Objectives:

Collapsing and re-expanding the operated lung during lung resection create the ideal condition for ischemia-reperfusion injury. Anesthetic agents used during these operations may be determinative on oxidative stress. In this study, we aimed to compare propofol with sevoflurane in terms of oxidative stress in patients undergoing lobectomy with single lung ventilation (SLV).

Materials and Methods:

Twenty-eight patients undergoing elective lobectomy for lung cancer were included in the study. Anesthesia was maintained with 5-10 mg kg-1 st-1 propofol and 0.1-0.2 μg kg^-1 min^-1 remifentanil infusion in group P (propofol), while 1-3% sevoflurane was used in group S (sevoflurane). Peripheral venous blood at baseline, pulmonary venous and peripheral venous blood before SLV lung ventilation was terminated and peripheral venous blood samples 20 minutes after SLV were obtained.

Results:

In both groups, plasma malondialdehyde levels increased compared to baseline (p<0.001). There was no significant difference between the groups in terms of baseline and pulmonary vein malondialdehyde after SLV. Peripheral venous malondialdehyde level after SLV was significantly lower in group S p=0.008, whereas peripheral venous malondialdehyde value at 20 minutes after reoxygenation was lower in group P (p=0.021).

Conclusion:

Due to the anesthetic method, patients with lung cancer may be less affected by oxidative stress. Total intravenous anesthesia using propofol and remifentanil is as safe and effective as sevoflurane in thoracic surgery.

Keywords: Ischemia Reperfusion Injury, Oxidative Stress, Malondialdehyde, Propofol, Sevoflurane