The Effect of Minimal Flow Anesthesia on Oxidative and Neuroendocrine Stress Response

Condition(s) studied

Investigational drug(s) / intervention(s)

The minimal flow anesthesia with sevoflurane group: In the minimal flow group, anesthesia will be maintained with minimal fresh gas flow (0.3-0.5 L/min). The effect of minimal flow anesthesia on oxidative and neuroendocrine stress response will be evaluated by the levels of: IL-6 (proinflammatory cytokine), ACTH (adrenocorticotropic hormone), Cortisol, TAS/TOS (total antioxidant/oxidant status) measured from blood samples. Blood samples will be taken from the antecubital area before the surgery begins, thus eliminating the need for repeated invasive procedures. Blood samples will be taken from the patients just before the surgery begins, at the end of the surgery, and at the 6th and 18th hours after the surgery.

The high flow anesthesia with sevoflurane group: Maintenance of anesthesia in the high flow group will be provided with a high fresh gas flow (4 L/min). The effect of high flow anesthesia on oxidative and neuroendocrine stress response will be evaluated by the levels of: IL-6 (proinflammatory cytokine), ACTH (adrenocorticotropic hormone), Cortisol, TAS/TOS (total antioxidant/oxidant status) measured from blood samples. Blood samples will be taken from the antecubital area before the surgery begins, thus eliminating the need for repeated invasive procedures. Blood samples will be taken from the patients just before the surgery begins, at the end of the surgery, and at the 6th and 18th hours after the surgery.

Study summary

Patients under general anesthesia who are unconscious and have stopped spontaneous breathing are actively ventilated with anesthesia machines, ensuring the anesthesia gas reaches the lungs and then the bloodstream. Not all the gas reaching the lungs during respiration is used; a small portion is absorbed by the body, and most of it is expelled during exhalation. After eliminating the carbon dioxide in the expired gas, it is more suitable to re-breathe the remaining gas. The portion taken by the patient needs to be provided for the next breath, and this added gas is called "fresh gas flow." Today, low flow anesthesia is defined when the fresh gas flow rate is 0.5-1 L/min, minimal flow anesthesia when it is 0.25-0.5 L/min, and metabolic flow anesthesia when it is 0.25 L/min. Our study will evaluate the effects of minimal flow anesthesia, which is widely used today due to its advantages, on oxidative stress and neuroendocrine stress response

Eligibility

Primary outcome measure(s)

• Interleukin 6 (IL-6) level — Just before surgery begins, postoperative 6th hour and postoperative 18th hour
  Proinflammatory cytokines (Biochemical marker)
• Adrenocorticotropic hormone (ACTH) level — Just before surgery begins, postoperative 6th hour and postoperative 18th hour
  Adrenocorticotropic hormone(Biochemical marker)
• Cortisol level — Just before surgery begins, postoperative 6th hour and postoperative 18th hour
  Biochemical marker
• Total oxidative status (TOS) Level — Just before surgery begins, end of surgery, postoperative 6th hour and postoperative 18th hour
  Total oxidative status; blood biochemical tests are used to calculate oxidative indicators.
• Total antioxidative status( TAS) Level — Just before surgery begins, end of surgery, postoperative 6th hour and postoperative 18th hour
  Total antioxidative status; blood biochemical tests are used to calculate oxidative indicators.

Trial sites (1)

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