The effects of etomidate, thiopental, and propofol in induction on hypoperfusion–reperfusion phenomenon during laparoscopic cholecystectomy

Yağmurdur, Hatice; Çakan, Türkay; Bayrak, Ahmet; Arslan, Müzeyyen; Baltaci, Bülent; İnan, Nurten; Kılınç, Kamer

doi:10.1111/j.0001-5172.2004.00417.x

Cited by 29 publications

(24 citation statements)

References 42 publications

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“…Post-operative examination showed that in etomidate and thiopental groups, AST and ALT levels in 24 hours showed a marked significant increase, but in propofol group no significant change has been marked. [17] Our study showed in that MDA level was higher in etomidate groups than in other groups.…”

Section: T H I O P E N T a L P R O P O F O L E T O M I D A T E I N T supporting

confidence: 43%

“…Thus, in clinically suitable concentrations, thiopental is stated to repress the neutrophil originated free oxygen radicals significantly. [17] Basu et al found that propofol had an inflammatory response-decreasing effect compared to thiopental in a study in which oxidative stress and inflammatory response after the renal transplantation were examined. [14] However, we did not detect any significant difference between these two groups in our study.…”

Section: T H I O P E N T a L P R O P O F O L E T O M I D A T E I N T mentioning

confidence: 99%

“…Yagmurdur et al showed in their studies that propofol hypoperfusion reperfusion condition related to lipid peroxidation inhibition and induction doses of propofol may have many advantages in the suspension of metabolites and free oxygen radicals. [17] In examining tissue antioxidant capacities during the propofol anesthesia, Runzer et al [19] detected that MDA levels decreased significantly when high-dose propofol was mixed with halothane. Nonetheless, in the same study, it was detected that the protective effect of propofol was significant in all tissues and had a significant protective effect primarily in liver and then kidney, heart, and lungs.…”

Section: T H I O P E N T a L P R O P O F O L E T O M I D A T E I N T mentioning

confidence: 99%

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Effects of Intravenous Anesthetics on Renal Ischemia/Reperfusion Injury

et al. 2009

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Background. Renal ischemia/reperfusion (I/R)-induced tubular epithelial cell injury, called ischemic acute renal failure, is associated with high mortality in humans. Protecting the kidney against I/R injury is very important during complicated renal operations, transplantation surgery, and anesthesia. Aim. The purpose of this study was to investigate and compare the efficiency of ketamine, thiopental, propofol, etomidate, and intralipid in reducing the injury induced by free radicals in a rat model of renal I/R. Method. Forty-two Wistar rats were divided into seven groups in our study. Rats in the sham group underwent laparotomy and waited for 120 minutes (min) without ischemia. Rats in the control group were given nothing with ischemia-reperfusion. Rats in the I/R groups were given ketamine (20 mg/kg), thiopental (20 mg/kg) propofol (25 mg/kg), etomidate (10 mg/kg) and 10% intralipid (250 mg/kg) intraperitoneally 15 min prior to the ischemia for 60 min, followed by reperfusion for 60 min. The blood samples and kidney tissues of the rats were obtained under anesthesia at the end of the reperfusion period. Biochemical malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), blood urea nitrogen (BUN), creatine (Cr), aspartate aminotransferase (AST) were determined, and histopathological analysis was performed with these samples. Results. MDA level was increased significantly in the control group (p < 0.05). Histopathological findings of the control group confirmed that there was renal impairment by tubular cell swelling, interstitial edema, medullary congestion, and tubular dilatation. MDA levels were lower in the ketamine, thiopental, and propofol groups compared to the control group (p < 0.05). In the thiopental and propofol groups, the levels of histopathological Effects of Intravenous Anesthetics in I/R Injury 291scores were significantly lower than control and etomidate groups in ischemia-reperfusion. Conclusion. Our results demonstrated that I/R injury was significantly reduced in the presence of propofol and thiopental. The protective effects of these drugs may belong to their antioxidant properties. These results may indicate that propofol and thiopental anesthesia protects against functional, biochemical, and morphological damage better than control in renal I/R injury.

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Section: T H I O P E N T a L P R O P O F O L E T O M I D A T E I N T supporting

confidence: 43%

Section: T H I O P E N T a L P R O P O F O L E T O M I D A T E I N T mentioning

confidence: 99%

Section: T H I O P E N T a L P R O P O F O L E T O M I D A T E I N T mentioning

confidence: 99%

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Effects of Intravenous Anesthetics on Renal Ischemia/Reperfusion Injury

et al. 2009

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“…2,6 This is particularly important for inhalation anesthetics because their transformation to reactive products is enhanced by hypoxia and I/R injury. 17,18 After hypoxia and I/R injury, ROS are released to rapid increase of the oxygen concentration in blood via reperfusion of the tissue. 10 In consequence, increased generation of ROS initiates chain reactions such as peroxidation of lipids and of nucleic acids.…”

Section: Discussionmentioning

confidence: 99%

New volatile anesthetic, desflurane, reduces vitamin E level in blood of operative patients via oxidative stress

Eroğlu

Yavuz

Ceylan

et al. 2010

Cell Biochemistry & Function

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It has been well known that some volatile anesthetic agents produce oxidative stress. Desflurane as a new volatile agent might have limited oxidative toxic effect because it is relatively a new short-acting anesthetic characterized by a short duration of action and a quick postanesthetic recovery. We investigated effect of desflurane on serum glutathione peroxidase (GSH-Px), lipid peroxidation (LP), vitamin E, and erythrocyte superoxide dismutase (SOD) values in patients. Fifteen adult patients are scheduled for elective surgery, ASA I or II physical status. Tidal volume and ventilation frequency were kept unchanged during the operation. Baseline values in venous blood samples were preoperatively taken and blood was also taken postoperatively at the 1st and the 12th hours of desflurane exposure. LP levels were significantly (p < 0.05) higher postoperatively at 1st hour than in preoperative values while alpha-tocopherol concentration was significantly (p < 0.001) lower in postoperative period at 1st hour than in preoperative period. Erythrocyte SOD and serum GSH-Px activities did not differ between pre- and postoperative periods. In conclusion, we observed that desflurane produced oxidative stress by decreasing alpha-tocopherol levels. Use of vitamin E may be possible to reduce the oxidative effect of desflurane.

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“…Propofol has got a preventive role as it scavenges reactive oxygen species and their metabolites in case of anticipated hypoperfusion-reperfusion phenomenon, which occurs in laparoscopic surgery. 5 Thus, propofol appears to be an ideal induction agent for laparoscopic surgeries in ASA I and II patients, but, this vasodilator and down regulation of baroreceptor effect of propofol is markedly pronounced in ASA III elderly, hypertensive patients as the baroreceptor reflex are set at higher level in hypertensives. 6 Fall of mean arterial pressure, if more than 30% may jeopardize coronary circulation.…”

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confidence: 99%

Cortisol Lowering Action and Cardiovascular Stability of Etomidate: A Comparison With Propofol in Controlled Hypertensives

Srivastava¹,

Ghosh²,

Bhattacharya³

et al. 2015

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BACKGROUND:Etomidate suppresses corticosteroid synthesis in the adrenal cortex by reversibly inhibiting the enzyme 11-beta-hydroxylase, leading to primary adrenal suppression. Continuous etomidate infusion for sedation of critically ill trauma patients in intensive care units has been associated with increased mortality due to adrenal suppression. Etomidate has a favorable haemodynamic profile and is the preferred drug in hypertensive patients but is often not used for the fear of adrenal suppression. Propofol is a widely used hypnotic agent used for induction of general anaesthesia. AIM: To study and compare the haemodynamic profile, the extent of adrenal suppression and the side effects of etomidate and propofol. METHOD: Sixty controlled hypertensives, undergoing laparoscopic major gynaecological surgery were randomly allocated in a double blind manner to receive as an inducing agent etomidate (0.3mg/kg) (group E) or propofol (2mg/kg) (group P). Anaesthesia was administered according to the standard institutional protocol and residual neuromuscular block was reversed. All patients were sent to post anaesthetic care unit. Systolic, diastolic , mean blood pressure and heart rates were recorded pre-induction, post induction and at 5 minutes thereafter until 30 minutes. Incidence of pain on injection was noted during induction and myoclonus was observed just after the induction. Incidence of PONV was noted in all cases. Serum cortisol levels were measured pre-operatively, after completion of operation and 24 hours post operatively. RESULTS: Mean blood pressure decreased in 60% patients in group P. 15% patients in this group suffered hypotension immediately after induction and needed bolus iv infusion and /or phenylephrine. No patient in group E needed phenylephrine. Patients receiving etomidate had a lower serum cortisol concentration immediately after the operation than those receiving propofol, but no differences between the groups were observed 24 hours postoperatively. Incidence of pain on injection, myoclonus and PONV were higher in group E but was not statistically significant. CONCLUSION: Induction with etomidate is a better than propofol in controlled hypertensives undergoing laparoscopic major gynaecological surgery with no serious deleterious effects due to decrease in cortisol levels.

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The effects of etomidate, thiopental, and propofol in induction on hypoperfusion–reperfusion phenomenon during laparoscopic cholecystectomy

Abstract: Propofol with antioxidant activity may offer many advantages by scavenging reactive oxygen species and their metabolites in case of anticipated hypoperfusion-reperfusion phenomenon, such as would occur in laparoscopic surgery.

Cited by 29 publications

References 42 publications

Effects of Intravenous Anesthetics on Renal Ischemia/Reperfusion Injury

Effects of Intravenous Anesthetics on Renal Ischemia/Reperfusion Injury

New volatile anesthetic, desflurane, reduces vitamin E level in blood of operative patients via oxidative stress

Cortisol Lowering Action and Cardiovascular Stability of Etomidate: A Comparison With Propofol in Controlled Hypertensives

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