From the Department of Anesthesiology and Reanimation (Kaşıkara, Dumanlı Özcan), Ankara City Hospital, from the Department of Medical Biochemistry (Biçer), School of Medicine; from the Department of General Surgery (Yalçın); from the Department of Anesthesiology and Reanimation (Aksoy, But); Ankara Yıldırım Beyazıt University, and from the Department of Anesthesiology and Reanimation (Altın), Hacettepe University, Ankara, Turkey.
Saudi Med J. 2022 Mar;43(3):227-235. doi: 10.15537/smj.2022.43.3.20210876.
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.
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 for anesthesia maintenance after 6 L.min was administered for the first 10 minutes. In the mid-flow anesthesia group, fresh gas flow was applied as 2 L.min. In the high-flow anesthesia group, the fresh gas flow was administered as 4 L.min 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.
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.
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.
通过测量手术患者的硫醇/二硫键水平,评估低流量、中流量和高流量七氟醚麻醉对氧化状态的影响。
该研究纳入了 99 名随机分为 3 组的患者。在低流量麻醉组中,在最初 10 分钟给予 6 L.min 后,将新鲜气体流量减少至 1 L.min 以维持麻醉。在中流量麻醉组中,新鲜气体流量应用为 2 L.min。在高流量麻醉组中,整个手术过程中均给予 4 L.min 的新鲜气体流量。在诱导前、诱导后 60 分钟和术后 2 小时采集血样。计算天然硫醇、总硫醇、分析二硫键以及二硫键/天然硫醇百分比、二硫键/总硫醇百分比和天然硫醇/总硫醇百分比。
与高流量麻醉组相比,中流量和低流量麻醉在诱导后 60 分钟时的二硫键值明显更低。在组内评估中,高流量组术中天然硫醇水平明显低于术前值。
七氟醚低流量麻醉可防止氧化损伤。因此,在这方面可以安全地使用低流量麻醉。