Oncul Sema, Karabiyik Lale, Coskun Erdem, Kadioglu Ela, Gulbahar Ozlem
Gazi University Faculty of Medicine, Department of Anesthesiology and Intensive Care, Ankara, Turkey.
Gazi University Faculty of Medicine, Department of Anesthesiology and Intensive Care, Ankara, Turkey.
Braz J Anesthesiol. 2017 Jan-Feb;67(1):35-41. doi: 10.1016/j.bjane.2015.08.013. Epub 2016 Apr 12.
The aim of this study was to compare the effects of sevoflurane and propofol anesthesia on oxidative DNA damage that occurs in low-extremity ischemia and is caused by tourniquet application.
Fourteen New Zealand rabbits were randomly allocated into two equal groups. Group S (n=7) received sevoflurane (2.5-4 percent) inhalation and Group P (n=7) received a propofol infusion (1-2mg·kg·min), after which a pneumatic tourniquet was placed on the right lower extremity. Blood samples were collected prior to tourniquet placement (baseline), 120min after ischemia, 15min after ischemia and 120minutes (min) after ischemia. Malondialdehyde (MDA) levels were analyzed to determine lipid peroxidation, and single cell gel electrophoresis (SCGE) was used to determine DNA damage.
At 15min after ischemia, the MDA levels in Group P (8.15±2.61μM) were higher than baseline (6.26±3.19μM, p=0.026) and Group S (4.98±0.77μM, p=0.01). DNA damage was similar in both groups, although DNA damage was higher than baseline (tail moment 0.63±0.27, tail intensity 3.76±1.26) in Group P at the 15th minute of reperfusion (tail moment 1.05±0.45, p=0.06; tail intensity 5.33±1.56, p=0.01). The increase in tail moment and tail intensity returned to normal levels in both groups 2hours after the termination of ischemia.
Given that oxidative stress and genotoxic effect disappear in the late stages of reperfusion, we conclude that neither sevoflurane nor propofol can be considered superior to the other in anesthesia practices for extremity surgeries involving the use of a tourniquet.
本研究旨在比较七氟醚和丙泊酚麻醉对下肢缺血及止血带应用所致氧化DNA损伤的影响。
14只新西兰兔随机分为两组,每组7只。S组吸入2.5% - 4%七氟醚,P组静脉输注丙泊酚(1 - 2mg·kg·min),之后在右下肢放置气压止血带。于止血带放置前(基线)、缺血120分钟后、缺血15分钟后及缺血120分钟后采集血样。分析丙二醛(MDA)水平以测定脂质过氧化,采用单细胞凝胶电泳(SCGE)测定DNA损伤。
缺血15分钟时,P组MDA水平(8.15±2.61μM)高于基线水平(6.26±3.19μM,p = 0.026)及S组(4.98±0.77μM,p = 0.01)。两组DNA损伤情况相似,不过再灌注第15分钟时P组DNA损伤高于基线(尾矩0.63±0.27,尾强度3.76±1.26)(尾矩为1.05±0.45,p = 0.06;尾强度为5.33±1.56,p = 0.01)。缺血结束2小时后,两组尾矩和尾强度的增加均恢复至正常水平。
鉴于再灌注后期氧化应激和基因毒性效应消失,我们得出结论,在涉及使用止血带的肢体手术麻醉中,七氟醚和丙泊酚在麻醉效果上并无优劣之分。