Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1016/j.bjane.2015.08.013
Brazilian Journal of Anesthesiology
Scientific Article

Comparisons of the effects of the sevoflurane and propofol on acute ischemia reperfusion and DNA damages in rabbits

Comparações dos efeitos de sevoflurano e propofol sobre isquemia-reperfusão aguda e danos ao DNA em coelhos

Sema Oncul; Lale Karabiyik; Erdem Coskun; Ela Kadioglu; Ozlem Gulbahar

Downloads: 0
Views: 830

Abstract

Abstract Background and objectives: 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. Methods: 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 (1-2 mg·kg-1·min-1), after which a pneumatic tourniquet was placed on the right lower extremity. Blood samples were collected prior to tourniquet placement (baseline), 120 min after ischemia, 15 min after ischemia and 120 minutes (min) after ischemia. Malondialdehyde (MDA) levels were analyzed to determine lipid peroxidation, and single cell gel electrophoresis (SCGE) was used to determine DNA damage. Results: At 15 min after ischemia, the MDA levels in Group P (8.15 ± 2.61 µM) were higher than baseline (6.26 ± 3.19 µM, p = 0.026) and Group S (4.98 ± 0.77 µM, 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 2 hours after the termination of ischemia. Conclusion: 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.

Keywords

Genotoxicity, Oxidative stress, Propofol, Sevoflurane, Ischemia reperfusion injury

Resumo

Resumo Justificativa e objetivos: Comparar os efeitos da anestesia com sevoflurano e propofol sobre o dano oxidativo ao DNA que ocorre na isquemia de extremidade inferior e é causada pela aplicação de torniquete. Métodos: Foram alocados aleatoriamente em dois grupos iguais 14 coelhos da raça Nova Zelândia. Grupo S (n = 7) recebeu inalação de sevoflurano (2,5-4%) e Grupo P (n = 7) recebeu perfusão de propofol (1-2 mg·kg-1·min-1), logo após um torniquete pneumático foi colocado na extremidade inferior direita. Amostras de sangue foram coletadas antes da colocação do torniquete (fase basal), após 120 minutos de isquemia, 15 minutos após a isquemia e 120 minutos após a isquemia. Os níveis de malondialdeído (MDA) foram analisados para determinar a peroxidação de lipídios e eletroforese em gel de célula única (EGCU) foi usada para determinar o dano ao DNA. Resultados: Aos 15 minutos após a isquemia, os níveis de MDA no Grupo P (8,15 ± 2,61 µM) foram superiores aos da fase basal (6,26 ± 3,19 µM, p = 0,026) e dp Grupo S (4,98 ± 0,77 µM, p = 0,01). O dano causado ao DNA foi semelhante nos dois grupos, embora tenha sido maior do que na fase basal (momento da cauda 0,63 ± 0,27, intensidade da cauda 3,76 ± 1,26) no Grupo P no 15 minutos de reperfusão (momento da cauda 1,05 ± 0,45, p = 0,06; intensidade da cauda 5,33 ± 1,56, p = 0,01). O aumento no momento da cauda e a intensidade da cauda voltaram aos níveis normais nos dois grupos duas horas após o término da isquemia. Conclusão: Como o estresse oxidativo e o efeito genotóxico desaparecem nos estágios finais da reperfusão, concluímos que não há superioridade tanto de sevoflurano quanto de propofol em práticas de anestesia para procedimentos cirúrgicos de extremidades que envolvem o uso de torniquete.

Palavras-chave

Genotoxicidade, Estresse oxidativo, Propofol, Sevoflurano, Lesão de isquemia reperfusão

References

Gogus N, Akan B, Bayrakci S. The effects of a small-dose ketamine-propofol combination on tourniquet-induced ischemia-reperfusion injury during arthroscopic knee surgery. J Clin Anesth. 2014;26:46-51.

Cheng YJ, Chien CT, Chen CF. Oxidative stress in bilateral total knee replacement, under ischaemic tourniquet. J Bone Joint Surg Br. 2003;85:679-82.

Willy C, Dahouk S, Starck C. DNA damage in human leukocytes after ischemia/reperfusion injury. Free Radic Biol Med. 2000;28:1-12.

Cordis GA, Maulik G, Bagchi D. Detection of oxidative DNA damage to ischemic reperfused rat hearts by 8-hydroxydeoxyguanosine formation. J Mol Cell Cardiol. 1998;30:1939-44.

Alleva R, Tomasetti M, Solenghi MD. Lymphocyte DNA damage precedes DNA repair or cell death after orthopaedic surgery under general anaesthesia. Mutagenesis. 2003;18:423-8.

Karabiyik L, Sardaş S, Polat U. Comparison of genotoxicity of sevoflurane and isoflurane in human lymphocytes studied in vivo using the comet assay. Mutat Res. 2001;492:99-107.

Braz MG, Magalhães MR, Salvadori DM. Evaluation of DNA damage and lipoperoxidation of propofol in patients undergoing elective surgery. Eur J Anaesthesiol. 2009;26:654-60.

Krause TK, Jansen L, Scholz J. Propofol anesthesia in children does not induce sister chromatid exchanges in lymphocytes. Mutat Res. 2003;542:59-64.

Karahalil B, Yağar S, Bahadir G. Diazepam and propofol used as anesthetics during open-heart surgery do not cause chromosomal aberrations in peripheral blood lymphocytes. Mutat Res. 2005;581:181-6.

Collins AR. The comet assay for DNA damage and repair: principles, applications, and limitations. Mol Biotechnol. 2004;26:249-61.

Tice RR, Agurell E, Anderson D. Single cell gel/comet assay: guidelines for in vitro and in vivo genetic toxicology testing. Environ Mol Mutagen. 2000;35:206-21.

Hardy SC, Homer-Vanniasinkam S, Gough MJ. The triphasic pattern of skeletal muscle blood flow in reperfusion injury: an experimental model with implications for surgery on the acutely ischaemic lower limb. Eur J Vasc Surg. 1990;4:587-90.

Guide for the care and use of laboratory animals. 1996.

Templar J, Kon SP, Milligan TP. Increased plasma malondialdehyde levels in glomerular disease as determined by a fully validated HPLC method. Nephrol Dial Transplant. 1999;14:946-51.

Singh NP, McCoy MT, Tice RR. A simple technique for quantitation of low levels of DNA damage in individual cells. Exp Cell Res. 1988;175:184-91.

Tice RR, Andrews PW, Hirai O. The single cell gel (SCG) assay: an electrophoretic technique for the detection of DNA damage in individual cells. Adv Exp Med Biol. 1991;283:157-64.

Kam PC, Kavanagh R, Yoong FF. The arterial tourniquet: pathophysiological consequences and anaesthetic implications. Anaesthesia. 2001;56:534-45.

McCord JM. Free radicals and myocardial ischemia: overview and outlook. Free Radic Biol Med. 1988;4:9-14.

Budic I, Pavlovic D, Kocic G. Biomarkers of oxidative stress and endothelial dysfunction after tourniquet release in children. Physiol Res. 2011;60(Suppl. 1):S137-45.

Budic I, Pavlovic D, Kitic D. Tourniquet-induced ischemia-reperfusion injuries during extremity surgery at children's age: impact of anesthetic chemical structure. Redox Rep. 2013;18:20-6.

Arnaoutoglou H, Vretzakis G, Souliotis D. The effects of propofol or sevoflurane on free radical production after tourniquet induced ischemia-reperfusion injury during knee arthroplasty. Acta Anaesthesiol Belg. 2007;58:3-6.

Aarts L, van der Hee R, Dekker I. The widely used anesthetic agent propofol can replace alpha-tocopherol as an antioxidant. FEBS Lett. 1995;357:83-5.

Green TR, Bennett SR, Nelson VM. Specificity and properties of propofol as an antioxidant free radical scavenger. Toxicol Appl Pharmacol. 1994;129:163-9.

Karahalil B, Polat S, Senkoylu A. Evaluation of DNA damage after tourniquet-induced ischaemia/reperfusion injury during lower extremity surgery. Injury. 2010;41:758-62.

Sardaş S, Karabiyik L, Aygün N. DNA damage evaluated by the alkaline comet assay in lymphocytes of humans anaesthetized with isoflurane. Mutat Res. 1998;418:1-6.

Braz MG, Braz LG, Barbosa BS. DNA damage in patients who underwent minimally invasive surgery under inhalation or intravenous anesthesia. Mutat Res. 2011;726:251-4.

5dcd9eee0e8825816ebf58f1 rba Articles
Links & Downloads

Braz J Anesthesiol

Share this page
Page Sections