A comparison of the effects of midazolam, propofol and dexmedetomidine on the antioxidant system: A randomized trial

Abstract

Abstract. Previous studies on the antioxidant activity of sedatives have predominantly been in vitro investigations that are lacking clinical data, resulting in conclusion without cogency. The aim of the present prospective, randomized study was to use single sedative drugs for anesthesia induction to compare their antioxidant properties. The effects on the antioxidant system of midazolam, propofol and dexmedetomidine were assessed using oxidative stress indicators and micronuclei (MN). Forty-nine patients undergoing esophageal cancer radical prostatectomy were selected. Midazolam, propofol and dexmedetomidine were used to induce anesthesia. Venous blood samples were obtained prior to and at 2 and at 24 h after surgery, and oxidative stress indicators were detected using the appropriate kits. The cytokinesis-block micronucleus cytome assay was executed and the frequencies of MN, nucleoplasmic bridges and nuclear buds were examined. It was found that the use of the three sedatives, respectively, led to a marked increase in the levels of free radical indicators at 2 h after surgery, which then decreased at 24 h after surgery. Furthermore, lower levels of oxidative stress were found following the use of propofol and dexmedetomidine compared with those following midazolam administration, and similar results were obtained regarding the level of MN. It is suggested that propofol and dexmedetomidine exhibit a superior antioxidant function to midazolam.

Dexmedetomidine Use in Application of Simultaneous Thoracic and Abdominal Endovascular Stent Graft Reconstruction

“…[6] ise genel anestezi ve DEX ile sedasyonu, abdominal aort anevrizmasının endovasküler onarımının yapıldığı olgularda karşılaştırmış, DEX kullanılan olgularda cerrahi ve anestezi süresinin kısaldığını, daha az opioide gereksinim duyulduğunu ve postoperatif ağrı skorlarında düşme sağladığı için genel anesteziye iyi bir alternatif olacağını raporlamışlardır. Tüm bu olumlu etkilerinin yanı sıra 3 gruba ayrılarak anestezi indüksiyon ve idamesinde midazolam, propofol ve DEX uygulanan yüksek riskli cerrahi geçiren 49 hastalık bir çalışmada DEX' in antioksidan sistem üzerine diğer 2 ajandan çok daha olumlu ve uzun süreli etkilerinin olduğu gösterilmiştir [7] . Sifringer ve ark.…”

Physiological Responses and Gene Expression in Ultrasound-Guided Supraclavicular Brachial Plexus Block: a Comparative Study

“…Surgical stress can decrease antioxidant activities in the body and oxidative stress can lead to elevations in the levels of free radicals [18]. Thus, the use of an anesthetic drug with antioxidant effects to lessen oxidative stress is crucial and of significant clinical value [19].…”

Comparison of oxidative stress under different propofol administration protocols in Thoroughbred racehorses by bOS and bAP assessment

“…Surgery-induced OS can cause immune suppression and delayed wound healing and therefore needs to be minimized [ 5 , 14 ]. A variety of studies have been conducted on the impact of anesthetics on OS [ 2 , 7 , 13 , 19 ]. The intravenous anesthetic agent propofol has a chemical structure similar to that of the exogenous antioxidant α-tocopherol [ 1 ].…”

“…The intravenous anesthetic agent propofol has a chemical structure similar to that of the exogenous antioxidant α-tocopherol [ 1 ]. Therefore propofol is known to have antioxidant capacity, and there have been many clinical studies of its antioxidant capacity in humans and animals [ 7 , 9 , 12 , 19 ]. However, as far as we know, there have been no studies evaluating the impacts of propofol on OS in horses.…”

“…The dose rates of medetomidine for sedation and constant rate infusion during maintenance of anesthesia were equal in all horses. The α-2 adrenergic receptor agonist dexmedetomidine, which is used mainly as a sedative in humans, reportedly has antioxidant capacity similar to that of propofol [ 7 ]. To our knowledge, there have been no previous studies describing the antioxidant potential of medetomidine, but the antioxidant capacity of dexmedetomidine has thus been demonstrated; therefore, the α-2 adrenergic receptor agonist medetomidine might have exhibited antioxidant capacity.…”