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01.08.2013 | original article | Ausgabe 15-16/2013

Wiener klinische Wochenschrift 15-16/2013

Effects of sevoflurane and desflurane on oxidative stress during general anesthesia for elective cesarean section

Zeitschrift:
Wiener klinische Wochenschrift > Ausgabe 15-16/2013
Autoren:
MD Asst. Prof. Saban Yalcin, MD Asst. Prof. Harun Aydoğan, MD Asst. Prof. Hasan Husnu Yuce, MD Asst. Prof. Ahmet Kucuk, MD Asst. Prof. Mahmut Alp Karahan, MD Asc.Prof. Mehmet Vural, MD Asst. Prof. Aysun Camuzcuoğlu, MD PhD Prof. Dr. Nurten Aksoy

Summary

Background

Anesthetic agents might considerably influence maternal-fetal oxidative stress and antioxidants during cesarean section (CS). The aim of this study was to investigate the effects of desflurane and sevoflurane on oxidative stress parameters both in mothers and newborns undergoing elective CS.

Materials and methods

Eighty ASA physical status I–II, term parturients undergoing elective CS under general anesthesia were randomized to desflurane (Group D) and sevoflurane (Group S) groups. Blood samples were collected from mothers before operation and postoperatively and umbilical artery samples were obtained at delivery. Total oxidant status (TOS), total antioxidant capacity (TAC) status, lipid hydroperoxide (LOOH), and free sulfhydryl (–SH) levels were measured and oxidative stress index was calculated. Secondary outcomes included maternal hemodynamics.

Results

Preoperative LOOH, TOS, OSI, TAC, and –SH levels were similar among groups. Postoperative maternal serum LOOH, TOS, and OSI levels were significantly increased in Group D compared to Group S (p = 0.003, p = 0.005, p = 0.04; respectively). Postoperative umbilical artery LOOH, TOS, OSI levels were also significantly increased in Group D compared to Group S (p = 0.04, p = 0.02, p = 0.01; respectively). Postoperative TOS (p = 0.001, < 0.001 respectively) and OSI (p = 0.003, < 0.001 respectively) levels in both Group D and Group S were statistically significantly decreased compared to preoperative levels. Postoperative LOOH and –SH levels in Group S (p = 0.04, 0.029 respectively) were statistically significantly decreased compared to preoperative levels. There were no significant differences in TAC and –SH levels among groups (p = nonsignificant [n.s.]). Maternal perioperative mean blood pressure and heart rate were similar among groups (p = n.s.).

Conclusion

Oxidative stress indices might be modified with preferred anesthetic agent and sevoflurane showed more favorable effects than desflurane in view of oxidative stress.

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