Oxidative stress under general intravenous and inhalation anaesthesia

Abstract

Oxidative stress occurs when reactive oxygen species (ROS) production overwhelms cell protection by antioxidants. This review is focused on general anaesthesia-induced oxidative stress because it increases the rate of complications and delays recovery after surgery. It is important to know what effects of anaesthetics to expect in terms of oxidative stress, particularly in surgical procedures with high ROS production, because their either additive or antagonistic effect may be pivotal for the outcome of surgery. In vitro and animal studies on this topic are numerous but show large variability. There are not many human studies and what we know has been learned from different surgical procedures measuring different endpoints in blood samples taken mostly before and after surgery. In these studies most intravenous anaesthetics have antioxidative properties, while volatile anaesthetics temporarily increase oxidative stress in longer surgical procedures.

Serum and Erythrocyte Antioxidant Defense in Colorectal Cancer Patients during Early Postoperative Period: Potential Modifiers and Impact on Clinical Outcomes

“…While there are no previous reports regarding the impact of robotic surgery in CRC patients on antioxidants, an inflammatory response has been shown to be reduced [13,43,44]. As longer exposure to volatile anesthetics induces oxidative stress [27], prolonged exposure to sevoflurane during robotic surgery might counteract the beneficial effect of minimizing the invasiveness of surgery.…”

“…They were treated with propofol, fentanyl, and rocuronium for induction and the general anesthesia was maintained with sevoflurane. While intravenous analgesics are claimed to scavenge reactive oxygen species, volatile anesthetics may, reportedly, induce oxidative stress during longer procedures (reviewed in [27]). The length of surgery and therefore the time our patients stayed under anesthesia differed but none of the evaluated antioxidants correlated with length of surgery.…”

“…The length of surgery and therefore the time our patients stayed under anesthesia differed but none of the evaluated antioxidants correlated with length of surgery. Free radical-scavenging properties or indirect antioxidant activity have been reported for propofol [27][28][29][30][31], fentanyl [29,32], and sevoflurane [33] as well as for rocuronium [34,35] muscle relaxant, likely contributing to an initial increase in antioxidant capacity.…”

Effect of Fresh Gas Flow Rate on Thiol/Disulphide Hemostasis and Ischemia-modified Albumin in Laparoscopic Cholecystectomy

“…Protection against ischaemia-reperfusion damage by sevoflurane in vital organs such as the heart, lung and the kidney has been determined. 14,18,19 The low disulphide and IMA levels as compared to baseline levels in both groups may be accepted as indicators of functioning antioxidant mechanisms. This may involve the protective effect of sevoflurane.…”

The effect of minimal-flow and high-flow hypotensive anesthesia on oxidative stress

“…Anesthesia-induced oxidative stress may affect proteins, lipids and DNA. Surgical patients can undergo surgeries that may cause inflammation, surgical trauma, and ischemiareperfusion injury all of which are resulted from oxidative stress (6).…”