Anesthetics modulate oxidative stress during one-lung ventilation in lung cancer patients: Comparison of target-controlled propofol infusion and desflurane

Abstract

Lung injury following thoracic surgery is a relatively uncommon disease, but has a major complication with high mortality. Many factors, including; ischemia reperfusion injury and the use of one-lung ventilation (OLV) are involved in this process. This study was conducted to compare the results of target-controlled infusion (TCI) of propofol versus desflurane in the aspect of oxidative stress in lung cancer patients operated with OLV. Thirty patients with non-small cell lung cancer whom were operated with OLV were studied. In propofol group (n = 15), anesthesia was based on propofol and remifentanil, both simultaneously administered via target-control infusion and in desflurane group (n = 15), anesthesia was maintained with desflurane. Serum malondialdehyde (MDA) levels were measured during operation and postoperatively. In each group, cases showed a statistically significant increase in serum malondialdehyde levels during operation as compared to baseline levels (P < 0.05 for both). The mean baseline levels of MDA were not significantly different among groups, although mean serum MDA levels were statistically significantly decreased at 30 min OLV, at 5 min of reoxygenation and at postoperative 6 h measurements in propofol group as compared to desflurane group (P < 0.01 for all). TCI of propofol maintained hemodynamic stability similar with desflurane in lung cancer patients which underwent lobectomy with OLV. Findings of the present study suggested that the oxidative stress during OLV might be modified with anesthetic approach and that the favorable results with propofol in view of oxidative stress might lead to the preferred use of this drug as compared to desflurane for general anesthesia with OLV. Key words: Oxidative stress, lung reexpansion, lung reperfusion, propofol, desflurane.