department of Anesthesiology , Faculty of Medicine, Turgut Ozal University , Ankara , Turkey.
authors: Ruveyda
authors: R
authors: Irem Demircioglu
authors: f Department of Anesthesiology , Faculty of Medicine, Turgut Ozal University , Ankara , Turkey.
authors: Bunyamin
authors: B
authors: Muslu
mesh_terms: D000328:Adult; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D017081:Cholecystectomy, Laparoscopic; D000077335:Desflurane; D005260:Female; D006801:Humans; D019194:Ischemic Preconditioning; D007530:Isoflurane / Q000008:administration & dosage / Q000031:analogs & derivatives*; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000502:physiology*; D011027:Pneumoperitoneum / Q000150:complications*; D015742:Propofol / Q000008:administration & dosage*
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D000077335:Desflurane; D007530:Isoflurane; D015742:Propofol
keywords: Pneumoperitoneum; desflurane; ischemic preconditioning; oxidative status; propofol