Kesimci Elvin, Çoşkun Erdem, Uğur Gökçer, Müderris Togay, İzdeş Seval, Karahalil Bensu
Clinic of Anaesthesiology and Reanimation, Atatürk Training and Research Hospital, Ankara, Turkey.
Department of Toxicology, Gazi University School of Pharmacy Ankara, Turkey.
Turk J Anaesthesiol Reanim. 2017 Oct;45(5):264-269. doi: 10.5152/TJAR.2017.09475. Epub 2017 Oct 1.
Volatile anaesthetics can inhibit the bronchociliary clearence in a dose- and time-dependend way. Moreover, they can have potential mutagenic/carcinogenic effects under chronic exposure. A genotoxicity test -micronuclei assay- was carried out in nasal epithelial cells to analyze the genotoxic effect of sevoflurane in adult patients undergoing general anesthesia.
In this study, micronucleus (MN) assay was conducted using nasal epithelial cells of 37 adult patients (age, 18-65 years) who underwent elective, minor, short surgical procedures under general anaesthesia with sevoflurane. Anaesthesia was induced and maintained using 8% sevoflurane (in 6 L min of oxygen) and an inspired concentration of 2% in O2-air mixture, respectively. Nasal epithelial samples were collected at three time points: before anaesthesia induction (T1), after recovery from anaesthesia in the postanaesthesia care unit (T2) and on postoperative day 21 (T3).
Sevoflurane significantly increased mean MN (‰) frequencies in nasal epithelial cells at T2 (6.97±2.33) and T3 (6.22±2.47) compared with those at T1 (3.84±1.89) (p<0.001). Similar result were observed for MN frequencies if the patients were analysed with regard to age (>40 or <40 years) or sex.
Short-term administration of sevoflurane anaesthesia induces MN formation in nasal epithelial cells of this patient population. Further studies are required for evaluation of the results. The prolonged administration of volatile anaesthetics in various risk groups and surgical protocols should be conducted for evaluating their safety.
挥发性麻醉剂可呈剂量和时间依赖性地抑制支气管纤毛清除功能。此外,长期接触时它们可能具有潜在的致突变/致癌作用。在鼻上皮细胞中进行了一项遗传毒性试验——微核试验,以分析七氟醚对接受全身麻醉的成年患者的遗传毒性作用。
在本研究中,对37例年龄在18至65岁之间、接受七氟醚全身麻醉下择期、小型、短时间外科手术的成年患者的鼻上皮细胞进行微核试验。分别使用8%七氟醚(在6 L/min氧气中)诱导麻醉,并使用2%的吸入浓度维持在氧气-空气混合物中。在三个时间点采集鼻上皮样本:麻醉诱导前(T1)、麻醉后护理单元麻醉恢复后(T2)和术后第21天(T3)。
与T1时(3.84±1.89)相比,七氟醚在T2时(6.97±2.33)和T3时(6.22±2.47)显著增加了鼻上皮细胞中的平均微核(‰)频率(p<0.001)。如果根据年龄(>40岁或<40岁)或性别对患者进行分析,微核频率也观察到类似结果。
短期给予七氟醚麻醉可诱导该患者群体鼻上皮细胞中微核形成。需要进一步研究以评估结果。应在不同风险组和手术方案中对挥发性麻醉剂进行长期给药,以评估其安全性。