Department of Anesthesia and Intensive Care, Gregorio Marañón's University Hospital, 28007 Madrid, Spain.
Department of Physiology, Faculty of Medicine, Autónoma University, 28029 Madrid, Spain.
Int J Mol Sci. 2024 Oct 7;25(19):10770. doi: 10.3390/ijms251910770.
An aortic aneurysm (AA) is a life-threatening condition. Oxidative stress may be a common pathway linking multiple mechanisms of an AA, including vascular inflammation and metalloproteinase activity. Endovascular aneurysm repair (EVAR) is the preferred surgical approach for AA treatment. During surgery, inflammation and ischemia-reperfusion injury occur, and reactive oxygen species (ROS) play a key role in their modulation. Increased perioperative oxidative stress is associated with higher postoperative complications. The use of volatile anesthetics during surgery has been shown to reduce oxidative stress. Individual biomarkers only partially reflect the oxidative status of the patients. A global indicator of oxidative stress (OXY-SCORE) has been validated in various pathologies. This study aimed to compare the effects of the main volatile anesthetics, sevoflurane and desflurane, on oxidative status during EVAR. Eighty consecutive patients undergoing EVAR were randomized into two groups: sevoflurane and desflurane. Plasma biomarkers of oxidative damage (protein carbonylation and malondialdehyde) and antioxidant defense (total thiols, glutathione, nitrates, superoxide dismutase, and catalase activity) were measured before surgery and 24 h after EVAR. The analysis of individual biomarkers showed no significant differences between the groups. However, the OXY-SCORE was positive in the desflurane group (indicating a shift towards antioxidants) and negative in the sevoflurane group (favoring oxidants) ( < 0.044). Compared to sevoflurane, desflurane had a positive effect on oxidative stress during EVAR. The OXY-SCORE could provide a more comprehensive perspective on oxidative stress in this patient population.
腹主动脉瘤（AAA）是一种危及生命的疾病。氧化应激可能是连接 AAA 的多种机制的共同途径，包括血管炎症和金属蛋白酶活性。血管内动脉瘤修复（EVAR）是 AAA 治疗的首选手术方法。在手术过程中，会发生炎症和缺血再灌注损伤，活性氧（ROS）在其调节中起着关键作用。围手术期氧化应激增加与术后并发症增加有关。研究表明，手术中使用挥发性麻醉剂可降低氧化应激。个体生物标志物仅部分反映患者的氧化状态。一种氧化应激的整体指标（OXY-SCORE）已在多种病理情况下得到验证。本研究旨在比较主要挥发性麻醉剂七氟醚和地氟醚对 EVAR 期间氧化状态的影响。连续 80 例行 EVAR 的患者随机分为两组：七氟醚组和地氟醚组。在手术前和 EVAR 后 24 小时测量氧化损伤的血浆生物标志物（蛋白质羰基化和丙二醛）和抗氧化防御（总巯基、谷胱甘肽、硝酸盐、超氧化物歧化酶和过氧化氢酶活性）。虽然组间分析个体生物标志物无显著差异，但地氟醚组 OXY-SCORE 呈阳性（表明抗氧化剂），七氟醚组呈阴性（有利于氧化剂）（<0.044）。与七氟醚相比，地氟醚对 EVAR 期间的氧化应激有积极影响。OXY-SCORE 可以为该患者人群的氧化应激提供更全面的视角。
