Impact of Oxidative Stress on Patients Before and After Exposure to Sevoflurane and Desflurane Inhalational Anaesthesia
Abstract
Background/Aim: Oxidative stress, which is characterised by an imbalance between reactive oxygen species (ROS) production and antioxidant defences, is a critical factor influencing surgical outcomes. Inhalational anaesthetics such as sevoflurane and desflurane are widely used, yet their differential effects on oxidative stress remain a subject of investigation. This study aimed to evaluate the impact of these anaesthetic agents on oxidative stress biomarkers in surgical patients.
Methods: The study included a total of 60 patients who underwent laparoscopic cholecystectomy. The patients were categorised into two categories based on the type of anaesthetic they received: Sevoflurane (n = 30) and desflurane (n = 30). Blood samples were collected pre- and post-anaesthesia to assess oxidative stress markers, including glutathione (GSH), total antioxidant capacity (TAC), total oxidative status (TOS) and malondialdehyde (MDA). Statistical analyses were performed using an independent t-test, with a significance threshold of p < 0.05.
Results: Sevoflurane and desflurane both induced significant oxidative stress, but desflurane exhibited a more pronounced effect. Post-anaesthesia, the desflurane group showed a greater decrease in GSH (ΔGSH: -493.48 ± 153.85 vs. -245.77 ± 201.89; p < 0.0001) and TAC (ΔTAC: -0.75 ± 0.13 vs. -0.35 ± 0.27; p < 0.0001), along with a higher increase in MDA (ΔMDA: 2.06 ± 0.74 vs. 0.77 ± 0.47; p < 0.0001). Although both anaesthetics elevated TOS, the increase was more substantial with desflurane.
Conclusion: Desflurane induces significantly higher oxidative stress compared to sevoflurane, likely due to differences in their metabolic pathways and mitochondrial effects. These findings highlight the need for tailored anaesthetic strategies, particularly for patients with pre-existing oxidative stress conditions. Future research should explore potential mitigation strategies, including antioxidant supplementation and multimodal anaesthesia approaches, to optimise perioperative care.
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