Koksal G M, Sayilgan C, Aydin S, Uzun H, Oz H
Istanbul University Cerrahpasa Medical Faculty, Department of Anaesthesiology, Istanbul, Turkey.
Eur J Anaesthesiol. 2004 Mar;21(3):217-20. doi: 10.1017/s0265021504003102.
To compare the effects of sevoflurane and desflurane anaesthesia on lipid peroxidation.
We studied 40 healthy patients undergoing elective laparoscopic cholecystectomy. Patients were randomly allocated to be anaesthetized either with sevoflurane (n = 20) or desflurane (n = 20). Anaesthesia was maintained with inspiratory concentrations of sevoflurane 1-1.5 MAC (n = 20) or desflurane (n = 20). Samples were taken for plasma malondialdehyde and superoxide dismutase assays before induction of anaesthesia, before skin incision and at the end of surgery. Alveolar cell samples were obtained from the lungs using the technique of protective blind bronchoalveolar lavage, after induction of anaesthesia and at the end of surgery for malondialdehyde and superoxide dismutase concentrations.
Plasma malondialdehyde increased more after the administration of desflurane than after sevoflurane: after induction 5.9 +/- 0.6 nmol mL(-1) for desflurane vs. 3.8 +/- 0.5 nmol L(-1) for sevoflurane (P < 0.001); at the end of the surgery: 6.7 +/- 0.4 nmol mL(-1) for desflurane vs. 4.2 +/- 0.3 nmol mL(-1) for sevoflurane (P < 0.001). There was a small but significant increase in plasma superoxide dismutase concentration after desflurane--from 24.2 +/- 1.2 to 24.9 +/- 0.9 U mL(-1) after induction and 25 +/- 1 U mL(-1) at the end of the surgery (P < 0.01)--but no increase with sevoflurane. Malondialdehyde concentrations increased significantly in the cells obtained by protective blind bronchoalveolar lavage at the end of surgery in the desflurane group (from 0.3 +/- 0.1 to 1.7 +/- 0.2 nmol mL(-1) (P < 0.001)), but not in the sevoflurane group. There were no significant differences between the two anaesthetics in the amounts of superoxide dismutase in the samples obtained by protective blind bronchoalveolar lavage.
Desflurane may cause more systemic and regional lipid peroxidation than sevoflurane during laparoscopic cholecystectomy in healthy human beings.
比较七氟醚和地氟醚麻醉对脂质过氧化的影响。
我们研究了40例择期行腹腔镜胆囊切除术的健康患者。患者被随机分配接受七氟醚（n = 20）或地氟醚（n = 20）麻醉。麻醉维持采用七氟醚吸入浓度1 - 1.5 MAC（n = 20）或地氟醚（n = 20）。在麻醉诱导前、皮肤切开前及手术结束时采集样本进行血浆丙二醛和超氧化物歧化酶检测。麻醉诱导后及手术结束时，采用保护性盲法支气管肺泡灌洗技术从肺中获取肺泡细胞样本，检测丙二醛和超氧化物歧化酶浓度。
地氟醚给药后血浆丙二醛升高幅度大于七氟醚：诱导后地氟醚为5.9 ± 0.6 nmol/mL，七氟醚为3.8 ± 0.5 nmol/L（P < 0.001）；手术结束时，地氟醚为6.7 ± 0.4 nmol/mL，七氟醚为4.2 ± 0.3 nmol/mL（P < 0.001）。地氟醚给药后血浆超氧化物歧化酶浓度有小幅但显著升高——诱导后从24.2 ± 1.2升至24.9 ± 0.9 U/mL，手术结束时为25 ± 1 U/mL（P < 0.01）——而七氟醚组无升高。地氟醚组手术结束时通过保护性盲法支气管肺泡灌洗获取的细胞中丙二醛浓度显著升高（从0.3 ± 0.1升至1.7 ± 0.2 nmol/mL（P < 0.001）），而七氟醚组未升高。通过保护性盲法支气管肺泡灌洗获取的样本中，两种麻醉剂的超氧化物歧化酶含量无显著差异。
在健康人腹腔镜胆囊切除术中，地氟醚可能比七氟醚引起更多的全身和局部脂质过氧化。
