Impact of Volatile Anesthetics on Oxidative Stress in Patients Undergoing Laparoscopic Cholecystectomy for Gallstones

Objective: This study aimed to investigate the total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI) and the paraoxonase and arylesterase activities of patients with gallstones and compare them with healthy individuals as well as to assess the impact of sevoflurane and desflurane on oxidative stress markers in laparoscopic surgery. Material and Methods: Forty patients scheduled for laparoscopic surgery (Patient Group) and 30 healthy volunteers as control subjects (Control Group) were enrolled in the study. The patient group was randomized to desflurane group (n= 0) and sevoflurane group (n= 20). Blood samples were collected preoperatively and at postoperative 6 hours in order to measure the levels of TAS, TOS, OSI, and paraoxonase and arylesterase activities. Preoperative and postoperative laboratory findings of sevoflurane and desflurane group were compared with the Mann Whitney U test between groups and the Wilcoxon test within a group. Results: Preoperative TOS, OSI levels in the patient group were significantly increased and arylesterase activities were significantly decreased compared to the control group (p<0.05) [(TOS (μmol H2O2 equiv/L), 19.64 ± 2.16 vs. 14.25 ± 1.83), (OSI 1.85 ± 0.53 vs. 0.98 ± 0.24), (Arylesterase (U/L), 45.19 ± 6.82 vs. 49.66 ± 4.78)]. There was no statistically significant difference between sevoflurane and desflurane group in laboratory findings of the preoperative and the postoperative period (p> 0.05). Preoperative and postoperative TAS, TOS, OSI results and activities of paraoxonase and arylesterase were not significantly different in the sevoflurane group (p> 0.05). Although the preoperative and postoperative levels of TAS and TOS and paraoxonase and arylesterase activities in the desflurane group was not significantly different, postoperative OSI was significantly increased (p< 0.05) (OSI 1.80 ± 0.57 vs 2.20 ± 0.67). Conclusion: Patients with gallstone are exposed to a potent oxidative stress influencing TOS, OSI levels and arylesterase activities. Sevoflurane and desflurane had similar effects on oxidative stress during laporoscopic surgery in this patient group; however, OSI was increased in the desflurane group in the postoperative period compared to preoperative levels (p< 0.05).