Alpha-lipoic acid alleviates oxidative stress and brain damage in patients with sevoflurane anesthesia

Sevoflurane, the most commonly used inhalational anesthetic, may negatively impact the brain by inducing oxidative stress. This study investigated the potential protective role of alpha-lipoic acid (ALA) in mitigating sevoflurane-induced oxidative stress and brain damage. A total of 155 patients undergoing sevoflurane anesthesia for liver resection surgery were randomly assigned to receive either ALA or a placebo. Perioperative internal jugular venous blood samples were collected to measure oxidative stress markers (8-OHdG, sORP, and cORP) and brain injury biomarkers (S100β and UCH-L1). Postoperative cognitive function was also evaluated. The results demonstrated that, compared to the placebo group, the ALA group exhibited a significant reduction in 8-OHdG levels by 0.007 nmol/L (95% CI, -0.011 to -0.003; P = 0.03) 24 h after surgery, accompanied by lower sORP levels and higher cORP levels. Furthermore, postoperative levels of S100β and UCH-L1 were significantly lower in the ALA group than in the placebo group (S100β, P = 0.02; UCH-L1, P = 0.03). Additionally, oxidative stress markers were significantly correlated with brain damage 24 h after surgery. Our findings suggest that ALA significantly reduces sevoflurane-induced oxidative stress and brain damage, while also improving postoperative cognitive function, indicating its potential neuroprotective effect. Clinical Trial Registration: https://www.chictr.org.cn/, identifier ChiCTR2300077321.