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Comparison of the Effects of Sevoflurane and Desflurane on Endothelial Glycocalyx in Patients Undergoing Laparoscopic
Kemal Tolga Saraçoğlu1, Tahsin Şimşek2, Hande Gürbüz3
1Qatar University, Hazm Mebaireek General Hospital HMC, Department of Anaesthesiology, Intensive Care Unit and Perioperative Medicine, Doha, Qatar.
Summary
Both sevoflurane and desflurane protect the endothelial glycocalyx during surgery. Desflurane demonstrated a more significant protective effect on heparan sulfate levels compared to sevoflurane.
Area of Science:
- Anesthesiology
- Vascular Biology
- Surgical Stress Response
Background:
- Endothelial glycocalyx is crucial for vascular integrity.
- Surgical stress and anesthesia can compromise the glycocalyx.
- Inhaled anesthetics may offer endothelial protection.
Purpose of the Study:
- To compare the effects of sevoflurane and desflurane on the endothelial glycocalyx.
- To evaluate changes in syndecan-1 and heparan sulfate levels.
- To assess anesthetic impact during laparoscopic hysterectomy.
Main Methods:
- Prospective randomized, double-blind study.
- 46 patients undergoing laparoscopic hysterectomy.
- Measurement of heparan sulfate and syndecan-1 at baseline, after pneumoperitoneum, and after extubation.
Main Results:
- No significant intergroup differences in syndecan-1 or heparan sulfate levels.
- Significant intragroup changes in heparan sulfate levels were observed in the desflurane group.
- Desflurane group showed statistically significant alterations in heparan sulfate between T1-T0, T2-T0, and T2-T1.
Conclusions:
- Both sevoflurane and desflurane mitigate surgical stress-induced endothelial glycocalyx damage.
- Desflurane exhibits a more pronounced protective effect on the endothelial glycocalyx than sevoflurane.
- Heparan sulfate levels are a key indicator of anesthetic impact on endothelial integrity.
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