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Isoflurane and Propofol Contribute to Increasing the Antioxidant Status of Patients During Minor Elective Surgery: A Randomized Clinical Study

Isoflurane is a volatile halogenated anesthetic used especially for anesthesia maintenance whereas propofol is a venous anesthetic utilized for anesthesia induction and maintenance, and reportedly an antioxidant. However, there are still controversies related to isoflurane-induced oxidative stress a...

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Autores principales: Braz, Mariana G., Braz, Leandro G., Freire, Cristiana M.M., Lucio, Lorena M.C., Braz, José R.C., Tang, Guangwen, Salvadori, Daisy M.F., Yeum, Kyung-Jin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4616612/
https://www.ncbi.nlm.nih.gov/pubmed/26252290
http://dx.doi.org/10.1097/MD.0000000000001266
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author Braz, Mariana G.
Braz, Leandro G.
Freire, Cristiana M.M.
Lucio, Lorena M.C.
Braz, José R.C.
Tang, Guangwen
Salvadori, Daisy M.F.
Yeum, Kyung-Jin
author_facet Braz, Mariana G.
Braz, Leandro G.
Freire, Cristiana M.M.
Lucio, Lorena M.C.
Braz, José R.C.
Tang, Guangwen
Salvadori, Daisy M.F.
Yeum, Kyung-Jin
author_sort Braz, Mariana G.
collection PubMed
description Isoflurane is a volatile halogenated anesthetic used especially for anesthesia maintenance whereas propofol is a venous anesthetic utilized for anesthesia induction and maintenance, and reportedly an antioxidant. However, there are still controversies related to isoflurane-induced oxidative stress and it remains unanswered whether the antioxidant effects occur in patients under propofol anesthesia. Taking into account the importance of better understanding the role of anesthetics on oxidative stress in anesthetized patients, the present study was designed to evaluate general anesthesia maintained with isoflurane or propofol on antioxidant status in patients who underwent minimally invasive surgeries. We conducted a prospective randomized trial in 30 adult patients without comorbidities who underwent elective minor surgery (septoplasty) lasting at least 2 h admitted to a Brazilian tertiary hospital. The patients were randomly allocated into 2 groups, according to anesthesia maintenance (isoflurane, n = 15 or propofol, n = 15). Peripheral blood samples were drawn before anesthesia (baseline) and 2-h after anesthesia induction. The primary outcomes were to investigate the effect of either isoflurane or propofol anesthesia on aqueous plasma oxidizability and total antioxidant performance (TAP) by fluorometry as well as several individual antioxidants by high-performance liquid chromatography. As secondary outcome, oxidized genetic damage (7,8-dihydro-8-oxoguanine, known as 8-oxo-Gua) was investigated by the comet assay. Both anesthesia techniques (isoflurane or propofol) for a 2-h period resulted in a significant decrease of plasma α-tocopherol, but not other antioxidants including uric acid, carotenoids, and retinol (P > 0.05). Propofol, in contrast to isoflurane anesthesia, significantly increased (P < 0.001) anti-inflammatory/antioxidant plasma γ-tocopherol concentration in patients. Both anesthesia types significantly enhanced hydrophilic antioxidant capacity and TAP, with no significant difference between them, and 8-oxo-Gua remained unchanged during anesthesia in both groups. In addition, both anesthetics showed antioxidant capacity in vitro. This study shows that anesthesia maintained with either propofol or isoflurane increase both hydrophilic and total antioxidant capacity in plasma, but only propofol anesthesia increases plasma γ-tocopherol concentration. Additionally, both types of anesthetics do not lead to oxidative DNA damage in patients without comorbidities undergoing minimally invasive surgery.
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spelling pubmed-46166122015-10-27 Isoflurane and Propofol Contribute to Increasing the Antioxidant Status of Patients During Minor Elective Surgery: A Randomized Clinical Study Braz, Mariana G. Braz, Leandro G. Freire, Cristiana M.M. Lucio, Lorena M.C. Braz, José R.C. Tang, Guangwen Salvadori, Daisy M.F. Yeum, Kyung-Jin Medicine (Baltimore) 3300 Isoflurane is a volatile halogenated anesthetic used especially for anesthesia maintenance whereas propofol is a venous anesthetic utilized for anesthesia induction and maintenance, and reportedly an antioxidant. However, there are still controversies related to isoflurane-induced oxidative stress and it remains unanswered whether the antioxidant effects occur in patients under propofol anesthesia. Taking into account the importance of better understanding the role of anesthetics on oxidative stress in anesthetized patients, the present study was designed to evaluate general anesthesia maintained with isoflurane or propofol on antioxidant status in patients who underwent minimally invasive surgeries. We conducted a prospective randomized trial in 30 adult patients without comorbidities who underwent elective minor surgery (septoplasty) lasting at least 2 h admitted to a Brazilian tertiary hospital. The patients were randomly allocated into 2 groups, according to anesthesia maintenance (isoflurane, n = 15 or propofol, n = 15). Peripheral blood samples were drawn before anesthesia (baseline) and 2-h after anesthesia induction. The primary outcomes were to investigate the effect of either isoflurane or propofol anesthesia on aqueous plasma oxidizability and total antioxidant performance (TAP) by fluorometry as well as several individual antioxidants by high-performance liquid chromatography. As secondary outcome, oxidized genetic damage (7,8-dihydro-8-oxoguanine, known as 8-oxo-Gua) was investigated by the comet assay. Both anesthesia techniques (isoflurane or propofol) for a 2-h period resulted in a significant decrease of plasma α-tocopherol, but not other antioxidants including uric acid, carotenoids, and retinol (P > 0.05). Propofol, in contrast to isoflurane anesthesia, significantly increased (P < 0.001) anti-inflammatory/antioxidant plasma γ-tocopherol concentration in patients. Both anesthesia types significantly enhanced hydrophilic antioxidant capacity and TAP, with no significant difference between them, and 8-oxo-Gua remained unchanged during anesthesia in both groups. In addition, both anesthetics showed antioxidant capacity in vitro. This study shows that anesthesia maintained with either propofol or isoflurane increase both hydrophilic and total antioxidant capacity in plasma, but only propofol anesthesia increases plasma γ-tocopherol concentration. Additionally, both types of anesthetics do not lead to oxidative DNA damage in patients without comorbidities undergoing minimally invasive surgery. Wolters Kluwer Health 2015-08-07 /pmc/articles/PMC4616612/ /pubmed/26252290 http://dx.doi.org/10.1097/MD.0000000000001266 Text en Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by-nd/4.0 This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author. http://creativecommons.org/licenses/by-nd/4.0
spellingShingle 3300
Braz, Mariana G.
Braz, Leandro G.
Freire, Cristiana M.M.
Lucio, Lorena M.C.
Braz, José R.C.
Tang, Guangwen
Salvadori, Daisy M.F.
Yeum, Kyung-Jin
Isoflurane and Propofol Contribute to Increasing the Antioxidant Status of Patients During Minor Elective Surgery: A Randomized Clinical Study
title Isoflurane and Propofol Contribute to Increasing the Antioxidant Status of Patients During Minor Elective Surgery: A Randomized Clinical Study
title_full Isoflurane and Propofol Contribute to Increasing the Antioxidant Status of Patients During Minor Elective Surgery: A Randomized Clinical Study
title_fullStr Isoflurane and Propofol Contribute to Increasing the Antioxidant Status of Patients During Minor Elective Surgery: A Randomized Clinical Study
title_full_unstemmed Isoflurane and Propofol Contribute to Increasing the Antioxidant Status of Patients During Minor Elective Surgery: A Randomized Clinical Study
title_short Isoflurane and Propofol Contribute to Increasing the Antioxidant Status of Patients During Minor Elective Surgery: A Randomized Clinical Study
title_sort isoflurane and propofol contribute to increasing the antioxidant status of patients during minor elective surgery: a randomized clinical study
topic 3300
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4616612/
https://www.ncbi.nlm.nih.gov/pubmed/26252290
http://dx.doi.org/10.1097/MD.0000000000001266
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