The effect of low flow anesthesia with sevoflurane on oxidative status

Abstract

Objectives: To assess the impact of low-flow, mid-flow, and high-flow sevoflurane anesthesia on the oxidative state by measuring thiol/disulfide levels in patients undergoing surgery. Methods:The study included 99 patients randomly assigned to 3 groups. In the low-flow anesthesia group, the fresh gas flow was diminished to 1 L.min -1 for anesthesia maintenance after 6 L.min -1 was administered for the first 10 minutes. In the mid-flow anesthesia group, fresh gas flow was applied as 2 L.min -1 . In the high-flow anesthesia group, the fresh gas flow was administered as 4 L.min -1 throughout the operation. Blood samples were obtained before induction, at the 60th minute after induction, and at 2 hours postoperatively. Native thiol, total thiol, disulfide analyzed and disulfide/ native thiol percentage, disulfide/total thiol percentage, and native thiol/total thiol percentage were calculated. Original ArticleResults: Disulfide values in mid-flow and low-flow anesthesia were significantly lower at the 60th minute after induction compared to the high-flow anesthesia group. In the group evaluations, intraoperative native thiol levels in the high-flow group were found to be substantialy lower than preoperative values. Conclusion:It was sighted that low-flow anesthesia with sevoflurane prohibited oxidative damage. It was concluded that low flow anesthesia can be utilized safely in this respect.

El estrés oxidativo en el perioperatorio: implicaciones clínicas

“…Por otro lado, se ha reportado que el uso de la anestesia con bajos flujos en el perioperatorio, especialmente en los pacientes con comorbilidades, puede reducir la lesión oxidativa en el postoperatorio y acelerar el proceso de recuperación. La anestesia con bajo flujo y sevoflurano no crea ninguna diferencia en los parámetros hemodinámicos, por lo tanto, se puede usar con seguridad (23) . Por otro lado, en el postoperatorio de cirugía cardíaca y no cardíaca, diversos estudios han demostrado resultados promisorios del manejo anestésico preventivo del EOx (24)(25)(26) .…”