Korean J Anesthesiol.  2012 Jul;63(1):18-24. 10.4097/kjae.2012.63.1.18.

In vivo effects of different anesthetic agents on apoptosis

• Osman ES
• Khafagy HF
• Samhan YM
• Hassan MM
• El-Shanawany FM
• Fathallah
• El-fandy G

• KMID: 2092334
• DOI: http://doi.org/10.4097/kjae.2012.63.1.18

Abstract

BACKGROUND
This study was designed to measure in vivo effects of propofol, isoflurane and sevoflurane on apoptosis by measuring caspase-3 and tumor necrosis factor (TNF)-related apoptosis inducing ligand (TRAIL) blood level as apoptotic markers.
METHODS
After obtaining ethical committee approval and informed written consents, sixty adult patients ASA I scheduled for open cholecystectomy participated in this study. They were randomally allocated into one of three equal groups to receive propofol infusion, low-flow isoflurane or sevoflurane for maintenance of anesthesia. Venous blood samples were collected preoperatively, immediately postoperative and after 24 hours to measure hemoglobin, hematocrit, creatinine, liver enzymes, serum TRAIL and caspase-3 levels.
RESULTS
There was no significant difference in hematological markers and serum creatinine. Liver enzymes showed significant postoperative rise (P < 0.05). In Propofol group, TRAIL and caspase-3 levels were significantly elevated immediately postoperative then decreased significantly after 24-hours (P < 0.05). In Isoflurane group, immediate postoperative level of TRAIL was significantly higher than 24 hours reading and significantly lower than its level in Propofol group at the same timing meanwhile caspase-3 levels were comparable at different timings. In Sevoflurane group, TRAIL and caspase-3 levels increased significantly in both postoperative samples than preoperative level and than those of Isoflurane and Propofol groups after 24 hours concerning TRAIL (P & 0.05).
CONCLUSIONS
This study concluded that isoflurane is superior and sevoflurane is the least effective among the three anesthetics in protection against apoptosis. This study neither proved nor excluded propofol-induced apoptosis. Further studies are required during lengthy procedure and in compromised patients.

Keyword

Apoptosis; In vivo; Isoflurane; Propofol; Sevoflurane

MeSH Terms

Adult
Anesthesia
Anesthetics
Apoptosis
Caspase 3
Cholecystectomy
Creatinine
Hematocrit
Hemoglobins
Humans
Isoflurane
Liver
Methyl Ethers
Propofol
Tumor Necrosis Factor-alpha
Anesthetics
Caspase 3
Creatinine
Hemoglobins
Isoflurane
Methyl Ethers
Propofol
Tumor Necrosis Factor-alpha